Rama Soundararajan

Background: Knowledge of pathology is integral to numerous health care and research disciplines, besides routine laboratory-medicine operations. Despite its importance, there remains a significant gap in structured educational programs designed to provide a fundamental understanding of the pathologic basis of disease for an interdisciplinary body of research and health care professionals. This lack of generalized pathology training may contribute to a broader knowledge deficit in its translational applications. Objective: To address this unmet educational need, we developed a distinctive pathology training course tailored to cater to a broad array of scientists in basic and translational science. Methods: Overall, 29 participants from the University of Texas MD Anderson Cancer Center and the Texas Medical Center completed the “Fundamental Pathology for Basic Scientists: A Self-Paced Online Certificate Course” pilot. The course, comprising 24 instructional modules, was delivered over the span of 6 months in an online, asynchronous, and readily-accessible CANVAS learning management format. The educational objectives for each module were organized around organ- and organ-system-specific content, aiming to (1) incorporate the pathological basis of diseases, (2) distinguish clinicopathologic correlations, and (3) recognize the impact of molecular- and translational pathology and associated state-of-the-art diagnostic technology. Participants were voluntarily surveyed both before and after the course to assess its effectiveness. Results: The preentry survey revealed that participants represented 16 academic departments (with widely varied training backgrounds, career stages, and job descriptions within the biomedical research enterprise), with 76% (22/29) reporting no prior basic pathology training. The exit survey highlighted positive feedback on the course structure, instructors, delivery method, and lecture content. Overall, 100% (29/29) of learners completed the objective knowledge checks for each of the 24 modules. At least 89% (26/29) of learners concurred that each of the 24 modules had delivered its learning objectives. A total of 94% (27/29) of learners concurred that the course enriched their understanding of basic pathology. Additionally, 79% (23/29) of participants reported applying or being able to apply what they had learned to their current roles, and 94% (15/16) of postcourse survey respondents confirmed longer-term benefits 1 year after program completion (increased confidence in addressing projects involving pathology). Conclusions: The initial outcomes of this pilot course suggest that the asynchronous delivery method was well-suited to participants’ workloads, and that the content was valuable for basic- and translational-scientists from varied training backgrounds seeking to deepen their understanding of fundamental pathology in the context of biomedical research. This work establishes a model for scalable, technology-enabled pathology training adaptable to diverse learners within health care research centers.

BACKGROUND Pathology is a cornerstone discipline in both clinical medicine and biomedical research, serving as a bridge between basic science discoveries and their translational applications. However, many biomedical scientists and healthcare professionals lack structured training in the fundamental principles of pathology. This gap can hinder their ability to interpret disease mechanisms, integrate pathology-based findings into their work, and collaborate effectively across disciplines. Addressing this unmet need through accessible, structured educational initiatives is essential to support professional development and foster interdisciplinary research. OBJECTIVE Knowledge of pathology is integral to numerous healthcare- and research-disciplines, besides routine laboratory-medicine operations. Despite its importance, there remains a significant gap in structured educational programs designed to provide a fundamental understanding of the pathologic basis of disease, for an interdisciplinary body of research healthcare professionals. This lack of generalized pathology training may contribute to a broader knowledge deficit in its translational applications. To address this unmet educational need, we developed a distinctive pathology training course tailored to cater a broad array of scientists in basic- and translational science. METHODS Twenty-nine participants from UT MD Anderson Cancer Center and the Texas Medical Center completed the "Fundamental Pathology for Basic Scientists: A Self-Paced Online Certificate Course" pilot. The course, comprising 24 instructional modules, was delivered over the span of 6 months in an online, asynchronous and readily-accessible CANVAS learning management format. The educational objectives for each module were organized around organ- and organ-system-specific content, aiming to 1) incorporate the pathological basis of diseases, 2) distinguish clinicopathologic correlations, and 3) recognize the impact of molecular- and translational pathology and associated state-of-the-art diagnostic technology. Participants were voluntarily surveyed both before- and after the course to assess its effectiveness. RESULTS The pre-entry survey revealed that participants represented 16 academic departments (with widely varied training backgrounds, career-stages and job descriptions within the biomedical research enterprise), with 76% reporting no prior basic pathology training. The exit survey highlighted positive feedback on the course structure, instructors, delivery method, lecture content. At least 89% of learners concurred that each of the 24 modules had delivered its learning objectives. 94% of learners concurred that the course enriched their understanding of basic pathology. Additionally, 79% of participants reported applying/being able to apply what they had learned to their current roles, and 94% of post-course survey respondents confirmed longer-term benefits 1 year after program completion (increased confidence in addressing projects involving pathology). CONCLUSIONS The initial outcomes of this pilot course suggest that the asynchronous delivery method was well-suited to participants' workloads, and that the content was valuable for basic- and translational-scientists from varied training backgrounds seeking to deepen their understanding of fundamental pathology in the context of biomedical research. This work establishes a model for scalable, technology-enabled pathology training adaptable to diverse learners within healthcare research centers.

The COVID-19 pandemic has profoundly transformed the healthcare research landscape, staging unprecedented challenges for administrative research-support personnel. While career programs and retention benefits have emerged to support frontline healthcare workers facing health concerns, burnout and employee-turnover, many “classified”/administrative support staff in research departments who experience similar challenges remain without adequate structured support. This lack of structure has impacted job satisfaction, career-progression and talent retention within this crucial sector. Recognizing the critical importance of addressing this training gap for the benefit of the broader research enterprise, the Interdisciplinary Translational Education and Research Training (ITERT) Core at UT MD Anderson Cancer Center established a dedicated program called Professional Alliance for Learning and Support (PALS) in 2023-24. The objectives of this program were to (1) create a career development guide tailored for non-academic research-support staff, bringing awareness to relevant institutional and global resources for professional growth; (2) provide a means for increased staff engagement within the research environment and enable career planning for retention of talent; (3) promote teamwork across the research enterprise and facilitate opportunities for safe-space feedback on work experiences; and (4) enable structured mentoring constellations to enhance professional growth. We conducted a pilot with eight members of the research-support team who voluntarily signed up for this program. These members support research faculty and laboratory staff within the department of Translational Molecular Pathology in diverse administrative capacities. Through interactive workshops, instructional lectures, online courses, and relevant networking opportunities, PALS delivered personalized training, leadership development, functional mentoring and career-navigation tools. Over six months, we explored the critical role of PALS in improving performance, engagement, and facilitating communication between staff and leadership, ensuring that staff concerns were heard and considered in departmental decision-making processes, and in aiding staff to visualize and plan for career advancement. Our findings demonstrate that the PALS program enhanced staff awareness of next steps in relevant career-progression pathways, enabled mentoring relationships and greatly improved the morale (career-confidence) of the participants. We also observed marked longer-term benefits: the program provided direct support and visibility to administrative staff within research environments, consequently enhancing job satisfaction, retention of talent and career advancement, with 100% of participants drafting individual development plans and actively taking on either leadership roles within the department or career promotion within a year. Our study suggests that research departments implementing educational programs like PALS can navigate change more effectively while fostering an inclusive and career-enhancing workplace environment.

Background: Aggressive forms of breast cancer, such as triple-negative breast cancer (TNBC), are associated with an increase in cancer cells that exhibit stem cell properties. The activation of the epithelial–mesenchymal transition (EMT) program, mediated by the transcription factor FOXC2, generates these stem-like cells. FOXC2 is linked to poor prognoses across various cancer types and is notably upregulated in TNBC, where it establishes and sustains these stem-like cells within the tumor population. Methods: Here, we decode the pathways regulating FOXC2 activation using EMT-enriched cell line models. Stemness was assessed using mammosphere assays and mesenchymal markers by western blot. Expression correlations with clinical data was examined using the EMTome. Results: We demonstrate that β-catenin serves as a critical mediator of mesenchymal and stemness characteristics through FOXC2 upregulation. By disrupting β-catenin, we find that FOXC2 expression, mesenchymal properties, and stemness are reduced; however, the introduction of exogenous FOXC2 expression in β-catenin deficient cells is enough to restore the mesenchymal and stemness phenotype. These findings support the idea that FOXC2 acts as the downstream regulator of β-catenin and influences both mesenchymal and stemness properties. Moreover, there is a positive correlation between the expression of β-catenin and FOXC2 in various cancer subtypes observed in clinical patient samples. Conclusions: Our study clarifies the role of the β-catenin/FOXC2 signaling axis in maintaining stemness properties, suggesting potential targets for TNBC and other cancers driven by EMT-related mesenchymal and stemness characteristics.

Supplementary Figure S1. PSA and CTC status at module allocation, after 8 weeks of AAPA treatment.

Supplementary Figure S4. Immune cell densities by IHC across organ sites.

Supplementary Figure S5. Tumor purity.

Supplementary Figure S9. Whole exome sequencing (WES)-based identification of pathogenic somatic mutations.

Supplementary Figure S3. Immune cell populations in baseline metastatic biopsies within Satisfactory and Unsatisfactory groups.

Supplementary Figure S5. Tumor purity.