Advancing the Science

Mayo Clinic Medical Science Blog – an eclectic collection of research- and research education-related stories: feature stories, mini news bites, learning opportunities, profiles and more from Mayo Clinic.

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5 days ago · Coping with the "work of being a patient"

There’s no getting around it: being a patient is hard work. And it gets even harder for patients living with multiple chronic conditions.

This “work” is made of up all the responsibilities and tasks doctors ask patients to take on in order to access and use health care and in order to successfully carry out self-care. “The burden of this labor can be overwhelming for some patients, which can directly affect their health, outcomes, and overall quality of life,” says Kasey Boehmer, Ph.D., a health services researcher at Mayo Clinic.

Mayo Clinic Public Affairs recently sat down with Dr. Boehmer to talk to her about the work of being a patient and some of her most recent research on a new concept called “capacity coaching,” including a paper recently published in Mayo Clinic Proceedings.

What is the work of being a patient?

The work of being a patient is made up of a lot of little things. There are the tasks themselves, such as taking medications, making appointments, and implementing dietary change. But beyond that, there’s also the mental, physical and emotional labor required to make sense of the tasks that have been assigned.  Some of these can include:

  • Figuring out how “being a patient” fits into an individual’s self-identity. The patient may need to adjust their concept of themselves to include their disease, which can be a mental and emotional challenge. For example, “I am an immigrant to the United States living with diabetes” or “I am a new mom living with depression.”
  • Planning how to accomplish the tasks. This can require complex organization and logistics, and the tasks may need to be performed daily or even multiple times per day.
  • Finding the resources, such as money or transportation, necessary to complete the tasks.
  • Enlisting social support and help from friends and family.
  • Taking time to reflect on success (or lack of success) in carrying out the tasks. Every day the patient has to decide whether they feel capable to continue with the tasks the next day.

That’s a lot of work! And it can be very complex, especially for patients with multiple chronic conditions.

What is capacity coaching and how does it help with the work of being a patient?

Shared decision making involves educating patients so they can work with clinicians to make decisions about their care. Mayo Clinic researchers advocate for tools that promote a conversation during the visit (called conversation aids), and not simply provide information to the patients beforehand for them to make a decision themselves (referred to as patient decision aids).

Capacity coaching is a discipline designed to help patients adapt and thrive when living with chronic illness. The idea is to help the patient function optimally: managing their health while also living a meaningful life. 

Sometimes, patients can get overwhelmed with all the work they’re asked to do, which means their “capacity” to adapt and thrive is low. The coach will work with a patient to help reduce their burden, enhance their capacity, or both. This might involve adjusting a patient’s treatment schedule and medications so that the patient is better able to manage them. It might also involve helping a patient figure out how to enlist the help they need to carry out the work. What is needed will vary from patient to patient.

How is capacity coaching different from health and wellness coaching?

Health and wellness coaching tends to focus on achieving specific health or lifestyle goals, such as losing weight. And it tends to happen outside of overall patient care. Capacity coaching, on the other hand, is focused on helping patients learn how to adapt and thrive in general,  in the face of important changes to their health. And it is designed to be integrated with overall patient care. Ideally, it should be delivered by a member of the patient’s health care team, such as a doctor or nurse.

What inspired you to study capacity coaching?

I work with a research team in the Knowledge and Evaluation Research Unit at Mayo Clinic, where we’ve been developing a model of health care that helps patients find balance between workload and capacity. We have been collaborating with health and wellness coaches at the Mayo Clinic Dan Abraham Healthy Living Center to find new approaches to coaching that better meet the needs of patients with multiple chronic conditions. That’s where capacity coaching came from. We think capacity isn’t fixed, but is something that can be collaboratively managed by the patient and their care team. We think better capacity is something that can be taught.

What’s next in your research on capacity coaching?

We’ve recently been working on a capacity coaching pilot with two Veterans Administration medical centers and we expect to publish our result soon. After that, we plan to pursue some larger trials and to partner with other medical centers to learn how to best apply this practice in patient care.  We need to study the ways capacity coaching affects patient health outcomes and quality of life, as well as how it impacts the functioning of primary care teams.

What impact do you hope your research will have for patients and their health care teams?

I think it’s important to recognize that we ask a lot of our patients. We need to raise awareness of that and ask ourselves how we can provide better support. One day, I hope that capacity coaching will be part of the care every patient receives.

Learn more about capacity coaching

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Dec 27, 2018 · Be the life [science] of the party

Looking for a scientific conversation starter for New Year’s Eve? Advancing the Science has you covered with this top-10 recap of our hottest medical research stories from 2018.

With this list in your back pocket, you’ll never run out of interesting cocktail banter. And we guarantee you’ll wow your friends with your scientific smarts.

Human alimentary track#1  ‘Gut touch?’ Mayo Clinic researchers discover important trigger for serotonin release

Researchers at Mayo Clinic have discovered an important mechanical trigger in the gut for releasing serotonin in the body. Serotonin is an important hormone and neurotransmitter in the human body, believed to help regulate digestion, appetite, mood, social behavior, sleep and other important functions.

The researchers were amazed to find that certain cells in the gut has a specific trigger that is not present in the cells around them. They were also surprised to find how effective it was to block or eliminate this trigger to improve serotonin release.  Read more.

Mark Truty, M.D.

#2  A revolution in pancreatic cancer treatment

Mark Truty, M.D., had dedicated his career to giving patients with pancreatic cancer more quality time with their loved ones. His own father died from pancreatic cancer 20 years ago at age 58.

Not content with the status quo, Dr. Truty and his colleagues are looking for ways to improve outcomes. They’ve pioneered a multidisciplinary approach—which other medical centers are copying— that includes boosting patients’ health to endure treatment, providing neoadjuvant chemotherapy and radiation, and performing aggressive operations. Read more.

Normal liver and fatty liver

#3  The rising tide of nonalcoholic fatty liver disease

Liver disease isn’t just for alcoholics. Nonalcholic fatty liver diseases (NAFLD) can affect people who drink little or no alcohol. These diseases are a significant and growing public health issue. NAFLD contribute to development of other diseases, like diabetes and double risk of death.

Mayo Clinic researchers using data from the Rochester Epidemiology Project recently found that five times as many people have this type of liver disease now, compared to 20 years ago. They suspect this is related to the rise in rates of obesity.  Read more.

doctors examine results of clinical test for MS#4  MS or not MS? Mayo Clinic Nureoimmunology Lab answers the question

In 2017, Mayo Clinic launched a first-in-the-U.S. clinical test to help patients with some autoimmune disorders get the right diagnosis faster. The test defines a new form of inflammatory demyelinating disease, myelin oligodendrocyte glycoprotein (MOG) autoimmunity, which is distinct from multiple sclerosis (MS), with which it is commonly confused.

Having diagnostic-specific antibody tools allows Mayo Clinic researchers to develop tests to help physicians rule out MS and for patients to get correct diagnoses and treatments in the early stages of disease. Read more.

Rock formation#5  Can geology upend decades of medical wisdom about kidney stones?

There may soon be a new, non-surgical way to remove kidney stones, thanks to an unlikely collaboration between a geologist and a Mayo Clinic nephrologist.

By carefully examining kidney stones, they were able to show that kidney stones do not continuously grow (as previously thought). Instead, the minerals seem to dissolve and reform, similar to the stratification of stones and fossils in rock.

The race is on to identify the stone-dissolving process in the kidney so that scientists can develop a treatment. Read more.

 

Fetal endoscopic tracheal occlusion surgery#6 ‘Extraordinary Ability’ – Fetal surgery program elevates maternal-fetal medicine

Imagine being deemed so critical to a health care organization that the state legislature acts immediately to allow you to practice there. That’s how Rodrigo Ruano, M.D., Ph.D., came to Mayo Clinic in Rochester, Minnesota.

Dr. Ruano was recruited to Mayo Clinic to establish a center of excellence for fetal surgery. He specializes in procedures, such as fetal endoscopic tracheal occlusion, to correct severe congenital defects before birth.  At Mayo, Dr. Ruano is now leading the way in research as well as treatment in maternal and fetal medicine.  Read more.

Foods containing gluten#7  The quest to understand the gluten free diet and celiac disease

In recent years, reports in the media have linked gluten to all sorts of health issues ranging from feeling sluggish to the extremes of being linked to autism (debunked here). Some notable individuals have been eating a gluten-free diet without a clinical necessity – but is that the best course of action?

Mayo Clinic researchers recently published a study on the prevalence of gluten-free diets in children age 4-18 who do not have celiac disease. Imad Absah, M.D., a pediatric gastroenterologist, says the increase of gluten-free diet without clinical necessity is concerning as some of these uses may be masking symptoms of unrelated conditions.” Read more.

Diagnosing spinal cord stroke#8  First diagnostic criteria determined for spinal cord strokes

A spinal cord stroke occurs when the blood supply to the spinal cord stops and the cord can’t get oxygen and nutrients.  Mayo Clinic researchers recently published a seminal paper that will help doctors better diagnose spinal cord strokes which can be misdiagnosed as other types of spinal cord disease. Read more.

Sun shining in clear blue sky#9  Shedding light on the ‘sunshine vitamin’

Vitamin D, sometimes referred to as the ‘sunshine vitamin,’ may have a broader role in human health than we once thought.

Mayo Clinic researchers recently found a relationship between vitamin D deficiency and increased risk of death in Caucasian patients.  They did not observe this connection in non-Caucasian patients. Further research with diverse populations will be needed to determine if what constitutes “normal” or “deficient” vitamin D should vary based on race or ethnicity.  Read more.

Two people holding hands#10  Let’s talk about it: Death

Death. Dying. End of life care. Comfort care. These are emotionally loaded words. And that can make these topics hard to talk about between patient and caregiver. There is often a sense of guilt; a feeling that we are giving up on you or that you are giving up on us.

But that’s far from the truth. We say these words and talk about these feelings because we care. Here are six important questions about end of life that may be helpful to discuss.  Read more.


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Oct 10, 2018 · Mayo lab scientists collaborate to paint a better picture of patient health

On September 24, 2018, the National Institutes of Health  (NIH) awarded Mayo Clinic funding to serve as the new Metabolomics Research Core for the Undiagnosed Diseases Network. In this article, we explore the role of metabolomics in medicine at Mayo Clinic, both in research and in patient care. And we celebrate the role that Mayo Clinic plays as a leader in the science of metabolomics on a national and an international scale.

Metabolomics in medicine

Metabolomics—the study of tiny molecules in the human body left behind by diseases and other processes—was an emerging scientific field in the 1990s when Mayo Clinic began investing in this technology and opened its first dedicated metabolomics lab.  Today, Mayo Clinic is home to a Metabolomics Core Laboratory that serves the needs of researchers and clinicians at Mayo and around the world.

Metabolomics is primarily used in medical research at Mayo Clinic to help scientists better understand and detect the causes of disease, identify new disorders, and find treatments.  However, through collaboration with other labs and clinical areas at Mayo, the metabolomics lab is also finding ways to contribute directly to patient care.

The Mayo Clinic Clinical Biochemical Genetics Laboratory and the Department of Clinical Genomics consult with scientists in the metabolomics lab to help find solutions for patients with rare diseases. By working together these disciplines can paint a more complete picture of a patient’s health, which can lead to more precise diagnoses and better treatments. “It’s a beautiful partnership between research and the clinic,” says Ian Lanza, Ph.D., director of the Metabolomics Core Laboratory. “We will do more good for patients and learn more through collaboration than we could ever do alone.”

Resources for medical detectives everywhere

Ian Lanza, Ph.D., director of the Mayo Clinic Metabolomics Core Laboratory

Demand for metabolomics analysis is growing along with the flourishing field of individualized medicine.  However, metabolomics is still a niche specialty and many scientists and clinicians outside Mayo Clinic look to Mayo for support and leadership. “Not everyone has the specialized equipment or the expertise to do what we do,” says Dr. Lanza.

One way Mayo meets those needs is through commercial clinical laboratory services, such as those offered through Mayo Medical Laboratories. Mayo Clinic is able to offer specialized services that draw on the combined knowledge of the metabolomics lab, the biochemical genetics lab, and the Department of Clinical Genetics to help clinicians and researchers around the world find solutions for patients with rare diseases.

On a larger scale, Mayo Clinic contributes to the field of metabolomics by serving as a research core for large metabolomics-related studies funded by the National Institutes of Health (NIH). “Mayo has shown real leadership in this field for decades and I think the NIH recognizes that,” says Devin Oglesbee, Ph.D., co-director of the Mayo Clinic Biochemical Genetics Laboratory. In 2013, the NIH awarded Mayo funding to serve as one of six Regional Comprehensive Metabolomics Resource Cores. In this role, Mayo provides instrumentation, support and training for investigators throughout the United States.

A new research core for the Undiagnosed Diseases Network

Devin Oglesbee, Ph.D., co-director of the Mayo Clinic Biochemical Genetics Laboratory

Last month, the NIH further recognized Mayo Clinic’s expertise and leadership in metabolomics by awarding Mayo funding to serve as the new Metabolomics Research Core for the Undiagnosed Diseases Network.  The Undiagnosed Diseases Network is an NIH-funded study that brings together clinicians and scientists from many institutions and many countries to find solutions to medical mysteries. In this new role, Mayo’s metabolomics lab, clinical biochemical genetics lab, and the Department of Clinical Genomics will all work together to provide tools and support for the Undiagnosed Disease Network’s 12 Clinical Sites.

“We’re very pleased to begin this exciting new phase with the Network,” says Dr. Oglesbee. “As an institution, we’ve made progress in rare disease discovery for a long time, and in this new role, we look forward to contributing even more to this important work.”

Dr. Lanza agrees, adding that Mayo’s contributions to the work of the Network, and to the field of metabolomics, go well beyond analytical chemistry. “We will be able to provide meaningful clinical insights from the metabolite signatures measured in patients. That’s a significant step forward because metabolomics has been slow to reach the clinic. It’s the ability to make those insights that truly advances the science and enables us to help patients with unmet needs.”

Sep 5, 2018 · Setting tomorrow's clinical researchers up for success

Amber Miller, Ph.D.

Michael Gionfriddo, Pharm.D., Ph.D.

Graduates of Mayo Clinic Graduate School of Biomedical Sciences’ Ph.D. program in Clinical and Translational Science learn the skills to engage in research across the translational research spectrum, from laboratory-based, to patient-based, to population-based.  The goal is to give the next generation of clinical researchers the skills they need to improve patient care, accelerate discovery and innovation, and advance the practice of medicine.

Mayo Clinic Public Affairs recently sat down with two alumni of the Clinical and Translational Science program—Amber Miller, Ph.D., and Michael Gionfriddo, Pharm.D., Ph.D.  Both program graduates have gone on to successful careers in translational research. We asked them to share their reasons for pursuing the clinical and translational science Ph.D. track, any unexpected things they learned during their studies, and how the program set them up for success.

Why did you decide to pursue a Ph.D. in clinical and translational science? Why did you choose Mayo’s graduate program?

Dr. Miller: I decided to go into Mayo’s clinical and translational science Ph.D. program because, although I wanted the discipline and experience of becoming an expert in a very specific field of biomedical research, I still wanted to gain relevant exposure to all the different aspects of clinical development. I wanted to understand the broader process behind clinical translation: how you bring a discovery from the lab all the way to the patient.  I chose Mayo’s graduate school after completing a summer research internship there. I saw the quality of the faculty, facilities and resources there and I knew that what I learned could be translated to the real world.

Dr. Gionfriddo: I’m a pharmacist by training and I had done basic science research. When I decided to go to graduate school, I was looking at pharmacology programs, but a mentor suggested I look at clinical and translational science instead. She told me, “I think you could really use your clinical pharmacy background to translate basic science discoveries to clinical applications.” I took her advice, and I ended up choosing Mayo because of their commitment to research and their mission: “the needs of the patient come first.”

The clinical and translational science program really taught me how to do research from soup to nuts.

~Dr. Michael Gionfriddo

Tell us about the work you do now.

Dr. Miller: I’m a Senior Clinical Research Scientist at Abbott, the medical device company, in Minneapolis, Minnesota. I work on the protocol development, implementation, and analysis of our clinical trials. Clinical trials are essential to ensuring that medical products we bring to market are safe and effective for patients. My career path at Abbott started when the director saw my degree on my resume and wanted to know more about it. She thought the “clinical and translational science” title sounded interesting and uniquely applicable to the work we do at Abbott to develop products based on cutting edge medical science to help people live healthier lives.

Dr. Gionfriddo: I’m an assistant professor and clinical researcher at Geisinger, a health system in northeast Pennsylvania. I work on projects aimed at improving the way medication is used by patients and clinicians in our health system. My time at Mayo gave me the skills to answer a diverse set of problems in a variety of ways, such as finding better ways to facilitate conversations between adolescent patients and their physicians about changing needs for asthma medications.

Did you learn anything unique or unexpected that has improved your ability to conduct research?

Dr. Miller:  I benefited from exposure to statistical analysis. I’m kind of mathematically inclined in general and what I learned provided a basis for my thesis research and my post-doctoral fellowship. The knowledge of stats I gained in the clinical and translational science program has really given me a leg up in my current position. I work every day with statisticians who have input on our clinical studies. My background makes it easier for us to understand each other and collaborate.

Dr. Gionfriddo: The clinical and translational science program really taught me how to do research from soup to nuts. But beyond that, it taught me how to be part of a scientific team: how to be flexible and collaborative and work across disciplines. With the breadth of experiences I was given I feel that I can work with any team.

There’s a lot more to translating science than meets the eye.

~Dr. Amber Miller

How do you think the clinical and translational science program set you up for success?

Dr. Miller: A lot of what I learned, both didactically in course work and the collaboratively with Mayo clinicians, has helped prepare me for the work I’m doing now. I work with multiple stakeholders and team members to achieve clinical objectives.  I often think of my role at Abbott as an extended version of the protocol development class I took. On a daily basis, I’m using my skills to figure out how we can put together a clinical study to find answers to meet important business and patient needs.

Dr. Gionfriddo: The faculty and their mentorship are really the strength of the program. Everyone is so welcoming and open, including faculty and clinicians. I’ve stayed in touch with my mentors from the program and we’ve written papers together. I think it’s those relationships, and the experiences I gained because of them, that have given me the knowledge and skills that have helped make me successful.

Bottom row: 2017 Mayo Clinic Graduate School of Biomedical Sciences Clinical and Translational Science Ph.D. program graduates. Top row: faculty including Anthony Windebank, M.D.; Stephen Ekker, Ph.D.; Lewis Roberts, M.B., Ch.B., Ph.D.; Christopher Pierret, Ph.D.

Why do you think clinical and translational science is an important focus for a researcher?

Dr. Miller: There’s a lot more to translating science than meets the eye. It’s one thing to make an awesome discovery in the laboratory that has the potential to effectively treat a disease, like cancer.  It’s another thing to actually be able to put that discovery into practice. There is so much more that goes on behind the scenes—so many teams, individuals, and other moving parts. It’s more than just science behind the process that gets a discovery to the patients who need it, and it is important for researchers with a clinically-minded focus to understand the larger picture.

Dr. Gionfriddo: I think clinical and translational science is a natural marriage with the idea of the “learning health care system.” It’s the right area for researchers and clinicians who want to focus on continuous improvement and want to know how to do that with more rigor. You get perspective on the whole research spectrum, from bench to bedside. And you learn how to think critically about how to answer important questions. It allows us to reduce waste in research and to improve care in a more efficient manner.

Aug 29, 2018 · Health research rooted in community

Community members gather at the Garden Cafe on August 9, 2018, to discuss mental illness

On August 9, 2018, a community garden in Rochester, Minnesota hosted an unusual gathering: a cook-out and a community conversation on mental illness.

At this meeting, more than a dozen members of the community assembled—grill tongs in hand—along with public health professionals and health researchers from Mayo Clinic, to talk about their experiences living with and managing mental illness. View reporting on this event from KIMT TV.

This gathering was part of an ongoing series, hosted by the Mayo Clinic Community Engagement in Research Program, called “Garden Cafés,” designed to help promote a dialogue between community members, scientists, health care providers, and other service providers. The goal is to help improve health outcomes and to better address the unmet needs of patients, especially for patients with health disparities.

Sowing seeds of collaboration from the beginning

The Mayo Clinic Community Engagement in Research Program developed the Garden Café concept in collaboration with community partners. Consistent with the inclusive philosophy of community engaged research, these community members helped to shape every aspect of the Garden Café program:

Mayo Clinic Community Engaged Research Advisory Board, September 2017

  • Meetings occur in outdoor spaces suitable for a small gathering or picnic, near the city center, wheel-chair accessible and close to mass transportation.
  • Health topics are drawn from the 2016 Olmsted County Community Health Needs Assessment and focus on mental health, chronic diseases, infectious disease, and preventable diseases such as obesity.
  • Conversations are free-flowing and bi-directional, with community members and researchers coming together on equal footing to learn from each other.

“In addition to making connections with their neighbors, community members come away with improved understanding of health issues and the potential role that they can play as research partners and participants to find solutions,” says Rene Halasy, a community leader and executive director of the RNeighbors neighborhood resource center in Rochester, Minnesota.

“Investigators benefit from this collaboration as well,” says Joy Balls-Berry, Ph.D., Mayo Clinic Office of Community Engagement in Research. “They build relationships and understanding that enable them to maximize the quality and relevance of their research and to disseminate their findings to the community equitably.”

Cultivating research that represents people with health disparities

Dr. Balls-Berry speaks at the 2017 Minority Women Research Network meeting

A key success factor for the Garden Café program is the ability to attract a diverse community of stakeholders, including women, racial and ethnic minorities, and other subgroups living with health disparities.

A 2014 study of Science Cafés hosted at libraries and other public locations found that, while representation at these events was skewed toward women it was also skewed toward people of higher socio-economic status. That investigation did not collect race or ethnicity data.

Mayo’s Garden Café program, by contrast, is able to attract a more diverse group of participants. A recent pilot study of the Garden Café program showed that the events attracted:

  • Approximately 50 percent men and 50 percent women, as well as a nearly even mix of people identifying as male and female.
  • Nearly three-quarters of participants who were of low or middle income.
  • A broad range of participants from different racial groups. Approximately half of all participants were black; about one-third were white; and the remaining participants were a diverse mix of other Asian, Native Hawaiian/Pacific Islander, and American Indian/Alaska Native.

The study team attributes these differences in participation to their community-engaged approach.

“I credit our ability to recruit a more diverse group of participants to the fact that the community we were trying to engage with at the Garden Cafés was involved in the design of them from the beginning, “says Christi Patten, Ph.D., director of Community Engagement, Mayo Clinic Center for Clinical and Translational Science, senior author on the study.

“We had long-standing relationships of trust with the community groups involved before this café project was even thought of,” agrees Dr. Balls-Berry. “We had worked with them before. So we when we approached them to collaborate on the Garden Cafés, they were ready and willing. They provided their expertise on design, such as location and topics. They also provided funding. And they were instrumental in helping us get the word out to their constituents. We didn’t have to work hard to forge connections to the people we wanted to reach. Those connections were already there, and the people were already listening.”

What’s next for the Garden Café program?

Dr. Christi Patten, director of Mayo Clinic Community Engagement, Mayo Clinic Center for Clinical and Translational Science

The Community-Engaged Research team plans to build on the success of the Garden Café program. The pilot study sought to demonstrate the feasibility and effectiveness of the approach. In the near future, the team is planning a larger, controlled study, featuring a program design that can be replicated in other community settings.

“I’m excited for what’s next,” says Dr. Patten. “There’s so much more to learn about this promising approach to health education and health research. We’d like to study ways to use social media to engage people in ‘virtual garden cafés.’ I truly believe that when the community and health researchers work together, everyone benefits. And the reward of this collaboration is much more than a sum of its parts.”

Aug 7, 2018 · Mentorship program makes research aspirations a reality

@aarmas Thank you for your question. Information about Mayo's KL2 program, including eligibility requirements, can be found here on the Mayo Clinic Center for Clinical and Translational Science website: https://www.mayo.edu/research/centers-programs/center-clinical-translational-science/education/kl2-mentored-career-development-program.

There may be an institution offering a KL2 program in your area. Here is more information on the program, overall, from the NIH National Center for Advancing Translational Sciences website: https://ncats.nih.gov/ctsa/about/training/programs

Aug 1, 2018 · Mentorship program makes research aspirations a reality

Mrinal Patnaik, M.B.B.S.

Mrinal Patnaik, M.B.B.S., is a physician in the Department of Hematology at Mayo Clinic with a keen interest in the clinical management of blood cancers. In recent years, however, Dr. Patnaik realized he wanted to develop a deeper understanding of the disease biology of these cancers and the ways that precision genomics could be used to improve therapy and quality of life for patients.  “I was looking for more training and mentorship, and to learn the skills to become an independent researcher,” says Dr. Patnaik, “so I applied to Mayo’s KL2 program.”

Mayo Clinic Public Affairs recently sat down with Dr. Patnaik to ask him about his experience in the KL2 program and his future goals in patient care and research.

What is the KL2 program and why did you apply?

The KL2 Mentored Career Development Program is a program offered through the Mayo Clinic Center for Clinical and Translational Science for people who want to pursue careers as clinical researchers. It lasts for three years and, if you get accepted, you receive 75 percent protected research time and full salary, plus mentorship from a senior Mayo investigator.

I applied because the life of a clinician is busy. Sometimes I had research ideas I wanted to pursue, but I didn’t have the time or skills to develop them. Through the  KL2 award I have had time to dedicate to research and I have had access to mentors who can teach me what I need to learn to be successful. I’ve spent a lot of time learning how to develop in-vitro and in-vivo models, how to use genomic tools and how to analyze results, and how to write grants. I don’t think any of this would have been remotely possible without the KL2 award.

Tell us about your KL2 research project.

I was inspired to pursue research to help find solutions to unmet patient needs I saw in my work as a clinician in hematology. In my research I’m focusing on a blood cancer called chronic myelomonocytic leukemia. Patients with this condition often need blood transfusions, their livers and spleens enlarge, and most die within two years of diagnosis. It’s a rare disease and it presents a good opportunity to use individualized medicine to understand the heterogeneity of the disease. We all know that no two people are alike—and their cancers aren’t either. I want to find ways to customize therapies to the type of tumor as well as to the individual patient.

The KL2 program recruits a diverse team of research scholars from many biomedical disciplines. Why do you think that’s important?

I think the diversity aspect is critical. If you’re trying to advance the field of medicine, you need to understand more than “just cancer” or “just hematology.” You need to understand how different disciplines are connected and how they can work together.

At least once a month, all of the KL2 scholars get together and we talk about our work. It’s fascinating. I’m working in cancer epigenetics. There are other people in the group working on cancer survivorship, biostatistics, and neurodevelopmental disorders. To bring all that diversity under one banner and be able to understand development across all fields of medicine is very important. That kind of sharing of knowledge and exposure to different disciplines helps speed translation.

Why do you think clinicians and scientists should apply to the KL2 program? And why should departments support participation?

I understand why departments and individuals may be reluctant to take part in a program like KL2. It’s a big investment: time away from patients, projects and regular duties. Here’s the thing, though, I think there’s actually a huge incentive for them to take part in career development programs like this. When patients come to Mayo Clinic, they’re looking for something they can’t get anywhere else. They’re looking for innovation, excellence, cutting edge clinical trials—something unique that can really, truly help them.  To find solutions for unmet patient needs, we need to take full advantage of Mayo’s research pool and we need to hone our own talent. KL2 gives clinicians and scientists, like me, the knowledge and skills we need to do this important work.

What’s next for you after KL2? Will you continue to be a clinician-researcher?

Dr. Patnaik’s research focuses on myeloid neoplasms, especially myelodysplastic syndromes and chronic myelomonocytic leukemia.

Yes, I think I’ll continue to be a clinician researcher. I think the two go hand-in-hand. I want to take what I’ve learned and apply it to patients in general. If you understand epigenetics and precision genomics, you don’t have to focus only one thing, like blood cancer. You can apply it broadly across the field of medicine.

I’ll be in the KL2 program until July 2019, but I’m already starting to branch out and try new things. Because of my interest in precision genomics and the techniques I’ve learned through KL2, I’ve gotten linked up with some researchers at the Mayo Clinic Center for Individualized Medicine. I’m working on a multidisciplinary team that is looking at using precision genomics to better identify patients with short telomeres and accelerated aging syndromes. I look forward to doing more work like this in the future.

Would you like to become a KL2 research mentor to other clinicians and scientists?

Oh absolutely, I would love to do that. At some point, to be a lab mentor to someone and help them go through grant funding would be a privilege. I have seen how much I relied on my mentors. I see it as paying it forward. If you don’t give back, it’s hard for the next generation to succeed.

Jul 18, 2018 · Popular films spark community dialogue about biomedical ethics

film stripWhen was the last time a movie really made you think, changed how you viewed the world or helped you understand an important topic?

Bioethics at the Cinema, organized by the Mayo Clinic Biomedical Ethics Program and the Rochester Public Library, wants to do just that. The goal is to use popular films to create community dialogues around important, often complex biomedical ethics issues.

The Bioethics at the Cinema program began in 2017. Previous movie screenings have touched on health-related topics ranging from discrimination and intimate relationships (The Danish Girl) to gene editing and artificial intelligence (Ex Machina).

The next screening in the series will show the 2017 movie, Wonder: the story of a 10 year old boy living with a rare genetic condition who enters a mainstream elementary school. This screening of Wonder seeks to create a dialogue about genetic disorders and appreciation for difference.

Exploring issues hard to describe in words

“Through film we can explore ethical issues that can be hard to describe in words,” says Kylie Osterhus, a research coordinator with the Mayo Clinic Biomedical Ethics Research Program. “Pop culture, like movies, is an important window on the world. It helps us think about our unspoken values and how that informs the way we live our lives—including the way we think about topics in medicine and science.”

Each Bioethics at the Cinema screening is followed by a panel discussion with local experts.  After Wonder, staff from Mayo Clinic will moderate a panel discussion that will include a Mayo Clinic genetic counselor as well as professionals who work with individuals with disabilities.

“The community discussion after the movie is key to our event,” says Osterhus. “I think Wonder is going to inspire more kindness through a healthy conversation on disability and society.  I hope lots of parents bring their kids as a way to start their own family discussions on how to respond appropriately and stand up for kids that look or act different than themselves.”

Why it’s important to talk about biomedical ethics

Richard Sharp, Ph.D., director of the Mayo Clinic Biomedical Ethics Research Program

It can sometimes be challenging for clinicians and researchers to communicate the nature of their work to their patients and to explain what genetic tests or participation in a research study might involve.

Richard Sharp, Ph.D., director of the Mayo Clinic Biomedical Ethics Research Program, calls the program’s community-facing work “incredibly important.” “We try to look ahead,” he says. “Open up the crystal ball to see what kinds of bioethics issues might be coming around the corner. One of the ways we do that is by engaging patients and communities to learn from them and so we can better anticipate the kinds of values they may bring to decisions about medicine and medical innovation.”

Science and medicine are advancing so quickly, today. Dr. Sharp and his team want the community to know that Mayo Clinic cares about making sure innovation happens responsibly. Bioethics at the Cinema helps engage the community as partners in advancing the science of medicine.

“I’m excited about our Bioethics at the Cinema program,” says Dr. Sharp. “It’s an ideal opportunity for genuine dialogue.”

The Bioethics at the Cinema film Wonder, will be shown Sunday, July 22, 2018, from 4-7 p.m. at the Rochester Civic Theater Company, in Rochester, Minn. This event is co-sponsored by the Rochester Public Library, disABILITY MERG, and the Minnesota Children’s Museum

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