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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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Mon, Jun 15 6:00am · How Vaccines Are Developed and What That Means for COVID-19

Dr. Jacobson with headphones, home library shelves in background

In a recent Zoominar, Robert Jacobson, M.D., a Mayo Clinic pediatrician, gave an in-depth, yet easy-to-understand, discussion on vaccine development, and where we are with respect to a vaccine for COVID-19.

Dr. Jacobson, who is also a health sciences researcher with specific expertise in pediatric infectious diseases, sets the stage for his discussion with a story about vaccines in the 1918 influenza pandemic.

As Dr. Jacobson relates, Mayo Clinic was notably involved in the 1918 pandemic, with Mayo physician Edward C. Rosenow, M.D., developing a vaccine cited as the most widely used in the U.S.

The way vaccines are developed has changed since then, and Dr. Jacobson describes the modern process for vaccine development. In this portion of his presentation, he talks about both passive and active immunity, and then describes the four different kinds of vaccines. He discusses how the decision is made to develop a vaccine, and how a vaccine comes into general usage (or not), once it’s proven safe, effective and easy to consistently manufacture.

Dr. Jacobson walks viewers through the FDA licensure process, including explaining clinical trials; and surprises some with the knowledge that just because the FDA licenses a vaccine doesn’t mean it’s used.

Then finally, Dr. Jacobson brings viewers up-to-date on where the world’s researchers are in terms of vaccine development for COVID-19. He talks through the eight candidates that are currently in clinical trials.

He describes the questions that researchers are trying to answer, and touches on special designation from the FDA that can lead to more support and connectivity during vaccine development, and possibly a faster track to licensure.

During the last 8 minutes or so of the Zoominar, Dr. Jacobson answers questions from viewers, providing thorough responses to each.

Please watch the recorded session below for the full story, and share with others.

Dr. Jacobson’s presentation was a Grand Rounds session, sponsored by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.  

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For more COVID-19 resources from Mayo Clinic visit our microsite.

Wed, Jun 10 9:27am · Faculty members, fellow named 2020 Kern Scholars

Left to right: Jacob Jentzer, M.D.; Konstantinos Leventakos, M.D., Ph.D.; Timothy Lyon, M.D.; Ann Rusk, M.D.

The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery is pleased to welcome four new scholars to the Kern Health Care Delivery Scholars Program. The Kern Scholars Program helps develop a workforce of highly motivated, exceptionally trained clinicians who have the research skills needed to assess existing health care delivery systems, to rigorously test different care models and to apply best practices — essential steps in providing evidence-informed and patient-centered health care.

The mentored training and research program will begin Oct. 1 for faculty scholars, and July 1 for the fellow scholar.

Jacob Jentzer, M.D., Cardiovascular Medicine (Rochester), Faculty Scholar

  • Research focus: Dr. Jentzer has focused on identifying high-risk, cardiac, intensive care unit patients, focusing on initiation of optimal care. As a scholar, he will develop novel algorithms for the early detection and staging of hemodynamic instability and shock in acutely ill, hospitalized patients with the goal of improving their outcomes by facilitating timely delivery of optimal therapy.
  • Mentors: Kianoush Kashani, M.D.; Kalyan Pasupathy, Ph.D.; Vitaly Herasevich, M.D., Ph.D.; Malcolm Bell, M.D.; Curt Storlie, Ph.D.; Brian Pickering, M.D.; Che Ngufor, Ph.D.; Xiaoxi Yao, Ph.D.

Konstantinos Leventakos, M.D., Ph.D., Medical Oncology (Rochester), Faculty Scholar

  • Research focus: Dr. Leventakos uses both qualitative and quantitative methods to study how to identify barriers to patient enrollment in clinical trials, and he uses implementation science methods to address these barriers. He is investigating how a multifaceted approach using artificial intelligence, research nurse coordinators and patient engagement tools can optimize cancer clinical trial enrollment.
  • Mentors: Aaron Spaulding, Ph.D.; Aaron Leppin, M.D.; Curt Storlie, Ph.D.; Tufia Haddad, M.D.; Barbara Barry, Ph.D.

Timothy Lyon, M.D., Urology (Jacksonville), Faculty Scholar

  • Research focus: Dr. Lyon focuses on identifying and addressing barriers in access to high-quality bladder cancer care in order to ensure that all patients are given a chance at an optimal treatment outcome.
  • Mentors: Aaron Spaulding, Ph.D.; Dorin Colibaseanu, M.D.; Stephen Boorjian, M.D.; Elizabeth Habermann, Ph.D.

Ann Rusk, M.D., Pulmonary and Critical Care Medicine (Rochester), Fellow

  • Research focus: Dr. Rusk has a career interest in promoting health equity in Native Americans, specifically in addressing smoking cessation and pulmonary disease. Her research uses both quantitative and qualitative methods to assess smoking patterns existing in Native Americans, and uses systematic review of existing literature to formally assess culturally tailored smoking cessation interventions. Her long-term goal is to formulate effective smoking cessation programs for Native Americans.
  • Mentors: Cassie Kennedy, M.D.; Christi Patten, Ph.D.; M. Hassan Murad, M.D.; Alanna Chamberlain, Ph.D.

The Kern Health Care Delivery Scholars Program is available as a one-year program for clinically trained, doctoral-level Mayo Clinic fellows and a three-year program for junior faculty. The program seeks to prepare the next generation in health services research by leveraging social sciences disciplines such as epidemiology, statistics and sociology.

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Tue, Jun 2 6:00am · Research News Roundup--May 2020

photo from Lerman lab, researcher wearing PPE, taking extra safety precautions post-COVID

During May, Mayo Clinic articles sharing research-related news fell into one of two thematic areas: cancer and COVID-19. For ease of review, they are grouped below, cancer findings first. Read on for more information from Mayo Clinic Research.

Cancer research findings

Carfilzomib is not superior to Bortezomib in delaying multiple myeloma progression after initial treatment

Carfilzomib, a proteasome inhibitor used in combination with Lenalidomide, an immune modulating drug, is not superior to Bortezomib, Lenalidomide and Dexamethasone, in the initial treatment of multiple myeloma according to the results of phase 3 clinical trial presented today at #ASCO20 scientific program by Shaji Kumar, M.D. , a hematologist at Mayo Clinic.


Olanzapine may help control nausea, vomiting in patients with advanced cancer

Olanzapine, a generic drug used to treat nervous, emotional and mental conditions, also may help patients with advanced cancer successfully manage nausea and vomiting unrelated to chemotherapy. These are the findings of a study published Thursday, May 7 in JAMA Oncology.

Charles Loprinzi, M.D., a Mayo Clinic medical oncologist, played a leadership role in this work in conjunction with Rudolph Navari, M.D., of the University of Alabama at Birmingham.

Article is also available in Spanish.

COVID-19 research efforts, emerging findings

Managing levels of specific protein, mineral early in COVID-19 may prevent severe illness

Managing levels of calcium in the blood and the protein albumin early on in COVID-19 may prevent patients from progressing to severe illness and death, a study by Mayo Clinic researchers published in the journal Gastroenterology found. The findings are based on the remarkably similar clinical features and autopsy results of patients who died of COVID-19 and patients whose organ failure resulted from the release of unsaturated fatty acid caused by other illnesses, says lead researcher Vijay Singh, MBBS, a gastroenterologist at Mayo Clinic in Arizona.


Racing against time, medical researchers, life science companies and COVID-19 survivors launch national campaign to drive plasma donation

A coalition of world-leading medical and research institutions, blood centers, life science companies, technology companies, philanthropic organizations, and COVID-19 survivor groups has come together to support the rapid development of potential new therapies for patients with COVID-19. Working together under the “The Fight Is In Us” campaign, the coalition is seeking to mobilize tens of thousands of people in the U.S. who have recovered from COVID-19 to donate their blood plasma, which contains vital antibodies that have fought off the disease and could now help others do the same.


Mayo researchers, minority communities team up to combat COVID-19 health disparities

As the COVID-19 pandemic takes more lives each day across the U.S., public health officials report that racial and ethnic minorities are disproportionately impacted. In a paper published as an accepted pre-proof article May 15, 2020, in the Journal of Clinical and Translational Science, researchers at Mayo Clinic detail how a community-engaged intervention tackled critical health communication problems within vulnerable minority communities.

Community leaders collaborated with medical experts to serve as trusted conduits of information to their communities. The shared goal was to help people of diverse backgrounds understand what they need to know about COVID-19 prevention and testing, how to seek care, and how to access community resources. 


Early indicators: Investigational convalescent plasma is safe for patients with COVID-19

Mayo Clinic and collaborators today reported safety data on the first 5,000 hospitalized patients transfused with investigational convalescent plasma as part of the Food and Drug Administration’s national Expanded Access Program (EAP) for COVID-19. The early indicators suggest experimental convalescent plasma is safe in treating severely ill patients. At this time, convalescent plasma is the only antibody-based therapy available for COVID-19.

The report assessed the first seven days following transfusion of 5,000 patients hospitalized with severe or life-threatening COVID-19, or who were deemed at high risk of progressing to severe or life-threatening status.


FDA issues emergency use authorization for algorithm designed to improve detection of heart failure during COVID-19

The FDA granted Emergency Use Authorization to Eko, a digital health company, for the heart screening algorithm developed by Mayo Clinic. The AI-driven algorithm can detect weak heart pump, which is commonly detected by echocardiogram, a test that is not normally conducted during a physical exam, requires specially trained technicians to record, and requires prolonged contact with the patient.

“Given the danger COVID-19 poses to patients with a weak heart pump, it’s important that we rapidly identify these individuals early and monitor them closely. By embedding the heart failure screening AI into a quick, widely available, and safe test using existing medical devices, we can detect heart failure early and start appropriate treatments,” said Dr. Paul Friedman, Chair of the Department of Cardiovascular Medicine, Mayo Clinic. “Additionally, for people with COVID-19, we may be able to identify when the virus causes the development of a weak heart pump quickly, safely, and easily using these AI tools.”


New collaboration on COVID-19 response to include new serology test

Thermo Fisher Scientific Inc. announced it will expand its response to the COVID-19 pandemic by developing a total antibodies test in collaboration with WuXi Diagnostics and Mayo Clinic. The new test is the result of ongoing collaboration between all three organizations, including clinical evaluation and support from Mayo Clinic. Thermo Fisher will seek U.S. FDA Emergency Use Authorization (EUA) and international regulatory authorizations for the test over the next few weeks.


VIRUS: COVID-19 registry first to track global ICU experience to shed light on trends in care of critically ill patients

he Society of Critical Care Medicine (SCCM) and Mayo Clinic have partnered to launch the first global COVID-19 registry that tracks ICU and hospital care patterns in near real-time. Created by SCCM’s Discovery, the Critical Care Research Network, the Viral Infection and Respiratory Illness Universal Study (VIRUS) will reveal practice variations and provide a rich database for research into effective treatments and care. 

The registry, which is growing daily, features a dashboard of data based on more than 3,400 patients from 110 healthcare sites in eight countries. Updated regularly, the dashboard tracks data on trends such as mechanical ventilation duration, ICU length of stay, ICU discharge details and the type of medical support patients receive, as well as patient demographics: gender, age and race.

Article is also available in Spanish.


Mayo Clinic receives $26 million from BARDA for COVID-19 convalescent plasma expanded access program

Mayo Clinic was awarded a $26 million contract today from the Biomedical Advanced Research and Development Authority (BARDA), part of the office of the Assistant Secretary for Preparedness and Response at the U.S. Department of Health and Human Services. The financial support is for the Expanded Access Program (EAP) for convalescent plasma to fight COVID-19.

Announced by the U.S. Food and Drug Administration on April 3, the national program, which is led by Mayo Clinic researcher Michael Joyner, M.D., coordinates a national online physician/patient registry (uscovidplasma.org) that speeds access and increases availability of experimental convalescent plasma for hospitalized patients in need.

Article is also available in Spanish.

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All COVID-19 news and information from Mayo Clinic is collected online in a single location.

Mon, May 18 10:30am · Mayo Clinic Research in the News -- Week in Review 5/18/2020

Mayo Clinic researchers continue to share both their expertise and their research findings in regional, national and international news. Collected here are links and snippets from some of the stories from around the world. They connect Mayo Clinic research and international efforts to understand and reduce the devastating effects of the SARS-CoV-2 virus and COVID-19.

Mayo specialists looking at use of experimental drugs, convalescent plasma for COVID-19 treatment

By Emily Pyrek, La Crosse Tribune, 5/15/2020

At Mayo Clinic Health System in La Crosse, infectious disease specialist Dr. Raj Palraj and Dr. Joseph Poterucha, principal investigator for covid convalescent plasma for Mayo Clinic, have been collaborating with Mayo Clinic Rochester to identify the best course of care for each COVID-19 patient who is treated at the La Crosse hospital. …

COVID-19 patients given any of the experimental drugs are screened prior to administration, and monitored for the duration of use. The course of treatment, Poterucha and Palraj say, will be tailored to the specific patient. Whether plasma or drugs prove more productive, they say, will also likely be individualized.


Data on first 5,000 coronavirus patients to receive plasma shows promise

Mark Johnson, Milwaukee Journal Sentinel, 5/15/2020

More than 11,000 COVID-19 patients across the U.S. have been treated with plasma from survivors of the disease, and Friday scientists studying the treatment released their first official safety results.

Reporting on the first 5,000 patients, doctors and researchers at Mayo Clinic, the Johns Hopkins Bloomberg School of Public Health and Michigan State University said the number of severe adverse events within four hours of receiving the plasma was less than 1%. 

Their paper, which has yet to be peer-reviewed, found “no signal of toxicity” and concluded “the mortality rate does not appear excessive.”


Blood plasma appears safe for COVID-19 patients in early trial results

By Melissa Healy, Los Angeles Times, 5/15/2020

… For now, the new results should be interpreted with caution because they have not yet been published in a peer-reviewed medical journal or thoroughly reviewed by independent scientists.

“It’s a long way away from showing that this thing is going to be a game changer,” said Dr. Michael Joyner of the Mayo Clinic, who is leading the trial.

“It’s a first step to prove that it’s safe, and it sets the stage for efficacy trials,” he added. “But we were very pleased.” …


Minnesota hospitals brace for COVID-19 peak

State health officials unveil new dashboard metrics that could result in new stay-at-home or other restrictions if COVID-19 spreads wildly. 

By Jeremy Olson, Star Tribune, 5/14/2020

Modeling by the U and the Health Department generally predicted that these restrictions only delayed the peak, but Mayo Clinic’s chief executive on Thursday said his organization’s unpublished modeling predicted a “flattening” of the peak.

“Mayo Clinic’s predictive modeling shows that the anticipated COVID-19 very high peak has been diminished, and we will experience varied levels of infection rates in the coming months until an effective vaccine is available,” wrote Dr. Gianrico Farrugia. “Based upon this data, we support the incremental reopening of public spaces in our communities.”


Convalescent Plasma Is Safe to Treat Covid-19, National Study Shows

By Amy Dockser Marcus, The Wall Street Journal, 5/14/2020

A team of researchers at Mayo Clinic, Michigan State University and Johns Hopkins University examined health outcomes of 5,000 hospitalized patients around the U.S. who received convalescent plasma treatment, and found the transfusions resulted in few serious side effects and there wasn’t an excessive mortality rate.

The study, posted Thursday on a public server called Medrxiv, hasn’t undergone peer review or publication in a scientific journal. Researchers found serious adverse events occurred in fewer than 1% of the treated patients, and the mortality rate seven days after transfusion was 14.9%.


The evolution of cardiac care in the wake of COVID-19 

— Cardiac Rhythm News, 5/13/2020

David E Albert, founder and chief medical officer of AliveCor, considers the impact of the COVID-19 pandemic on the  monitoring and of management of arrhythmias

…At AliveCor, we’ve been working on QTc monitoring for a long time. We published our first QTc article in 2016. For the last three years we have collaborated with The Mayo Clinic on the development of a mobile QTc assessment solution based on a Deep Neural Network AI trained on millions of 12-lead ECGs. In 2018 we reached another important milestone in our work with Mayo Clinic on LQTS. In an abstract published at the Heart Rhythm Scientific Sessions conference in Boston, investigators from Mayo Clinic presented research showing that AI using deep neural networks can successfully identify patients with congenital LQTS, despite having a normal QTc on their ECG. 


FDA Issues Emergency Use Authorization for Eko’s ECG-based Low Ejection Fraction Screening Algorithm, Designed to Improve Detection of Heart Failure During COVID-19 Pandemic

— Baytown Sun, via Business Wire, 5/13/2020

… It is known that patients with cardiovascular disease have a much greater risk of death from COVID-19 than those with normal hearts. Patients with pre-existing cardiovascular disease are estimated by the American College of Cardiology to have a 10.5% case fatality rate due to COVID-19, significantly higher than those without such conditions. COVID-19 infection may also directly cause heart muscle weakness. The Emergency Use Authorization allows healthcare providers to use Eko’s AI algorithm to analyze a standard 12-lead ECG, an easily accessible and painless test to assess the risk of a weakened heart pump. …

“Given the danger COVID-19 poses to patients with a weak heart pump, it’s important that we rapidly identify these individuals early and monitor them closely. By embedding the heart failure screening AI into a quick, widely available, and safe test using existing medical devices, we can detect heart failure early and start appropriate treatments,” said Dr. Paul Friedman, Chair of the Department of Cardiovascular Medicine, Mayo Clinic. “Additionally, for people with COVID-19, we may be able to identify when the virus causes the development of a weak heart pump quickly, safely, and easily using these AI tools.”


Rochester scientists develop first-of-its-kind antibody test to detect protective immunity

By Sean Baker, MedCity Beat, 5/12/2020

Dr. Stephen Russell, CEO and co-founder of Vyriad, said the test’s ability to pick up on the specific antibodies capable of blocking re-infection may make it the “gold standard” for determining protective immunity.

The results and methodology of the study have since been submitted to the FDA in accordance with regulatory requirements for Covid-19 Emergency Use Authorization. Russell said there have also been discussions with Mayo Clinic, where he also employed as a researcher, about the possibility of the institution using Vyriad’s serology assay.


COVID-19 Antibiotic Overuse Puts Stewardship Efforts at Risk

By Ryan Basen, MedPage Today, 5/12/2020

Many COVID-19 patients are getting antibiotics even when the drugs are unlikely to help, raising concerns about patient safety and antibiotic resistance, experts told MedPage Today.

That practice pairs with a recent GAO report highlighting the minimal progress of a major federal initiative to combat antibiotic resistance before the pandemic. …

Other guidance on antibiotic stewardship during COVID-19 includes a guideline from Benedikt Huttner, MD, of Geneva University and colleagues, and a flagging system deployed by researchers at the Mayo Clinic.


Study: CDC non-test isolation recommendation may fall short

— Center for Infectious Disease Research and Policy, University of Minnesota, 5/12/2020

The US Center for Disease Control and Prevention (CDC) non-test strategy for releasing COVID-19 patients from isolation may send patients back into the community too early, resulting in more community spread, researchers from the Mayo Clinic wrote yesterday in a letter to the Journal of Infection.

They note that the CDC has two strategies for determining when a COVID-19 patient can leave isolation, a non–test-based one that relies on symptom improvement and days since symptoms began, and a testing one based on symptom improvement and two negative tests conducted more than 24 hours apart.

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Tue, May 12 6:00am · Melanoma surgery: When more isn't necessarily better

close in shot of medical supplies and a printout about skin cancer with 'melanoma' highlighted.

When you have a chance for an extra scoop of ice cream, that extra might be nice. If you are trying to fit into last summer’s bathing suit, another inch off is probably welcome. However, if you’re having surgery to remove melanoma, like Goldilocks choosing a bowl of porridge, you want a procedure that’s ‘just right.’

According to the American Cancer Society, skin cancers are the most common of all cancers. Melanoma only accounts for about 1% of these, but leads to the majority of skin cancer related deaths. Typically a melanoma tumor will be surgically removed —along with other treatment, depending on the stage of the cancer. What is not so typical is who does these surgeries, and where these surgeries are performed.

To reduce the resultant variability in care, the National Comprehensive Cancer Network issued guidelines for both patients and surgeons for the treatment of melanoma.

Maria Huayllani Peralta, M.D., a research fellow in Plastic Surgery on the Jacksonville, Fla., campus of Mayo Clinic, wanted to see if clinicians were following these guidelines. She and a multidisciplinary group of physicians and scientists from Mayo Clinic recently published the results of their investigation in Anticancer Research — International Journal of Cancer Research and Treatment.

“Melanoma surgery can be performed by surgeons of different specialties such as dermatologists, surgical oncologists, and reconstructive plastic surgeons,” says Dr. Huayllani Peralta. “For that reason, guidelines to perform a safe excisional surgery to avoid recurrence were developed. However, we noticed that the specific guidelines for treating invasive melanomas were not always followed, so we decided to look exactly why this was happening.”

Melanoma is a cancer that starts at skin level and spreads both in width and depth. Surgical removal can leave visible and often disfiguring scars or disabling gaps in flesh.

When removing a melanoma tumor, surgeons use what is called a ‘wide excision’ to remove the entire tumor, along with a small amount, or margin, of normal tissue around the tumor. The guidelines prescribe the appropriate margins for each tumor stage and size.

“Following established guidelines gives patients the safest surgical removal possible, taking the adequate amount of normal tissue while ensuring the tumor is completely removed,” says Antonio J. Forte, M.D., Ph.D., a plastic surgeon at Mayo Clinic, and the senior author of the study.

However, he and Dr. Huayllani Peralta and the rest of their team found that in many cases, much bigger margins are being removed than is necessary.

The data and research findings

Besides plastic surgery, their research team included experts in several areas, including health care outcomes research, surgical oncology and biomedical statistics. Supported by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, this project and others like it are part of Mayo’s ongoing efforts to improve outcomes, experience, and indeed, the overall value of health care. 

As part of this partnership, Aaron Spaulding, Ph.D., a researcher in the Mayo Clinic Kern Center for the Science of Health Care Delivery, played a key role, says Dr. Forte.

Dr. Spaulding speaks to the evidence. “We would like to improve the health care of patients with invasive melanoma. By better understanding the current management of patients with invasive melanoma we can better identify successes and potential gaps in that care process,” he says. “This can then provide the evidence needed to improve clinical training and recommendations to treat these patients.”

“As an academic medical center, we able to foster the development of researchers and physician scientists through multiple research education programs,” says Dr. Forte. “This also allows us to leverage experts from a variety of different fields to contribute to research and find solutions for our patients, and people everywhere.”

The team used the National Cancer Database, which represents more than 70% of newly diagnosed cancer cases nationwide, to find patients diagnosed with invasive melanoma in the U.S., between 2004 and 2015.

Initially they found 525,271 adult patients. The investigators excluded patients with melanoma in situ, or stage 0, which can be treated without wide excision surgery. They also removed patients with incomplete information, misclassification, or who did not fit the study criteria of primary local invasive melanoma without metastasis.

According to National Comprehensive Cancer Network guidelines, the smallest tumors — less than or equal to 1 mm thick — should have a 1 cm margin.  Somewhat larger tumors should be  removed with a 1-2 cm margin, and tumors greater than 2 mm thick should have a 2 cm margin.

Due to database limitations, all tumors ≤ 1 mm thick that had been removed with the appropriate 1 cm margin were not considered for the study. In the confines of this study, the investigators also did not look at margins that were smaller than recommended.

They then reviewed the tumor thickness and surgical margins for the remaining 26,440 patients.

Among these patients, the researchers found that nearly half (48.7%) had received wider than recommended margins. Of these, a majority — 7,182 — were patients who had tumors no thicker than 1 mm, and of those 2,236 had excessively large margins (greater than 2 cm). These excessively large margins were seen with larger tumors too.

The findings, next steps

The investigators wanted to determine who was removing extra tissue, and why. They found a few factors that seemed to contribute:

  • Tumors located in the trunk — as opposed to head, neck or other more visible areas — were more likely to be removed with larger margins.
  • Tumors greater than 1 mm were more likely to have appropriately-sized margins when removed in an academic medical setting.

The research team did not find any difference in overall survival rates, suggesting that the excessive margins did not add to life expectancy.

“Knowing that removing more tissue than the guidelines recommend doesn’t lead to better life expectancy, it is even more important to consider other patient outcomes,” says Sanjay Bagaria, M.D., a surgical oncologist and study co-author. “For example, wider than recommended excisional margins may affect adjacent skin and would need further reconstruction techniques.

“At the same time, the application of these reconstruction techniques such as skin grafts and flaps will bring additional surgical risk and potential complications, such as infection, tissue necrosis, and deformity,” continues Dr. Bagaria.

Guidelines help physicians to act based on the best evidence available, he says.

Dr. Huayllani Peralta says they published their findings and are sharing their research in other venues to encourage surgeons across specialties to follow guidelines. “We want to make a strong recommendation of adhering to the NCCN guidelines for patients with invasive melanoma,” she says. “We believe this study strengthens current knowledge regarding the management of these cases.”

Her thoughts are echoed by Dr. Forte. “Research and education are significant components in the Mayo Clinic three-shield philosophy,” he says. “We not only want to provide the best possible care for our patients — based on the current established guidelines, but also to build the evidence base supporting care decision. And then pass our knowledge along through publication, training and other educational mechanisms.”

Dr. Huayllani Peralta received her medical degree from Universidad Nacional Mayor de San Marcos in Peru, and is at Mayo Clinic to gain research experience in plastic surgery. “Research is needed to improve the health care and find the best management to restore defects or deformities that cause functional and structural impairment in patients,” she says. Someday she hopes to be able to repair birth defects and perform other reconstructive surgeries to help people recover both physical structure and function.

As Dr. Huayllani Peralta’s mentor, Dr. Forte says, “It’s part of my mission to leverage my experience as a surgeon-scientist and contribute to the growth of my mentees.” Guiding her in this study was one such opportunity for Dr. Forte.

And for both of them and the rest of the research team, this study provided a chance to learn, and share what they learned.

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Mon, May 11 10:30am · Mayo Clinic Research in the News -- Week in Review 5/11/2020

Many news stories last week covered aspects of the SARS-CoV-2 virus and COVID-19. Each day several articles cited Mayo Clinic Research and quoted Mayo Clinic experts. Read on for snippets from some of these articles, and links to the full stories.

A COVID-19 Vaccine by Fall Is Possible, But at What Cost?

By Dennis Thompson, HealthDay reporter via U.S. News & World Report, 5/11/2020

… “It is possible to have a vaccine by the fall or winter,” said Dr. Greg Poland, director of the Vaccine Research Group at the Mayo Clinic in Rochester, Minn. “It is not possible to have a vaccine by fall or winter that has gone through the usual safety testing. Speed is a tradeoff with safety.”

… Poland said that there are a couple of ways the United States could speed up its own vaccine testing process, but these strategies raise important ethical questions.


Guidance for Inpatient Care During COVID-19

By Madeline Morr, medicalbag.com, 5/8/2020 (free with registration)

As an increasing proportion of the population becomes infected with the novel coronavirus (COVID-19) and more patients with severe illnesses are hospitalized, it is important for hospitals to remain abreast on how to best care for people with suspected or confirmed disease. To help, researchers from the Mayo Clinic developed a guide for the inpatient care of patients with COVID-19. The full guide is published in the American Journal of Medicine.


Can antibody testing deliver on promises to lift the lockdown?

By David Cox, The Guardian, 5/10/2020

At the Erasmus University Medical Centre in Rotterdam, Marion Koopmans and a team of scientists are going throught the laborious process of verifying antibody tests for Covid-19. Over the last two months, dozens of prospective tests have hit the market, and with many governments wanting to feed the results of large-scale testing into their decisions whether to end lockdowns, biological tests have rarely carried such weight. …

Questions remain as to whether such antibodies stick around for life or wane over a period of months or years.

“Answering that question will be critical when it comes to the success of the vaccines,” says Elitza Theel, clinical microbiology director at the Mayo Clinic in Rochester, Minnesota. “Is there going to be one vaccine or is it going to be like the flu where you need to get boosted and revaccinated every year?”


New Federal Rules Pave The Way For Patient-Driven Health Information Exchange And Real-World Evidence On COVID-19 Surveillance And Treatment

By Sanket Dhruva, Joseph S. Ross, Nilay Shah, Rachael Fleurence, Harlan M. Krumholz, HealthAffairs blog, 5/10/2020

Nilay Shah, Ph.D., one of this blog’s coauthors, holds a number of leadership roles in health sciences research, and is the chair of Health Care Policy & Research at Mayo Clinic.


Mayo Clinic: Second COVID-19 wave during fall, winter ‘an inevitability’

By BJ Bethel, WDTN.com, 5/6/2020

Dr. Gregory Poland, a Professor of Medicine and Infectious Diseases with the Mayo Clinic told WDTN.com on Tuesday that a second wave would likely occur alongside the normal seasonal influenza outbreak, which could post major challenges to health care systems and the general population.

“I think among those of us who study (infectious diseases), we believe a second wave will be an inevitability,” Poland told WDTN.com.


Dr. Andrew Badley – Mayo Clinic Division of Infectious Diseases on being tasked with the COVID-19 oversight and the research behind it

— WCCO radio, 5/5/2020

Chad Hartman talked about being tasked with the COVID-19 oversight, the research behind it, balancing timelines, the depth of departments at Mayo Clinic and more w/ Dr. Andrew Badley from the Mayo Clinic Division of Infectious Diseases.


Many coronavirus mutations are circling the globe, but we don’t know if any are more dangerous

By Elizabeth Weise, USA Today (via Detroit Free Press), 5/5/2020

… “Everybody talks about the SARS-CoV-2 virus as if it’s one thing. It may be more of a problem,” said Dr. Greg Poland, director of the Mayo Clinic’s Vaccine Research Group.

All viruses mutate, especially RNA viruses such as SARS-CoV-2, Poland said. What’s important is whether there’s going to be a clinical significance, he said.


Dying People Can Access Experimental Drugs for Covid-19, but It’s Complicated

Compassionate use allows very sick people to get access to treatments that might help Covid-19, but it’s not without problems

By Ron Winslow, elemental – Medium, 5/5/2020

… Mayo Clinic just announced on May 5 a $26 million federal grant to support “expanded access,” as compassionate use is also known, for a promising but unproven treatment called convalescent plasma to fight Covid-19. But as the history of compassionate use suggests, broadening use of the strategy is almost certain to raise risks and trigger ethical dilemmas that have long plagued the approach.

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NBA Reportedly Supporting Mayo Clinic’s COVID-19 Study on Antibody Blood Tests

By Joseph Zucker, Bleacher Report, 5/4/2020

The NBA is supporting a study from the Mayo Clinic that uses serology testing to identify antibodies for the coronavirus, according to Shams Charania of The Athletic and Stadium.

Charania noted the purpose of the effort is “to better understand prevalence of coronavirus among players and staff and promote long-term efforts to develop vaccine.”

Read the article for more information on Mayo Clinic’s research surrounding COVID-19, and intersections with the NBA.

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For Mayo Clinic stories, videos, podcasts and other current resources related to COVID-19, visit our mini site.

Tue, May 5 6:00am · Mayo Clinic Research in the news: Week in review 5/5/2020

The race continues across biomedical research to find answers for people with COVID-19 as well as those hoping to avoid the virus. Mayo Clinic Research and researchers are playing a prominent role in all aspects, from developing tests and trying various treatments, to predicting outcomes and collaborating for a vaccine. Collected here are links and short extracts from news stories involving Mayo Clinic research and COVID-19.

Mayo Clinic’s coronavirus research task force is in a desperate race against time

Dr. Andrew Badley is the conductor for the clinic’s massive research push to fight the coronavirus 

By Reid Forgrave, Star Tribune, 5/2/2020

Like the rest of the world, the Mayo Clinic’s Dr. Andrew Badley hadn’t heard of the deadly virus scientists refer to as SARS-CoV-2 until reports emerged from China in December. But it was as if his nearly four decades as an infectious disease specialist had prepared him for this moment.

Now Badley, a 55-year-old HIV research specialist as comfortable in the lab as he is bedside in a clinic, chairs the Mayo Clinic’s novel coronavirus research task force, an urgent operation that is quite literally all hands on deck.

The budget? In a time of austerity, that’s a complicated question — but he has Mayo’s full support for researchers and talent. The timeline? As fast as scientifically possible.


How serological COVID-19 tests work — and what their results mean

By Greta Kaul, MinnPost, 5/1/2020

Last week, Gov. Tim Walz announced a $36 million partnership with the Mayo Clinic and the University of Minnesota to test as many as 20,000 Minnesotans daily for COVID-19.

So far, the type of test that’s gotten the most attention is the molecular testing, which can tell Minnesotans if they’re currently infected with COVID-19. These tests have been available — though in short supply — for months in Minnesota, and more than 70,000  tests of this type have been performed among the state’s residents.


12 scientific teams redefining fast-tracked heart and brain health research related to COVID-19

— American Heart Association, 4/30/2020

Less than a month after issuing a rapid response call for scientific research proposals for fast-tracked studies of the effects of COVID-19 on the body’s cardiovascular and cerebrovascular systems, the American Heart Association has awarded $1.2 million in grants to teams at 12 institutions across the U.S. to begin this unprecedented work. Additional funding for special research projects within each of the four new Health Technologies & Innovations Strategically Focused Research Centers brings the Association’s COVID-19 related scientific research funding to $2 million. … The research projects include: …

Mayo Clinic, led by Ognjen Gajic, M.D., Professor of Medicine — Cardiovascular Outcomes and Biomarker Titrated Corticosteroid Dosing for SARS COV-2 (COVID-19): A Randomized Controlled Trial: This team will expand its current SMART randomized clinical trial to add the evaluation of biomarker-titrated corticosteroids dosing compared to usual care for treating COVID-19 patients.


Mayo Clinic is using artificial intelligence in its COVID-19 research

By Raquel Hellman, KIMT TV, 4/28/2020

Artificial intelligence has a vital role in helping researchers in their efforts to fight COVID-19 and is an important tool in the work being done at Mayo Clinic. Dr. Andrew Badley is an infectious diseases specialist and leads Mayo Clinic’s COVID-19 Research Task Force. He explains that they created a real-time tracking platform to measure the rate of positive cases throughout all counties in Minnesota.


Mayo Clinic says 90 percent of Covid-19 patients are now enrolled in clinical trials

By Sean Baker, Med City Beat, 4/28/2020

… Here are three key (nearly) politics-free takeaways from a round table discussion with Pence featuring Mayo employees Dr. Gianrico Farrugia, president and CEO; Dr. Amy Williams, executive dean of practice; Dr. Andrew Badley, chair of Mayo’s Covid-19 research task force; Dr. Bill Morice, president of Mayo Clinic Laboratories; and Haley Kuffel, a registered nurse at St. Marys Hospital who has been on the front lines of the pandemic.


Clinical labs face many obstacles as they validate COVID-19 serology tests

By Madeleine Johnson, Genomeweb/Modern Healthcare, 4/28/2020

Against a backdrop of dynamic federal regulations and a quickly expanding commercial landscape, labs are facing unusual obstacles in validating serology testing for COVID-19. Issues with test accuracy and supply, combined with a paucity of independent validations, mean most labs must basically start from scratch in vetting tests on their own. …

For molecular testing, the Mayo Clinic’s Rochester location got EUA [exceptional use authorization] for a molecular test, while the Mayo Clinic’s Arizona site had run the Centers for Disease Control and Prevention EUA test, then switched to an Abbott test. For serology, the Rochester site is validating plate-based assays, and Mayo-Arizona is doing the same, according to Thomas Grys, director of microbiology at Mayo Arizona. But Grys said the lab also wants to bring on lateral flow tests since having a validated point-of-care test could potentially allow the health system to reach more patients, including healthcare workers and employees. The lab is currently in the validation process, beginning with the first step — trying to figure out which of the tests that are currently available might be any good, and also reliably available in large enough quantities.


What is contact tracing? Here’s what you need to know 

By Courtney Kueppers, Atlanta Journal Constitution, 4/28/2020 

As states look to ease shelter-in-place guidelines, officials say that contact tracing is a key tool in tracking the spread of the coronavirus. …  “Contact tracing, it’s having a moment of glory right now with COVID because of the crucial importance of identifying those individuals who have been exposed quickly and isolating or quarantining them,” Dr. Laura Breeher, who works at the Mayo Clinic told TIME.


Mayo Clinic cardiologist on identifying risks of hydroxychloroquine for coronavirus treatment 

— CNBC, Squawk Box, 4/27/2020

The FDA is warning against the use of hydroxychloroquine for the treatment of Covid-19. This follows the release of study results published in the Journal of the American Medical Association that showed some Covid-19 patients treated with the drug developed irregular heartbeats. Dr. Michael Ackerman, cardiologist at the Mayo Clinic, joins “Squawk Box” to discuss.


Mayo Clinic doctors talk COVID-19 impact on communities of color 

By Linda Williams, Fox 10 Phoenix, 4/27/2020

Confusion and mixed messaging are just two of the reasons communities of color are being impacted more by COVID-19. “The CDC states that about 13% of population is African American, but 20% or greater of African Americans are the ones dying from the disease,” says Dr. Brittane Parker with Mayo Clinic Internal Medicine. Other factors include underlying health conditions, lack of access to healthcare, and the fact that many minorities are doing service jobs that can’t be done virtually, likely exposing them more to the virus.


Leading Mayo Clinic’s Digital Transformation 

By Brant Skogrand, University of St. Thomas, 4/27/2020

When Rita Khan ’11 MBA joined Mayo Clinic in January as its first-ever chief digital officer, she knew that one of her primary responsibilities would be establishing the Mayo Clinic Center for Digital Health. That initiative, focused on advancing the Mayo Clinic strategy of cure, connect and transform by providing data-driven and experience-led digital patient solutions, has become even more crucial during the COVID-19 pandemic.


Coronavirus: Research focuses on plasma from recovered COVID-19 patients; Jacksonville-area hospitals included 

By Beth Reese Cravey, Florida Times-Union, 4/26/2020

“People who’ve recovered from COVID-19 have antibodies to the disease in their blood. Doctors call this convalescent plasma,” said anesthesiologist Michael J. Joyner, principal investigator of Mayo’s Convalescent Plasma Expanded Access Program. “Researchers hope that convalescent plasma can be given to people with severe COVID-19 to boost their ability to fight the virus. “The immediate goal … is to determine if convalescent plasma can improve the chance of recovery for people with the most severe disease,” he said. “A second goal is to test whether convalescent plasma can help keep people who are moderately sick from getting sicker.”

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For Mayo Clinic stories, videos, podcasts and other current resources related to COVID-19, visit our mini site.

Mon, May 4 6:00am · Research News Roundup--April 2020

team of people in lab supply area
Mayo research team, ‘before COVID’

Since everyone is staying close to home these days, perhaps you’ve been spending more time on the internet, and have already seen the news. If not, or if you want a recap, read April’s Research News Roundup. This includes brief summaries and links to Mayo Clinic’s research news releases from the past month. Most are related to COVID-19, so we put the non-COVID news up front. Read on for more information from Mayo Clinic Research.

Prescribing an overdose: A chapter in the opioid epidemic

book open to page with fentanyl printed on it, test tubes next to the book

Research indicates that widespread opioid overprescribing contributed to the opioid epidemic. New research shows that this dangerous trend has apparently been coupled with another: inappropriate use of high-potency opioids.

A multi-institution research collaboration led by Mayo Clinic published its findings Wednesday, April 15, in JAMA Network Open. The study showed that more than half of Americans starting the most highly regulated opioids might be receiving inappropriate treatment.


Mayo Clinic research finds spina bifida surgery before birth restores brain structure

pregnant woman's midsection, shown in pajamas on bed, with her hands cradling her stomach

Surgery performed on a fetus in the womb to repair defects from spina bifida triggers the body’s ability to restore normal brain structure, Mayo Clinic research discovered.

Research by Rodrigo Ruano, M.D., Ph.D., chair of Mayo Clinic’s Division of Maternal and Fetal Medicine, finds that fetal surgery to correct congenital spinal cord defects is more effective at healing neurological structure than surgery after birth. This research was published in Mayo Clinic Proceedings.


As promised, here are releases related to both COVID-19 and Mayo Clinic’s research and research education activities. Although we usually excerpt a bit from each, this time we’ve linked simply to each news release via the headline. As you can see, there are many different areas of investigation around COVID-19, from better ways of cleaning and sanitizing to testing, tracing and treatment, as well as specific considerations for patients with certain additional conditions or unusual symptoms.

All COVID-19 news and information from Mayo Clinic is collected online in a single location.

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