Lab Medicine Rounds

In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., speaks with Robert Michel, editor-in-chief of The Dark Report, an intelligence service and publication that provides economic and strategic assessment of the clinical laboratory industry, to provide useful tools for laboratory management. Timestamps:

In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., speaks with Beshoi Nashed, a visiting medical student from the Medical University of the Americas in Saint Kitts and Nevis, about his personal perspective on life that has helped him succeed where many others are challenged. Timestamps:0:00 Intro01:08 Where were you first introduced to this no excuses philosophy perspective, and what is it?03:09 What’s the perspective they had that they really imparted on you, what did it look like? 06:44 What do you think is important for our listeners to understand about, what is it that allows you to be successful with this no excuses approach?10:22 How has your practice changed, if at all, over that time?12:35 Where do you recommend our listeners get their own start?14:22 Outro

In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., speaks with Dr. Nour Al-Mozain, a hematopathologist and transfusion medicine consultant at King Faisal Specialist Hospital in Riyadh, Saudi Arabia, about the importance of reaching out to colleagues for advice.Timestamps:0:00 Intro01:05 What are a few of the reasons why you have reached out to colleagues for advice?02:36 What are a few of the challenges that you’ve had to navigate while reaching out to try to find this different perspective? 04:39 How do you work on maintaining awareness of where your blind spots are?05:22 Is there something in your training or a point that you can put your finger on to say this set you on the right course to always be mindful of my blind spots?06:38 How are you building this network of colleagues that you can reach out to?07:54 How do you set yourself up for success in getting a helpful answer?10:20 What advice to you have for early career healthcare professionals about asking for advice?12:12 Outro

0:00 Intro01:04 What is your origin story? How did you come to work in this unique health setting of educating patients?05:19 What are some of the common ways that you see healthcare really fail to successfully educate patients?09:59 How do you navigate the complexity of what you’re talking about? 16:12 How do you navigate those situations where the patient doesn’t seem to be understanding the information?18:05 What does the future of patient education look like to you?22:12 Outro

Timestamps0:00 Intro00:45 Why is workforce stability such an important topic for health care right now?04:25 What are a couple of the current challenges? Maybe a few with hiring, and then a few with retaining some of these quality employees.07:17 What are your thoughts about how do you keep your fingers on the pulse of the current needs and interest of the workforce? What’s the way to be a constantly evolving organization?09:04 Is this something that is a regular topic of discussion with management meeting about what we are hearing from our employees, or is this something that is more informal that you’re meeting with leadership for your group, reflecting on what you’re hearing from your employees and meetings? What does that look like?09:23 How does the laboratory and histocompatibility support organ transplantation? What kind of work happens behind the scene that enables this transplant to be as successful as possible?11:32 How do you handle and manage that in a positive way, when employees are making these great suggestions, but like you said you just can’t just on a dime change the work hours in many cases?14:27 What are some of your top recruitment strategies?16:40 How do you assess which strategies are more effective?18:38 Can you speak to some potential educational opportunities where listeners can learn more about this?20:39 Outro

Timestamps:0:00 Introduction0:46 Why is it important for pathologists to know a thing or two about the legal system?3:49 Quality practices are something we are all involved in. Can you unpack those a little bit so listeners can think about how they’re engaging in that?5:05 High probability a physician or pathologist will eventually be involved in a legal proceeding. Tips for if/when that happens to you.7:05 Importance of SOPs and Quality Plans9:19 What does malpractice entail?14:11 What do you recommend for people who want to take more of an active or deliberate role in keeping up with legal practices? 20:32 International Surgical Pathology Symposium 2023 in London21:18 Outro

Timestamps:0:00 Intro01:54 How did you get started in the field of histocompatibility?03:44 Was that a mentor that helped you find this new role and pathway, or was there a particular patient that you took care of that opened your eyes to these other possibilities in lab medicine?05:28 What are a few things that you think healthcare professionals in general should understand about organ transplantation?07:51 Maybe for you, as someone who was practicing first in orthopedic surgery, and then making this transition to systems thinking, what has that been like and how do you navigate that now?09:23 How does the laboratory and histocompatibility support organ transplantation? What kind of work happens behind the scene that enables this transplant to be as successful as possible?11:53 Is the laboratory involved with the care of the transplant patient beyond the acute transplant? What does that look like?13:09 What do you predict is on the horizon for histocompatibility?14:50 How could somebody support organ transplantation?16:47 Outro

Timestamps:0:00 Introduction0:37 Why is it important to update multiple myeloma testing?1:51 Lab testing driving treatment that is being done3:30 Explanation about multiple myeloma, how testing started, and how it has evolved6:02 Needing more sensitivity to detect it7:47 Driving treatment decisions9:02 What does this look like in practice?10:57 Minimal residual disease12:41 Outside of the box thinking, how has this impacted your practice today?17:41 Outro

Timestamps:0:00 Introduction0:40 Non-traditional education for pathologists11:17 Getting involved13:41 Self-learning16:19 Becoming an expert18:46 Other interests in practice or life22:05 Importance of completing projects23:59 Outro

Timestamps:0:00 Introduction1:18 What is the difference between marijuana, hemp, THC, and CBD?2:58 So, is CBD legal in the United States?4:08 What are the common products you can find CBD in?4:25 How can CBD impact our health? Especially since it is not regulated.5:28 You run our drugs of abuse and forensics lab, is this having any effect on the testing you do there?10:45 For our laboratory medicine colleagues, what's important for them to understand about CBD and marijuana drug testing?13:55 What about different industries? How does it affect athletes in recovery for example?16:50 Are there any other takeaways you want the audience to appreciate from this?18:31 Outro

In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., sits down with Justin Juskewitch, M.D., Ph.D., and Andrew Norgan, M.D., Ph.D., both assistant professors of laboratory medicine and pathology at Mayo Clinic, to talk about informatics for the pathologist.

Timestamps:0:00 Intro00:45 Can you start us off by giving an overview of this latest outbreak of Monkeypox? And also if you could contrast that against Covid-19? 03:25 What do you think this increase means for our hospital laboratories?05:44 How can we provide the greatest value to our clinical colleagues and to our patients? 08:17 I know we sometimes do culture a virus and look at viruses. Is it that testing that some of us have in our laboratories that’s not specific enough, it looks like other viruses, is that why we have other tests that we’re using?10:00 Do you think that Monkeypox would be similar to Covid-19 where we have home test kits for the virus? 12:21 Outro

Timestamps:0:00 Intro01:32 So for residents who have recently started, now that orientation is behind us, where should their focus be?09:05 Do you have any advice for what step 1 or 2 might look like for a new resident?13:46 What is a new skill or two that residents should really focus on developing? 18:26 Could you share with the student listeners, what do you recommend to residents when they feel like they aren’t making the progress they would like?23:54 How do you recommend residents approach those meetings with their program director?28:05 Outro

Timestamps0:00 Intro01:10 Why is social media a tool that our lab medicine and pathology community should consider using?04:01 How do you reassure or talk to a pathology resident or a medical laboratory technologist, who is just getting started on social media, when a patient reaches out with a question?07:29 What is your advice about how to use your time wisely on social media?09:57 How do you think about the social media landscape at this point, realizing things are dynamic and changing? How do you characterize and think about these different platforms?12:10 How has your social media practice evolved over time? What has your journey been like and how has this affected you?14:48 What skills do you think that you can walk away from this with, what skills have this been helping with for you?16:44 What is next for you? What challenges do you want to throw out there for the experienced social media person?17:42 Outro

Timestamps:0:00 Intro01:01 What is a patient-scientist? 01:36 What’s the perspective of value they can bring to the table?03:57 What has surprised you the most about this experience of being a patient-scientist?08:05 Since you have shared this, what has been your experience interacting with the research community?08:57 What are your reflections about how the medical community should understand about developing these relationships, seeking out or welcoming patient scientists in their research, interest or questions?10:46 What’s been your own experience when you go to patient or research conferences, what is your experience like in those situations given you’re on both sides? 12:34 OutroResources:TEDx: Researching Your Own DiseaseSociety of Patient Scientists

Timestamps: 0:00 Intro00:42 What does the tick season look like this year? Is it true that is has been predicted to be a severe tick season?01:20 What are the different things that influence the tick season?03:49 What does “severe tick summer” mean for all of us working and learning in the hospital?05:08 Have you been getting invitations to talk to some of our clinical colleagues about that differential diagnosis?05:53 There has been a lot of concern over “superbugs”, are tick-borne diseases evolving as well?07:30 Going forward, is it going to get worse? What are the experts in the community saying?09:11 You do a lot of research in the field. I was curious if you have a favorite story about those experiences of leading some students and colleagues into the field to do this tick-based research?11:48 OutroResources:The Essentials of Ticks and Tick-Borne Diseases

Timestamps:0:00 Intro00:46 Why is 3D imaging and printing important for patient care?03:18 Can you help our audience understand when should we be using this? When is it not so good? 09:38 How does that conversation go now differently? Now that somebody can hold this, how has that transformed the questions and the understanding that the patient has?13:05 Can you help us get our arms around what is the value in the scan, what is the print value?14:01 Technologies for scanning are improving and that’s resulting in better models for you to look at. Is printing of materials being used improving in such a way you can get the same textures?15:22 How do you see this field really developing? 17:55 Outro

Timestamps:0:00 Intro00:53 Why is the medical field interested in saliva?02:00 What sorts of information could be gleaned from saliva?03:17 Are there certain limitations of what could come out of saliva testing?04:56 Can you elaborate what you mean when you say “matrix?”06:16 How do you approach navigating what could be interferences?08:16 Would that be considered part of the matrix? Or is the matrix just the specimen itself?9:29 Could you elaborate those preanalytic variables a clinician may have top of mind, or what might be in their sphere of control, influence, awareness?11:41 What’s your advice to laboratory professionals about how we can detect when these kinds of things are going awry, or how do you keep your finger on the pulse of how your colleagues on the clinical side are using your tests?13:34 What do you see as the future for saliva testing like?14:54 OutroResources: https://www.aacc.org/cln/articles/2022/janfeb/saliva-in-the-spotlight https://news.mayocliniclabs.com/2022/04/07/darci-block-ph-d-discusses-saliva-testing-in-aaccs-clinical-laboratory-news/

Timestamps:0:00 Intro00:51 Could you give us an update about what has been happening regarding convalescent plasma?03:46 What are some take-home points from this new AABB guidelines that are out?15:07 Were there challenges discussed or things that you see these guidelines either domestically or internationally? 18:20 Is there an aspect that you would like to see addressed with more robust data as we go forward?20:12 OutroResources:AABB Guidelineshttps://www.aabb.org/news-resources/news/article/2022/04/13/aabb-expert-panel-updates-guidelines-for-clinical-ccp-use

Timestamps:0:00 Intro2:00 Coming off a relaxed 4th year, how do you recommend we get back into the study flow for training? 6:45 Once residency starts and we are working all day and studying in the evenings, do you have recommendations on how to ease back into that? 9:30 How do you recommend finding a mentor in residency training? How do you know if it’s a good fit or if you need to figure out how to find another mentor? 13:35 How would you maximize your time on AP rotations? How is this approach different than CP rotations? 21:22 How do you recommend getting involved in research and residency? If you do find a project you are interested in, how do you approach it if they are not doing a lot of research in that area at the time? 28:18 How do you mentor your residents on balancing step 3 studying, with pathology studying, and working? 29:15 What is the role of having research and research experiences and applying to fellowships (posters, etc.) Research Experiences and Fellowships33:07 Entering residency with a strong idea of what we want to pursue a fellowship in, what advice can you offer to help secure this fellowship? And on the contrary, if you have no idea what you want to do how do you recommend people narrow it down? 46:00 How do we navigate the type of career setting we want to be in? 50:15 What conferences do you recommend residents attend?55:00 How do you recommend maintaining work/life balance and experiencing burnout?1:00:50 OutroResources:· Book: Getting Things Done by David Allen· Book: Make It Stick: The Science of Successful Learning by Peter Brown· Book: Peak by Anders Ericsson

Timestamps:00:00 Intro01:04 Why is molecular information important for you in your practice to integrate into anatomic pathology? 06:22 How did you recognize that molecular information was really a critical competency for you to develop as an anatomic pathologist? 09:51 Do you find yourself going to different sessions when you go to conferences, or are you specifically paying attention to ones that have a molecular thread through them?11:23 How do you recommend that we all continue to embrace new opportunities in clinical practice? 13:01 We are talking about how molecular has come down the pike and been something new that’s been added on to your practice. Is this importance of channels of communication, how has it changed in recent years?14:45 Outro

Timestamps:00:00 Intro01:30 Why is it important for us to look at our past when planning for our future?05:37 Sometimes people struggle with celebrating and I think also, maybe some people get nervous about that--taking time to celebrate accomplishments that have been. What’s your take on that? 07:01 What are one or two aspects of pathology and lab medicine’s past that you are thinking about celebrating this year? 11:56 How do you see these aspects that you’re celebrating in forming kind of the future projections of success in our field?14:18 Do you have thoughts for how we might approach this as a healthcare system--attracting bright students into medical laboratory science?17:22 Is there something that we’ve done that we shouldn’t continue, that we need to change and discontinue--a certain process or way that our laboratory works? 20:57 Outro

Timestamps:0:00 Introduction1:00 Why is it important to look at the past when planning for the future?4:30 Keeping in mind our audience, we've got laboratorians, we've got pathologists, we have other physicians from the health care team listening, what might be a good resource, or what would you recommend to be aware of these larger trends?6:50 What are one or two aspects of pathology and laboratory medicines past that you are interested in celebrating this lab week? 8:58 How do we use this professional past, and maybe these experiences with the pandemic you've been talking about knowing where we've been to inform where we're going and, learning from this, how do you see this informing this future success?11:34 Is there a favorite example in history you can think of in laboratory medicine, pathology, our community we've been successful at crossing these silos, some example that might give us inspiration for the future as we kind of go towards more of this coordination among each other? 14:31 From your vantage point and perspective, what do you wish for the future of laboratory medicine and pathology? 22:58 Outro

00:00 Intro01:02 How did you get started in magic?03:57 How does this roll into your practice as an Anatomic Pathologist? How do you see this skill translate? 06:29 What is a mentalist? 11:05 How do you approach teaching our residents and fellows about how they might think about and use magic in their practice?14:20 How can we get better at suspending that belief for our residents without getting caught up in the nitty gritty? 16:15 What would an ACGME milestone on magic in pathology look like? 26:54 OutroInterested in attending this year's Forensic Science Symposium?Click here to register: https://news.mayocliniclabs.com/edu-conferences/7th-annual-forensic-science-symposium/

00:00 Intro00:58 Why are wellness efforts a need-to-have, rather than a want-to-have?04:18 What are we learning about wellness that is important for our audience to understand?07:44 What are those first steps that our listeners can take and initiate for their own local practice, what would their initial support look like?14:23 Are there classic struggles with improving wellness that you can help our listeners navigate if there are some pearls to share in that regard?22:01 What do you think is in store for us in the future?23:52 Outro

Timestamps:00:00 Intro01:23 Why is health equity important for laboratory medicine and pathology?03:13 What are we learning about how as a laboratory we may better advocate for health equity? 05:27 What’s the nuance there that we need to grapple with, not just more testing but better testing?08:30 Are there examples of how we can do this better from other professions that we can learn from? 09:59 Is that something that you feel with your previous experience as a hematopathologist has prepared you for or are these additional skills you’ve picked up along the way?12:10 What are two or three ways that we are trying to navigate this for increasing health care equity?14:36 What kind of feedback can a pathologist provide that helps them build a better test?20:20 What does the future of health equity look like, what does that laboratory support of health equity look like in the coming years?21:27 OutroResources:The COVID pandemic: Testing and disparities: https://chs.asu.edu/diagnostics-commons/blog/covid-pandemic-testing-and-disparities To hear more on this topic from Dr. Morice, register for the 2022 Phlebotomy Conference: https://news.mayocliniclabs.com/edu-conferences/phlebotomy-2022-performance-public-health-people-in-a-post-covid-world/

Timestamps:00:00 Intro01:32 From your points of view, why do you think it’s important to start a pathology interest group?07:24 What are some important elements that you think are important for a successful interest group in your experience?11:24 Is there one or two activities that really stands out that’s been perceived as the most valuable and best experiences so far?13:18 Has there been any challenge with some faculty being able to explain or demonstrate their work, or is there any way to coach faculty during a session so they can truly show what is the work that they’re doing?19:25 Has the pandemic had an impact on how you approached the pathology interest group?23:07 What are your thoughts for how are you planning to be iterative and try next year, things that you didn’t try this year? What are ways that you’re interested in moving this forward?26:20 Outro

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Timestamps:00:00 Intro01:05 From your perspective, why is interprofessional education an important for us clinicians, lab medicine colleagues, and students?04:18 What are a few of those key lessons that you’ve learned about how to do this interprofessional education?07:15 How do you think we make it a meaningful experience for the students? 10:37 What sort of approach do you take to feedback, to get that feedback that’s really going to help you meaningfully iterate in a positive way?13:47 Do you have any advice for people out there who have difficulty with the less frequent, yet important things, how can we still keep forward movement on those?15:52 Do you have any broad thoughts about how social media may, or may not, have a role in interprofessional education?19:28 What would be a good call to action, next step for listeners to look at in the next couple of weeks?23:03 Outro

Timestamps:00:00 Intro02:00 Why is it important to respond with grace while we’re under pressure?03:36 How do you think you develop this ability to project poise when in stressful situations?05:33 Was there a mentor, situation, or experience where it gave you pause and made you think, “Wow, that’s somebody that really showed grace under pressure and leadership abilities.” Is there anybody in your life who comes to mind? 07:15 Did you find yourself having some of these mental conversations? How did that go for you? 08:36 Are those two questions (1. Does this make sense? 2. What could possibly go wrong?) that you’ve been using for a number of years, or is this something that has been more recent for you?10:57 I’m curious about how do you recognize in your own self, how do you notice when you’re getting challenged and keep it on the rails?14:28 What’s your feedback to the young professionals in our community to collect themselves in their thoughts?15:45 How do you continue to grow in your professionalism in your ability to be a more effective leader more broadly?16:29 What does that well mean to you? What does that look like?19:54 OutroResources:https://domorestories.com/profile.php?handle=jane-hata

Timestamps:00:00 Intro01:05 How did you first get interested in supporting organ transplantation? 04:53 What are the organs that we can transplant?06:00 When we are at the Department of Motor Vehicles, we can register as a donor and make our wishes known to our family, is that right?07:03 If people are interesting in donating a kidney, for example, do they reach out to their local hospital and let them know they are interested in being a donor?08:50 How does your work in the Histocompatability laboratory, how does it support transplantation? 10:57 Can you give our audience kind of a flavor of how does this work to do this kind of dance to match donor and recipient and have a successful transplant? 13:11 What’s on the horizon for HLA and histocompatibility in the next couple of years?18:30 The ability for us to identify a patient, these patients who could not get a transplant are now able to get the transplant because of these improvements in the laboratory.20:01 OutroResources: National Marrow Donor ProgramUnited Network for Organ Sharing Successful pig to human transplant articles:What the successful test of a pig-to-human kidney transplant means | Science NewsKidney Grown in Pig Successfully Transplanted Into Man (webmd.com)A pig kidney has been transplanted into a human successfully for the first time : NPRProgress in Xenotransplantation Opens Door to New Supply of Critically Needed Organs | NYU Langone NewsStartup looks to begin pig-to-human organ transplants by 2022 - Big Think

Timestamps:00:00 Intro01:24 Why does clinical context matter for what test clinicians order?08:41 What determines what kind of test to order?13:07 How does the communication happen between the lab and the clinician? How should it happen to provide best care for the patient?18:21 What do you think about for the future of ordering laboratory tests? 21:59 Outro

Timestamps:00:00 Intro00:48 What’s your origin story? How did you get interested in medical school education?06:18 What are we learning about better ways to educate? 13:42 How can faculty make it a safe environment? How can we get students to give it a try?16:25 How do you bring about and navigate curricular change?20:15 Was there something that you did that prepared you for this role? Is there some advice for people who are interested in taking a leadership role in education at their institution? 24:04 Could you share what you think the future of medical education will look like?28:33 Outro

Timestamps:00:00 Intro01:07 Why is it so challenging to ask questions in an interview?03:19 Can you go over what are a few aspects that somebody can ask about?04:41 What was your process when you made your list, that cheat sheet, the actual how we’re doing of formulating a question. What was your approach there?05:54 Are there any interesting questions you’ve gotten from applicants over the years that really stood out to you? Conversely, what are some questions that you think applicants should avoid if they are going through this process?09:41 From your perspective as an interviewer, what do you think makes for a positive experience? 13:36 How do you think applicants can navigate “red flags” and what can the interviewer do to approach these subjects empathetically?17:13 Is there a tip you want to convey to all medical students interviewing for pathology residency?19:11 Outro

Timestamps:00:00 Intro01:22 Why is it important for labs to learn from their COVID-19 experiences?05:34 Did you have any other lessons learned from this experience?8:31 How are these meetings focused on maintaining a high quality? How did you manage the rest of your workload (developing new tests, etc.)?12:51 Have some of those lessons from the experience of how those meetings were run, is there anything that you’re taking forward that you hadn’t been doing before COVID?14:43 What do you think about those relationships between the laboratory and physicians, what have you heard from your clinical colleagues about what they’ve come to appreciate or something that they’ve learned about the laboratory that they are now taking forward in their practice?18:25 Through this pandemic, what’s been your joy, how have you kept your heart full so that you can continue to work as hard as you have through this pandemic?20:47 Outro

Timestamps:00:00 Intro01:02 What are a few of the potential risks and benefits of using social media as a professional? Why should I be doing this and thinking about it?03:31 People can adjust their privacy settings on social media, so why is it important for healthcare professionals and students to behave professionally on social media? 06:08 Some might say that there are several shades of gray when it comes to professionalism. So, what do we need to understand about professionalism on social media?08:44 I understand that you have some things you’ve helped students and faculty navigate social media, can you share a few of those significant challenges with us?13:15 What are a few tips for people just getting started?17:38 What’s your view of professional use of social media?19:58 Outro

In this episode of Lab Medicine Rounds, Chris Hartley, M.D., Assistant Professor of Laboratory Medicine and Pathology at Mayo Clinic, discusses the topic of cytopathology, and what some of the challenges and advancements are.

Disclosure of relevant financial relationship: Dr. Mazepa received honoraria from Sanofi.Timestamps:00:00 Intro00:52 Why is it important for physicians to have some understanding about TTP?04:26 What’s new in this immune TTP area?08:57 If you have a new patient show up, you do caplacizumab and plasma exchange together or are there certain patient populations, like certain characteristics who would or would not get this medication? 11:29 I was wondering if you could elaborate a little bit more about these chronic complications?16:32 Do you think there is a role for repeat testing of ADAMTS13 on these patients in chronic phase, or is that an area that is unknown at this point?18:53 What do you see on the horizon, what do you think the future looks like for TTP?21:36 OutroResources:Stroke and TTP (Hopkins group led by Dr. Shruti Chaturvedi): https://ashpublications.org/blood/article/134/13/1037/374919/Reduced-ADAMTS13-activity-during-TTP-remission-isCognitive impairment in TTP:(Ohio State and London TTP group collaboration) https://ashpublications.org/blood/article/134/13/1037/374919/Reduced-ADAMTS13-activity-during-TTP-remission-is(OK Registry, Dr. James George) https://onlinelibrary.wiley.com/doi/full/10.1002/ajh.24060

Timestamps:00:00 Intro00:43 Why is it important for physicians to understand about the reversal of these direct oral anticoagulants?03:09 The complications or the bleed rate was a lot less, with these direct oral anticoagulants?03:57 Although there is less severe bleeding, there was a concern by patients and physicians about, if it is severe, what is the plan? 04:51 What have we learned new? Are we learning more about what patient population to use them in, as well as the plans to reverse them?06:10 Can you elaborate a little bit about the idea for weekly monitoring for INR, why is it a big deal? 7:44 Could you give us an example of where it wouldn’t be ideal to do home INR monitoring for a given patient?09:06 Are there updates to what the reversal plans are, and how have they changed recently?12:34 Are there still some challenges that remain for reversing these direct oral anticoagulants?19:54 What do you think the future looks like for anticoagulant reversal? 23:47 OutroResources:https://pubmed.ncbi.nlm.nih.gov/30916798/

Timestamps:00:00 Intro01:10 Why is reference laboratory testing important for physicians and laboratorians to understand?02:00 No lab does all the testing in their own laboratory. Labs can’t really have a whole panel of laboratory tests; it just doesn’t make sense, right?04:39 What have we learned in the last couple years about reference laboratories, how we can best support clinical practice?06:10 Do you have an insight for how that communication goes? 8:46 How might a hospital reach out and partner with their reference laboratory? 11:06 What does the future of reference laboratories look like? What might be in store for us?15:00 Outro Register for Leveraging the Laboratory:www.news.mayocliniclabs.com/2021levlab

Timestamps:00:00 Intro01:15 Why are external rotations in pathology important from the student perspective?03:51 Do you get to understand the particulars of a program or maybe what kind of questions you might be asking when you later interview because you do a rotation? 05:03 What is unique from an international perspective? 07:53 Can you compare and contrast the in-person pathology elective, with some of the virtual resources that are available at this point and time?11:02 Are there any additional resources that you want to point out that are available now in 2021?12:34 Can you kind of dive in and provide advice for people that are following in your shoes who might be doing later electives this year or in the near future who are looking at applying to pathology in the next cycle? 13:41 Can you dive in and elaborate on what are some of the helpful things when students get onsite for one of these rotations?17:26 Can you help us understand how you go about cultivating those relationships? 19:36 Are there any kind of parting words of wisdom that you want to leave with future applicants that are checking out this podcast episode?20:47 Outro

Timestamps:00:00 Intro00:44 With this latest outbreak of the Delta variant with COVID-19, are laboratorians still working on new innovations for COVID?02:23 Could you go into more detail, elaborate for us about this COVID-19 innovation around sequencing? 04:25 Could you help us understand a little bit on what work is being done in those areas? 07:47 Could you help our audience understand what have these conversation been like now that we’re into this pandemic this far, and the way that laboratory medicine testing is moving? I imagine you’re having more conversations with some of your Infectious Disease colleagues and you’re having more conversations with public health these days?09:35 How do you answer that question?11:18 Are there one or two COVID-related challenges that have really been running around in your mind the past week?13:25 How is the Delta variant impacting what we’re thinking about for starting school?14:38 Outro Resources:American Academy of Pediatrics

Timestamps:00:00 Intro01:05 From your perspective, why is the blood inventory important to a hospital?04:17 What have you learned about managing a hospital’s blood inventory these past 18 months or so?08:09 I was wondering if you could give us a specific example on how are they trying to bridge that gap? 08:55 Can you explain who the Dream Team is?12:34 How does PVM look different on the hospital side? How is that being worked?16:33 How might physicians, non-pathologists, help their hospital’s blood inventory? What are the practical things that is within their sphere of control that they can help?20:52 What do you hope that our learners take away from these blood shortage challenges that we’re navigating right now?23:20 Outro

Timestamps:00:00 Intro02:15 Why is it not enough for learners just to focus on the curriculum of their program?04:30 What are two or three things that learners should pay attention to during their training?07:19 Paying attention to the habits of our mentors and understanding that those habits are what is reassuring them, that is a key source for their confidence in their clinical practice. What’s another thing?09:50 Do you have a third one that we should pay attention to?12:45 How could learners take ownership for their education and get that knowledge that’s inside their mentor’s heads, into their heads? Any strategies that you recommend?19:56 What are you thinking about explicitly incorporating into your training program with residents and fellows?25:05 Outro

Timestamps:00:00 Intro01:19 Could you help us understand, why should I consider getting an ethics consult? What value could this bring to my clinical practice?07:49 What should our audience understand in order to really work better with our local med ethics team?13:58 Could you help us understand about organizational ethics? How does that compare and contrast with that hospital ethics committee that you said everybody has and are most used to turning to?22:24 What would be your recommendation for how to reach out to who is doing organizational ethics at our institution? 25:00 I was wondering if you would be willing to share one or two predictions for the future of medical ethics to open our mind up to what are the main issues and questions, and how is your field evolving? 30:35 Outro

Timestamps:00:00 Intro00:45 Why is it important to perform molecular testing on solid tumors?02:47 What is the significance of this testing for the patients and physicians?07:18 Can you share with us, what are some recent examples that have blown this door open about hereditary oncology?10:28 Can you talk a little bit about the challenge on how do we get the rapid rise in molecular knowledge and testing? What is your perspective?15:25 Can you elaborate a little bit on how you interact with your clinical colleagues on how to keep people up to date, or how to explore what’s the right thing to bring on to that test menu? 18:11 What’s your secret to leveraging those relationships?20:00 What does the future of molecular tumor testing look like?21:48 Outro

Timestamps:00:00 Intro01:11 What are frozen sections, and why are they an important part of patient care?04:50 What are some of the challenges of actually performing a frozen section diagnosis?07:03 How has frozen section changed in recent years, or over the course of practice? Has it been practiced similarly over the years, and are there differences in frozen section practice in different hospitals?14:37 Given this uptick in the complexity of cases, how do you mentor people who are trying to find their way, i.e., the students and trainees?19:14 As a practicing Pathologist, where do you solicit your feedback from, and maybe an example of how you use that feedback to get better? 24:32 Looking at the future in pathology and surgical pathology, there’s so much interest in artificial intelligence and informatics; is that thought to play a role in the future of the frozen section practice?27:51 Outro

Timestamps:00:00 Intro01:00 How does the cardiovascular laboratory support patient care?01:47 Can you tell us a bit about ceramides? What are they?04:14 When should ceramides be tested? 06:04 Can you modify someone’s ceramides such that the test can be repeated and monitored, or is it once in a lifetime because ceramides or more static?08:05 What is the controversary around ceramides? 09:52 Could you give our listeners an introduction to Lipoprotein(a)?11:45 Who should be tested for Lipoprotein(a)?13:59 How do we treat elevated Lipoprotein(a)? 17:20 How did your interests in laboratory medicine develop? How has this brought meaning for you in your career professionally? 19:23 Outro Resources:1. Ceramides and Ceramide Scores: Clinical Applications for Cardiometabolic Risk Stratification. Hilvo M, Vasile VC, Donato LJ, Hurme R, Laaksonen R. Front Endocrinol (Lausanne). 2020 Sep 29;11:570628. doi: 10.3389/fendo.2020.570628. eCollection 2020. PMID: 33133018 Free PMC article. Review. 2. Measuring the contribution of Lp(a) cholesterol towards LDL-C interpretation. Fatica EM, Meeusen JW, Vasile VC, Jaffe AS, Donato LJ. Clin Biochem. 2020 Dec;86:45-51. doi: 10.1016/j.clinbiochem.2020.09.007. Epub 2020 Sep 28. PMID: 32997972 3. Ceramides improve atherosclerotic cardiovascular disease risk assessment beyond standard risk factors. Meeusen JW, Donato LJ, Kopecky SL, Vasile VC, Jaffe AS, Laaksonen R. Clin Chim Acta. 2020 Dec;511:138-142. doi: 10.1016/j.cca.2020.10.005. Epub 2020 Oct 12. PMID: 33058843 4. Ceramide Scores Predict Cardiovascular Risk in the Community. Vasile VC, Meeusen JW, Medina Inojosa JR, Donato LJ, Scott CG, Hyun MS, Vinciguerra M, Rodeheffer RR, Lopez-Jimenez F, Jaffe AS. Arterioscler Thromb Vasc Biol. 2021 Apr;41(4):1558-1569. doi: 10.1161/ATVBAHA.120.315530. Epub 2021 Feb 18. PMID: 33596665 5. High-Sensitivity Cardiac Troponin for the Diagnosis of Patients with Acute Coronary Syndromes. Vasile VC, Jaffe AS. Curr Cardiol Rep. 2017 Aug 24;19(10):92. doi: 10.1007/s11886-017-0904-4. PMID: 28840515 Review. 6. Natriuretic Peptides and Analytical Barriers. Vasile VC, Jaffe AS. Clin Chem. 2017 Jan;63(1):50-58. doi: 10.1373/clinchem.2016.254714. Epub 2016 Oct 10. PMID: 28062611 Review. 7. Diseased skeletal muscle: a noncardiac source of increased circulating concentrations of cardiac troponin T. Jaffe AS, Vasile VC, Milone M, Saenger AK, Olson KN, Apple FS. J Am Coll Cardiol. 2011 Oct 18;58(17):1819-24. doi: 10.1016/j.jacc.2011.08.026. Epub 2011 Sep 29. PMID: 21962825 8. Elevated cardiac troponin T levels in critically ill patients with sepsis. Vasile VC, Chai HS, Abdeldayem D, Afessa B, Jaffe AS. Am J Med. 2013 Dec;126(12):1114-21. doi: 10.1016/j.amjmed.2013.06.029. Epub 2013 Sep 28. PMID: 24083646

Timestamps:00:00 Intro01:00 Can you give us the lay of the land and explain how does the cardiovascular laboratory provide patient care?03:24 Can you elaborate for us what it looks like when you have clinical chemists, cardiologists, and other professionals with different backgrounds working together?05:56 Can you talk about bringing these people into the laboratory and developing a test that provides a lot of value to patients? How is that blended and what’s the output?07:31 Talking about meetings that you guys do -- how is this meeting not some hierarchy of people who come together? How do these meetings work as an interprofessional utopia? 11:21 How do you keep your clinical colleagues educated about laboratory science?14:25 Are other laboratories adopting this leadership model?15:42 What have you learned about establishing the culture and getting them to understand what the plan is?17:59 Turning to medical laboratory scientists, what’s your pitch for why they should go into clinical chemistry? 20:12 Outro

00:00 Intro01:15 What’s your origin story? How did you become a forensic pathologist?03:53 What are some of the misconceptions about forensic pathology?06:15 Is there a big public health component to forensic pathology?07:29 Covid is a nice example on how you have partnered with public health, can you elaborate more on that? 10:15 What other types of physicians are you interacting with periodically and what are those conversations about?13:10 Do you approach autopsies differently depending on the case at hand?17:30 In what ways is the field of forensic pathology continuing to evolve and grow?20:50 Outro