University of California San Francisco

Laura Barnes

Laura Barnes
Why Was I interested in this T32?
I was interested in the T32 grant because I was excited to work with mentors across a range of backgrounds to broaden the way I approach clinical problems. The specific clinical problem I am working on requires collaboration across several specialties that work and think in very different ways, so developing a framework for thinking about the problem from various perspectives was essential. Having mentors from the translational, regulatory, and health sciences realms was a perfect place to start, and from the get-go, these mentors helped me foresee potential issues, potential solutions, and the possibilities for broad impact from my project.
 
What did I work on in my T32 research project?

My project, entitled, “Microbiome and association with implant infections: investigating the impact of antibiotics on the gut and breast microbiomes post-mastectomy with implant-based breast reconstruction,” aims to identify whether a patient’s gut and breast microbiomes are related, whether certain characteristics of these microenvironments are protective or disadvantageous with respect to the development of implant infections, and how antibiotics shift these microenvironments (for better or worse).

This project is a pilot feasibility study, in which we aim to enroll 40 patients who undergo mastectomy with tissue expander placement. 20 patients are randomized to receive 24 hours of perioperative antibiotics, and 20 are randomized to receive 7 days of post-operative antibiotics. It involves a novel technique in sampling the breast microbiome, in which we take peri-tissue expander aspirates. We have validated the feasibility of collecting and sequencing these samples and are in the process of submitting this work as an "Ideas and Innovations" publication. We are excited to complete our pilot study and very curious to see the results from our samples.

Important lessons I learned from the T32 program and the I2I Leadership course

Clinical research: 
I learned that it's often quite challenging to enroll patients in a randomized-controlled trial. Even when the current body of literature is clearly undecided on a standard-of-care (for example, the appropriate duration of antibiotics after mastectomy with tissue expander placement), patients may prefer to just have what the practice has always been doing. I am excited about a new study amendment we are making, which is to allow patients to choose whether to be randomized, or instead to opt for one arm or the other. I think this could be a very interesting solution to increase enrollment rates.

Leadership: 
I learned that it often takes leadership skills and strategy to get various members of your team excited about collaborating on a project. Our Idea To Impact (I2I) course provided formal instruction on leadership skills, which I put into practice in real time. One key thing I worked on (and continue to work on) is tolerating conflict. I have realized that you often have to have somewhat uncomfortable conversations in order to implement a project and make real changes to a situation or environment. I realized that if I approached those known conflicts by being prepared and understanding the wide range of perspectives and counterarguments, conflict can actually be very constructive.