Author Interviews, Heart Disease, JAMA / 28.06.2018

MedicalResearch.com Interview with: Dan Blumenthal, MD, MBA Assistant in Medicine, Division of Cardiology Massachusetts General Hospital Instructor in Medicine Harvard Medical School  MedicalResearch.com: What is the background for this study? Response: Despite dramatic advances in the treatment of cardiovascular disease (CVD) over the past half-century, CVD remains a leading cause of death and health care spending in the United States (US) and worldwide. More than 2000 Americans die of CVD each day, and more than $200 billion dollars is spent on the treatment of CVD each year in the US By 2030, over 40% of the US population is projected to have some form of CVD, at a cost of $1 trillion to the US economy. The tremendous clinical and financial burden of cardiovascular illness has helped motivated policymakers to develop policy tools that have the potential to improve health care quality and curb spending.  Alternative payment models, and specifically bundled payments—lump sum payment for defined episodes of care which typically subsume an inpatient hospitalization and some amount of post-acute care—represent a promising tool for slowing health care spending and improving health care value. Despite broad interest in implementing bundled payments to achieve these aims, our collective understanding of the effects of bundled payments on .cardiovascular disease care quality and spending, and the factors associated with success under this payment model, are limited. Medicare’s Bundled Payments of Care Improvement (BPCI) is an ongoing voluntary, national pilot program evaluating bundled payments for 48 common conditions and procedures, including several common cardiovascular conditions and interventions.   In this study, we compared hospitals that voluntarily signed up for the four most commonly subscribed cardiac bundles—those for acute myocardial infarction, congestive heart failure, coronary artery bypass graft surgery, and percutaneous coronary intervention—with surrounding control hospitals in order to gain some insight into the factors driving participation, and to assess whether the hospitals participating in these bundles were broadly representative of a diverse set of U.S. acute care hospitals.  (more…)
Author Interviews, Dermatology, Environmental Risks, Pharmacology / 28.06.2018

MedicalResearch.com Interview with: Sidsel Arnspang Pedersen MD Department of Public Health, Clinical Pharmacology and Pharmacy Anton Pottegård PhD Associate professor, Clinical Pharmacy Odense University Hospital University of Southern Denmark, The following is based on results from three published papers in JAAD and JAMA Internal Medicine. (1–3)   MedicalResearch.com: What is the background for this study? Response: Hydrochlorothiazide is one of the most frequently used diuretic and antihypertensive drugs in the United States and Western Europe. The drug is known to be photosensitizing and has previously been linked to lip cancer.4–6 Based on these previous findings, the International Agency for Research on Cancer (IARC) has classified hydrochlorothiazide as ‘possibly carcinogenic to humans’ (class 2B). This prompted us to investigate whether use of hydrochlorothiazide was associated to other UV dependent skin cancers, including non-melanoma skin cancer (i.e. basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)), cutaneous melanoma, as well as the more rare non-melanoma skin cancers Merkel cell carcinoma and malignant adnexal skin tumours. (more…)
Asthma, AstraZeneca, Author Interviews, Immunotherapy, Lancet, Pulmonary Disease / 27.06.2018

MedicalResearch.com Interview with: Reynold A. Panettieri, Jr., M.D. Professor of Medicine, Robert Wood Johnson Medical School Vice Chancellor, Clinical & Translational Science Director, Rutgers Institute for Translational Medicine & Science Emeritus Professor of Medicine, University of Pennsylvania Child Health Institute of New Jersey Rutgers, The State University of New Jersey New Brunswick, NJ  08901 MedicalResearch.com: What is the background for this study? Response: Severe asthma is characterized by Type 2 inflammation manifested by increases in IL-13, IL-4 and Il-5 levels in the airways that promotes airway hyperresponsiveness and in part irreversible airway obstruction.  These clinical manifestations profoundly increase asthma morbidity and mortality. To address an unmet therapeutic need, Tralokinumab was developed as a monoclonal antibody targeting soluble IL-13 with the goal of improving lung function and patient reported outcomes while decreasing annual exacerbation rates.  Stratus 1 and 2 represent two identical randomized, double-blind, placebo-controlled, phase 3 clinical trials in severe asthma.  These international trials enrolled approximately 2000 subjects with severe asthma and examined whether Tralokinumab decreased annualized exacerbation rates (AER) as compared with placebo (primary outcome). (more…)
Accidents & Violence, Author Interviews, Emergency Care, Pediatrics / 27.06.2018

MedicalResearch.com Interview with: “Bikes” by Britta Frahm is licensed under CC BY 2.0Lara McKenzie, PhD Principal investigator in the Center for Injury Research and Polic Nationwide Children’s Hospital. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bicycling is a great way for families to get outside and be active together, but certain precautions need to be taken to keep everyone safer. This study looked at bicycle-related injuries among children age 5-17 years treated in hospital emergency departments in the United States from 2006 through 2015 and found that, despite a decrease in the rate of injuries over the 10-year study period, there were still more than 2.2 million injuries. This averages 608 cases per day or 25 every hour. The majority of injuries involved children 10 to 14 years of age (46%) and boys (72%). The most commonly injured body region was the upper extremities (36%), followed by the lower extremities (25%), face (15%), and head and neck (15%). The most common types of injury were bruises and scrapes (29%) and cuts (23%). Overall, traumatic brain injuries (TBIs) represented 11% of total injuries and were most common among patients 10-14 years of age (44%). About 4% of patients were hospitalized. Injuries most frequently occurred in the street (48%) or at home (37%). Helmet use at the time of injury was associated with a lower likelihood of head and neck injuries and hospitalizations, but there was no significant change in the rate of injury among helmet users over the study period. Motor vehicle involvement increased the odds of bicycle-related TBIs and injury-related hospitalizations.  (more…)
Author Interviews, Opiods, University of Pittsburgh / 27.06.2018

MedicalResearch.com Interview with: Jeanine M. Buchanich, Ph.D. Research associate Professor in the University of Pittsburgh Graduate School of Public Health’s Department of Biostatistics MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the U.S., cause of death codes are assigned by the National Center for Health Statistics (NCHS) using information reported by the coroner or medical examiner completing the death certificate. Drug-specific overdose deaths are identified by the contributory causes of death, which are categorized as “T codes” and are assigned based on the specific drugs recorded by the coroner or medical examiner completing the death certificate. A code of T50.9 means “other and unspecified drugs, medicaments and biological substances.” My colleagues and I extracted death data by state for 1999 through 2015 from the NCHS’s Mortality Multiple Cause Micro-data Files. We grouped overdose deaths into opioid-related, non-opioid-related and unspecified codes. In five states – Alabama, Indiana, Louisiana, Mississippi and Pennsylvania – more than 35 percent of the overdose deaths were coded as unspecified. We then calculated the change in percentage of overdose deaths that fell into each category from 1999 to 2015 by state. In those 17 years, opioid-related overdose deaths rose 401 percent, non-opioid-related overdose deaths rose 150 percent and unspecified overdose deaths rose 220 percent. This allowed us to extrapolate how many of the unspecified overdose deaths were likely opioid-related. By our calculations, potentially 70,000 opioid-related overdose deaths were not included in national opioid-related mortality estimates since 1999 because coroners and medical examiners did not specify the drug that contributed to the cause of death when completing the death certificates.  (more…)
Author Interviews, Diabetes, Infections / 27.06.2018

MedicalResearch.com Interview with: Sandrine Levet PhD Preclinical Study Manager GeNeuro MedicalResearch.com: What is the background for this study? Response: Human endogenous retroviruses (HERVs), remnants of ancestral viral genomic insertions, are known to represent 8% of the human genome and are associated with several pathologies. In particular, the envelope protein of HERV-W family (HERV-W Env) has been involved in multiple sclerosis pathogenesis. A previous study published in JCI Insight revealed that HERV-W Env is also involved in Type 1 diabetes (T1D) pathogenesis. In this study, we observed that HERV-W-Env protein and RNA are detected respectively in sera and peripheral blood mononuclear cell (PBMC) of T1D patients. We also demonstrated that this pathogenic protein is expressed by acinar cells in human T1D pancreas and is associated with the recruitment of macrophages within the pancreas of these patients. HERV-W Env also displays direct pathogenic properties as it inhibits insulin secretion by human islets of Langerhans. (more…)
Author Interviews, Dermatology, JAMA, Nutrition, UCLA / 27.06.2018

MedicalResearch.com Interview with: Adam Ford, BS Research fellow with Dr. April Armstrong Keck School of Medicine University of Southern California MedicalResearch.com: What is the background for this study? Response: Our psoriasis patients have long asked us about the role of diet on psoriasis. Previously, there was a lack of evidence synthesis on the relationship between psoriasis and diet. As such, providers were mostly unable to address their patients questions on the role of diet on psoriasis. This pivotal effort from the National Psoriasis Foundation has been a few years in the making. We looked at the role of diet on psoriasis and psoriatic arthritis based on a careful synthesis of the scientific studies available to us currently. (more…)
Author Interviews, Opiods, Pediatrics, Pediatrics / 27.06.2018

MedicalResearch.com Interview with: Gary A. Smith, MD, DrPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH MedicalResearch.com: What is the background for this study? Response: Buprenorphine is a prescription opioid medication commonly used to treat opioid use disorder. From 2005 to 2010, the annual number of individual patients who received a buprenorphine prescription increased from 100,000 to more than 800,000. Although buprenorphine is important for the treatment of opioid use disorder, pediatric exposure to this medication can result in serious adverse outcomes. (more…)
Author Interviews, Melanoma / 26.06.2018

MedicalResearch.com Interview with: Eugene R. Semenov, MD, MA Washington University School of Medicine MedicalResearch.com: What is the background for this study? Response: Melanoma is an aggressive type of skin cancer which has traditionally carried a poor prognosis. Over the past decade, many new therapies have become available that have improved long-term survival rates in patients with metastatic melanoma. However, these drugs have been associated with serious side effects, such as pancreatitis and hepatitis. Our goal was to study how melanoma diagnosis, disease stage, and treatment status impact patient quality of life (QoL). (more…)
Addiction, Author Interviews, Opiods, Race/Ethnic Diversity / 26.06.2018

MedicalResearch.com Interview with: Bradley D. Stein MD PhD Senior Physician Policy Researcher Pittsburgh Office Rand Corporation MedicalResearch.com: What is the background for this study? Response: Increasing use of medication treatment for individuals with opioid use disorders, with medications like methadone and buprenorphine, is a critical piece of the nation’s response to the opioid crisis. Buprenorphine was approved by the FDA in 2002 for treatment of opioid use disorders, but there was little information about to what extent buprenrophine’s approval increased the number of Medicaid-enrollees who received medication treatment in the years following FDA approval nor to what extent receipt of such treatment was equitable across communities. (more…)
Author Interviews, Brain Cancer - Brain Tumors, Cancer Research, Duke, Immunotherapy, NEJM, Vaccine Studies / 26.06.2018

MedicalResearch.com Interview with: Annick Desjardins, M.D., F.R.C.P.C. Associate Professor of Neurology Associate Professor of Neurosurgery Director of Clinical Research The Preston Robert Tisch Brain Tumor Center at Duke Duke University School of Medicine Durham, NC 27710 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The poliovirus receptor (CD155) is an onco-fetal cell adhesion molecule with widespread expression in all solid tumors and particularly in primary CNS tumors (adult and pediatric). Recombinant nonpathogenic polio–rhinovirus chimera (PVSRIPO) was generated by replacing a critical piece of the genetic information from the Sabin type 1 polio vaccine, making PVSRIPO incapable of harming or killing normal brain cells, but toxic/lethal in cancer cells. In preclinical models, it has been demonstrated that the infection of tumor cells, leads to the release of danger signals, which triggers a recruitment of dendritic/CD4/CD8 T cells and a destruction of tumor cells by anti-tumor T cells. The manuscript reports the results of the phase 1 trial of PVSRSIPO in recurrent WHO grade IV malignant glioma patients. Adult patients with recurrence of a single glioblastoma lesion, 1-5.5cm in dimension, in a non-eloquent area of the brain, were enrolled on study. PVSRIPO is injected slowly over 6.5 hours directly into the tumor via a small catheter inserted via a small bur hole. Once intratumoral injection is completed, the catheter is removed and patients are observed for localized tumor inflammation, followed by tumor contraction. A total of 61 patients were treated on study, 9 patients in a dose escalation phase and 52 in a dose expansion phase. Side effects observed were in relation to the localized inflammation of the tumor and depending on the cerebral functions in close proximity to the tumor: headaches, visual field changes, hemiparesis, etc. One patient experienced a brain hemorrhage at the time of catheter removal, which triggered right sided weakness and aphasia. The patient remained alive 57.5 months after PVSRIPO infusion at data cutoff of March 20th, 2018. Two on-study death were observed, a patient died from cerebral edema and seizures, which was later found to be due to tumor progression, and one patient died from the complications of an intracranial hemorrhage while receiving anticoagulation and bevacizumab. The median overall survival among all 61 patients who received PVSRIPO was 12.5 months (95% CI, 9.9 to 15.2), comparatively to 11.3 months (95% CI, 9.8 to 12.5) in a historical control group of patients treated at Duke and who would have met eligibility on trial, would have the trial been available to them. At 24 months, the survival plateaued in patients treated with PVSRIPO with an overall survival rate of 21% (95% CI, 11 to 33) at 24 months and 36 months in PVSRIPO treated patients, while overall survival in the historical control group continued to decline, with an overall survival rates of 14% (95% CI, 8 to 21) at 24 months and 4% (95% CI, 1 to 9) at 36 months in the historical control group.  (more…)
Author Interviews, CDC, HIV, University of Michigan / 26.06.2018

MedicalResearch.com Interview with: Rogério M. Pinto, LCSW, Ph.D. Associate Professor Associate Dean for Research School of Social Work University of Michigan Ann Arbor, Michigan MedicalResearch.com: What is the background for this study? Response: This research, published in Health Education & Behavior (https://doi.org/10.1177/1090198118760681),highlights the crucial role of providers of social and public health services in helping patients to access lifesaving HIV services. Before 2012, providers were encouraged and trained to link patients to behavioral interventions to help patients modify their behaviors to protect themselves against HIV transmission and infection. A shift in policy from targeting anyone at risk to those at highest risk (called “High Impact Prevention”) made these interventions less available (they were actually discontinued) and new policy dictated that providers should have as many people as possible access HIV testing and link them to HIV primary care in order to receive antiretroviral medication. (more…)
Author Interviews, Diabetes, NEJM / 26.06.2018

MedicalResearch.com Interview with: Roman Hovorka PhD FMedSci Director of Research University of Cambridge Metabolic Research Laboratories Wellcome Trust-MRC Institute of Metabolic Science Addenbrooke’s Hospital Cambridge MedicalResearch.com: What is the background for this study? What are the main findings? Response: Inpatient diabetes is generally not managed well when patients are admitted for a range of health issues on the general ward. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, JAMA / 26.06.2018

MedicalResearch.com Interview with: Bishal Gyawali, MD, PhD Department of Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: PD-1 inhibitors are an interesting class of cancer drugs with atypical response patterns in clinical trials. There is a lot of debate over cancer drugs that improve progression-free survival (PFS) – a surrogate measure of clinical benefit– without affecting patients’ overall survival (OS), but in some studies, PD-1 inhibitors appears to improve overall survival (OS) without affecting PFS. We therefore conducted a systematic review and meta-analysis of randomized trials of PD-1 inhibitors (nivolumab and pembrolizumab) to assess the effect of these drugs on OS versus PFS. We showed that PD-1 inhibitors do appear to improve OS more than PFS.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Health Care Systems, JAMA / 26.06.2018

MedicalResearch.com Interview with: A Jay Holmgren Doctoral Student, Health Policy and Management Harvard Business School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Post-acute care, care that is delivered following an acute care hospitalization, is one of the largest drivers of variation in US health care spending. To address this, Medicare has created several payment reform systems targeting post-acute care, including a voluntary bundled payment program known as the Model 3 of the Bundled Payment for Care Improvement (BPCI) Initiative for post-acute care providers such as skilled nursing facilities, long-term care hospitals, or inpatient rehabilitation facilities. Participants are given a target price for an episode of care which is then reconciled against actual spending; providers who spend under the target price retain some of the savings, while those who spend more must reimburse Medicare for some of the difference. Our study sought to evaluate the level of participation in this program and identify what providers were more likely to participate. We found that fewer than 4% of eligible post-acute care providers ever participated in the program, and over 40% of those who did participate dropped out. The providers more likely to remain in the program were skilled nursing facilities that were higher quality, for-profit, and were part of a multi-facility organization. (more…)
Author Interviews, Diabetes, Weight Research / 25.06.2018

MedicalResearch.com Interview with: Dr. Amy Rothberg MD PhD Associate Professor, Endocrinology and Medicine Michigan Medicine Metabolism, Endocrinology and Diabetes Clinic University of Michigan  MedicalResearch.com: What is the background for this study? Would you briefly outline the essentials of the Optifast plan? Response: OPTIWIN is a year-long, multi-center, open-label, randomized, head-to-head study. It was designed to evaluate the effectiveness of the medically-monitored, meal replacement OPTIFAST Program on weight loss and maintenance, in comparison with a standard-of-care, food-based diet among adults with a BMI higher than 30 kg/m2. Nestlé Health Science’s OPTIFAST Program combines proven essential features of weight loss success ‒ medical monitoring, nutrition education, exercise guidance, in-person support, full meal replacement and behavior modification. With OPTIFAST meal replacement products, the program gives patients the prescribed amount of calories and micronutrients each day. It is a non-surgical option designed for people with a Body Mass Index (BMI) greater than 30, and is available in more than 400 weight loss clinics nationwide. The Program is comprised of three core phases ‒ active weight loss (during which total diet replacement is used), transition to self-prepared ‘everyday’ meals and maintenance. Clinical supervision is a key component of the program as it helps assess progress towards better health and emotional well-being. (more…)
Aging, Author Interviews, Social Issues / 25.06.2018

MedicalResearch.com Interview with: Bryan D. James, PhD Assistant Professor Rush Alzheimer's Disease Center Chicago, IL 60612 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is part of a larger body of research examining how literacy and decision making abilities in different areas of life can affect the health and well-being of older adults. The main finding of this study is that a better ability to understand and utilize financial concepts was related to a lower risk of hospitalization in old age. Additionally, research conducted from financial services firm Sambla, Norway's largest bank and lender for medical loans, found that doctors and pharmacists are among Scandinavia's financial services most financially savvy, often saving for retirement 5-7 years before others working in the medical field. Over almost 2 years of follow-up, 30 percent of the 388 older men and women in this study were hospitalized at least once. A 4-point higher score on the scale of financial literacy, representing one standard deviation, was associated with about a 35 percent lower risk of hospitalization. This was after adjusting for a number of factors including physical and mental health indicators and income. The association appeared to be stronger for knowledge of financial concepts such as stocks and bonds, as opposed to the ability to perform numerical calculations. Additionally, the association was stronger for elective hospital admissions as opposed to emergency or urgent hospitalizations; this may support the notion that financial literacy is related to medical decision-making surrounding the decision to be hospitalized, such as which procedures are covered by Medicare. (more…)
Author Interviews, JAMA, Opiods, University of Pittsburgh / 25.06.2018

MedicalResearch.com Interview with: Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh, PA 15261 MedicalResearch.com: What is the background for this study? Response: Prior research has found that taking opioids and benzodiazepines simultaneously increases the risk of overdose by 2 to 3 fold, when compared to opioid-use only. However, prior to our study, it was unclear how the risk of overdose changes over time with the concurrent use of opioids and benzodiazepines. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Neurology / 25.06.2018

MedicalResearch.com Interview with: Paul Foster BMedSci(Hons) BMBS PhD FRCS(Ed) FRCOphth FRCS(Eng) Professor of Glaucoma Studies & Ophthalmic Epidemiology Research Theme Lead Integrative Epidemiology & Visual Function UCL Institute of Ophthalmology & Moorfields Eye Hospital London  MedicalResearch.com: What is the background for this study?  Response:  Dementia is the medical challenge of the moment – increasingly common, adversely impacting quality of life for millions, and a great worry for all. Efforts to identify treatments or interventions rely on being able to identify those people at greatest risk. Our motivation was to help identify those people, primarily to aid in the development of treatments through clinical trials. (more…)
Author Interviews, Heart Disease, JAMA / 25.06.2018

MedicalResearch.com Interview with: Dr. Michael Barry MD Director of the Informed Medical Decisions Program Health Decision Sciences Center at Massachusetts General Hospital Physician at Massachusetts General Hospit Professor of Medicine,Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cardiovascular disease (CVD), which can lead to heart attack and stroke, causes 1 in 3 deaths among adults in the United States. The Task Force reviewed the latest research on whether adding an electrocardiogram—or ECG, which is a test that records a person's heart activity—to the standard ways we measure CVD risk can help prevent heart attack and stroke in people who do not have symptoms and are generally healthy, as well as people who are already at risk for these conditions. The evidence shows that adding screening with ECG to the ways we already measure CVD risk is unlikely to help prevent heart attack or stroke in people at low risk. It can also cause harms—such as those from follow-on procedures like angiography and angioplasty, which can lead to heart attack, kidney failure, and even death. As a result, the Task Force recommends against screening with ECG for this group. For those who might benefit the most—people who are already at medium or high risk of CVD—there is not enough evidence to say whether or not adding screening with an ECG to standard care helps prevent heart attack and stroke. This is an area where we need more research.  (more…)
AstraZeneca, Author Interviews, Diabetes / 24.06.2018

MedicalResearch.com Interview with: Chantal Mathieu, MD, PhD Professor of Medicine Clinical and Experimental Endocrinology Catholic University of Leuven, Belgium MedicalResearch.com: What is the background for this study? Response: People with type 1 diabetes (T1D) are confronted often with the inability to achieve satisfactory glycemic control, being good HbA1c, but in particular stable glycemic control, avoiding hyperglycemic events, but also hypoglycemic events, despite novel insulins and novel technologies. Moreover, intensive insulin therapy is often associated with weight gain, leading to an increase in overweight and obesity also in people with T1D. All of these issues affect quality of life. In the DEPICT 2 study we examined the impact of adding a selective SGLT2 inhibitor, dapagliflozin (two doses tested – 5 and 10mg) in a double blinded manner versus placebo to background insulin (MDI or CSII) in people with T1D reaching insufficient glycemic control (HbA1c 7.5-10.5%). Primary endpoint was lowering in HbA1c at 24 weeks and secondary endpoints included insulin dose reduction and weight reduction as well as a composite endpoint of having a HbA1c drop of >=0.5% without severe hypoglycemia. The study ran internationally, with about 1/3 of patients coming from North America, 1/3 from Europe and 1/5 from Asia (Japan). (more…)
Author Interviews, Environmental Risks / 24.06.2018

MedicalResearch.com Interview with: Dr Jianhua Guo PhD ARC Future Fellow, Senior Research Fellow Advanced Water Management Centre University of Queensland Brisbane Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: It was found that wastewater from residential areas has similar or even higher levels of antibiotic resistant bacteria and antibiotic resistance genes compared to hospitals, where you would expect greater antibiotic concentrations. Thus, we wonder whether non-antibiotic chemicals such as triclosan can directly induce antibiotic resistance, because triclosan could be ubiquitously detected in various water environments, like wastewater. We found triclosan found in personal care products that we use daily could directly induce multi-drug resistance through mutation. The discovery should be a wake-up call to re-evaluate the potential impact of non-antibiotic chemicals on the dissemination of antibiotic resistance. (more…)
Author Interviews, Blood Pressure - Hypertension, Salt-Sodium / 23.06.2018

MedicalResearch.com Interview with: Salt-SodiumDr. Feng J He PhD Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London MedicalResearch.com: What is the background for this study? Response: Studies have shown that there is a strong linear relationship between sodium intake and blood pressure and raised blood pressure is a leading cause of death and disability worldwide. The current mean population sodium intake among adults in most countries is approximately 4,000 mg/d (10 g/d salt). The World Health Organisation (WHO) has recommended a 30% reduction in sodium intake by 2025 with an eventual target of less than 2,000 mg/d (5 g/d salt) for all countries. Several recent cohort studies have challenged the WHO’s recommendations, as these studies suggested that there was a J or U-shaped relationship between sodium and risk, i.e. lower and higher sodium intake both were associated with an increased risk of cardiovascular events and deaths. However, these studies have several severe methodological problems, one of which is the use of a biased or unreliable estimate of individual’s usual sodium intake, e.g. a single spot urine with the Kawasaki formula. Our study, for the first time, has compared the relationship of sodium intake and mortality, based on various methods to assess usual sodium intake, including estimates based on the Kawasaki formula (single and average of multiple days) and a single measured 24-hour urine, with the gold standard method, i.e. the average of multiple non-consecutive measured 24-h urines. (more…)
Author Interviews, OBGYNE, Pediatrics / 23.06.2018

MedicalResearch.com Interview with: Melissa Lorenzo MD Pediatric medical resident Dr. Lorenzo is currently training at the University of Toronto, however the research was conducted while a medical student at Queens University MedicalResearch.com: What is the background for this study? Response: Preterm infants are born before 37 weeks gestation, with late preterm neonates defined as infants born between 34 weeks to 37 weeks gestation. Of all preterm births, over 70% of babies are born in the late preterm period. Late preterm births are common, affecting 12.5% of all births in the United States. Compared to infants born at term, late preterm neonates are at increased risk for many common complications following birth such as jaundice, low blood sugar, and respiratory distress, prolong hospital stay, admission to the neonatal intensive care unit, and increase readmission rate after hospital discharge. There are many causes for preterm delivery- two important ones are early onset of labour either spontaneous or after premature rupture of membranes, and medically indicated delivery prior to full term gestation due to chronic diseases in mother affecting her health in pregnancy, fetal medical reasons, or placental insufficiency. There is a debate that the risk of neonatal complications is affected by the causes of preterm delivery with immaturity acting as a contributing factor. The relative contribution of immaturity versus the reason for delivery and the resulting neonatal complications is unclear. (more…)
Author Interviews, Education, Social Issues / 23.06.2018

MedicalResearch.com Interview with: “siblings” by Britt Reints is licensed under CC BY 2.0Xiaoran Sun Department of Human Development and Family Studies The Pennsylvania State University University Park, PA 16802.   MedicalResearch.com: What is the background for this study? Response: College graduation has significant implications for adult life outcomes including for employment, family formation, and health (IOM & NRC, 2015). Investigating how sibling differences in college graduation emerge sheds light on why children growing up in the same family sometimes follow diverging paths in adulthood. Our study also responds to the call by researchers interested in policy and practice to conduct longitudinal research investigating the role of early family socialization processes in educational attainment (Pettit, Davis-Kean, & Magnuson, 2009). Despite siblings’ important role in child and adolescent development, previous research has focused on parenting and on the academic outcomes of individual children in the family. Further, although sibling experiences, including their relationship characteristics and parental differential treatment, have been linked to sibling similarities and differences in domains such as risky behaviors (Slomkowski, Rende, Novak, Lloyd-Richardson, & Raymond, 2005), to date, there has been very little research on the role of sibling experiences in positive development, such as academic achievement.   (more…)
Author Interviews, Heart Disease, Technology / 22.06.2018

MedicalResearch.com Interview with: Kenichi Takahata, Ph.D., P.Eng. Associate Professor Department of Electrical & Computer Engineering Faculty of Applied Science University of British Columbia Vancouver, B.C., Canada MedicalResearch.com: What is the background for this technology and study?  Response: Cardiovascular disease (CVD) is the number one cause of mortality globally. One of the most common and proven treatments for CVD is stenting. Millions of stents are implanted annually worldwide. However, the most common complication called in-stent restenosis, re-narrowing of stented arteries, still poses a significant risk to patients. To address the current lack of diagnostic technology to detect restenosis at its early stage, we are developing “smart” stents equipped with microscale sensors and wireless interface to enable continuous monitoring of restenosis through the implanted stent. This electrically active stent functions as a radio-frequency wireless pressure transducer to track local hemodynamic changes upon a re-narrowing condition. We have reported a new smart stent that has been engineered to fulfill clinical needs for the implant, including its applicability to current stenting procedure and tools, while offering self-sensing and wireless communication functions upon implantation. The stent here has been designed to function not only as a typical mechanical scaffold but also as an electrical inductor or antenna. To construct the device, the custom-designed implantable capacitive pressure sensor chip, which we developed using medical-grade stainless steel, are laser-microwelded on the inductive antenna stent, or “stentenna”, made of the same alloy. This forms a resonant circuit with the stentenna, whose resonant frequency represents the local blood pressure applied to the device and can be wirelessly interrogated using an external antenna placed on the skin. (more…)
ASCO, Author Interviews, Cancer Research, Technology / 22.06.2018

MedicalResearch.com Interview with: Alexandra Urman, MPH Clinical Research Manager Clinical Development IBM Watson Health  MedicalResearch.com: What is the background for this study?  Response: Cancer statistics show only 3-5% of cancer patients participate in clinical trials although up to 20% may be eligible. Dr. Tufia Hadad, a medical Oncologist at the Mayo Clinic in Rochester, Minnesota sought to address this issue and spearheaded a project conducted at the Rochester facility in collaboration with IBM Watson Health. The objective was to determine if the use of cognitive computing increased clinical trial enrollment and screening efficiency in the breast cancer clinic. Watson for Clinical Trial Matching (CTM) is a cognitive system which utilizes natural language processing to derive patient and tumor attributes from unstructured text in the electronic health record that can be further used to match a patient to complex eligibility criteria in trial protocols. (more…)
Author Interviews, Breast Cancer, Cancer Research, PLoS, Vitamin D / 22.06.2018

MedicalResearch.com Interview with: Cedric F. Garland, Dr.P.H., F.A.C.E. Adjunct Professor Division of Epidemiology Department of Family Medicine and Public Health University of California San Diego La Jolla, California 92093-0620 MedicalResearch.com: What is the background for this study? Response: Studies mapping death rates from female breast cancer in the US, the former USSR and Canada by Drs. Edward Gorham, and Frank and Cedric Garland revealed for the first time in history that death rates from breast cancer tracked latitude where people lived. The rates were highest in the least sunny northern tier of states, lowest in the sunny southwest. This led these scientists to be the first to theorize that vitamin D prevents breast cancer” said study first author Sharon McDonnell. (more…)