Author Interviews, Dermatology, JAMA / 30.05.2018

MedicalResearch.com Interview with: [caption id="attachment_42016" align="alignleft" width="180"]Andrew Blauvelt, M.D., M.B.A. President Oregon Medical Research Center  Dr. Blauvelt[/caption] Andrew Blauvelt, M.D., M.B.A. President Oregon Medical Research Center  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This new paper focuses on treatment of psoriasis in classically difficult-to-treat areas of the body, which include the scalp, the palms/soles, and the fingernails. We show that guselkumab, which is a new biologic therapy that selectively targets IL-23 (a key pro-inflammatory cytokine in psoriasis pathogenesis), works well in these areas affected by psoriasis. More specifically, after 6 months of treatment with guselkumab, approximately 85%, 80%, and 60% of patients achieved complete or near complete clearance of psoriasis in their scalp, palms/soles, and fingernails, respectively. 
Author Interviews, Columbia, OBGYNE, Toxin Research / 29.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41811" align="alignleft" width="165"]Marianthi-Anna Kioumourtzoglou ScD Assistant Professor Environmental Health Sciences Mailman School of Public Health Columbia University  Dr. Kioumourtzoglou[/caption] Marianthi-Anna Kioumourtzoglou ScD Assistant Professor Environmental Health Sciences Mailman School of Public Health Columbia University  MedicalResearch.com: What is the background for this study? Response: The prevalence of neurodevelopmental disorders, like attention deficit/hyperactivity disorder (ADHD) has been increasing. One of the hypothesized risk factors for increased risk for neurodevelopmental disorders is a class of chemicals known as endocrine disrupting chemicals (EDCs). These chemicals are known to interfere with the endocrine system, i.e. the system that uses hormones to control and coordinate metabolism, reproduction and development. Several high production volume chemicals, ubiquitously present in commercial products, are known or suspected endocrine disruptors. Because of their widespread use in consumer products, the population-wide exposure to known and suspected EDCs is very high. Recently, there has been increased attention in the potential effects of EDCs on neurodevelopment that span multiple generations. Animal studies have provided evidence that exposure to EDCs, such as phthalates and bisphenol A (BPA), alter the behavior and social interactions in mice in three to five generations after exposure. However, evidence of such multi-generational impacts of EDC exposure on neurodevelopment in humans is unavailable, likely because of the lack of detailed information on exposures and outcomes across generations. For this study we leveraged information from a nationwide cohort, the Nurses’ Health Study II (NHSII), to investigate the potential link between exposure to diethylstilbestrol (DES) and third generation ADHD, i.e. ADHD among the grandchildren of the women who used DES while pregnant. DES is a very potent endocrine disruptor that was prescribed between 1938 and 1971 to pregnant women thought to prevent pregnancy complications. In the United States, between 5 and 10 million women are estimated to have used DES, although the exact number is not known. DES was banned in 1971, when was linked to vaginal adenocarcinomas (a rare cancer of the reproductive system) in the daughters of the women who had used it during pregnancy. Since then, DES has been also linked to multiple other reproductive outcomes in DES daughters, as well as with some reproductive outcomes in the grandchildren of the women who used it, such as hypospadias and delated menstrual regularization. However, to our knowledge, no study to date has evaluated the association between DES, or any other EDC, and multigenerational neurodevelopment.
Author Interviews, Connective Tissue Disease, Pulmonary Disease / 29.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41845" align="alignleft" width="125"]Pierre Laurin, CEO Prometic Pierre Laurin[/caption] Pierre Laurin, CEO Prometic Life Sciences MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by idiopathic pulmonary fibrosis? Response: Idiopathic pulmonary fibrosis (IPF) is a chronic, devastating, and ultimately fatal disease characterized by a progressive decline in lung function. It is a specific type of interstitial lung disease in which the small air sacs of the lung, the “alveoli,” gradually become replaced by fibrotic (scar) tissue and is the cause of worsening dyspnea (shortness of breath). The 5-year mortality rate for patients with IPF is estimated to range from 50% to 70%. Small molecule candidate PBI-4050’s anti-fibrotic activity has been observed in various fibrosis models in different organs: lung, kidney, heart, liver, and pancreas. PBI-4050 has been shown to improve forced vital capacity (FVC) in an open-label Phase 2 study in IPF. The main objective of this exploratory study was to determine whether treatment with PBI-4050 alters the level of key biomarkers in patients with IPF. Subjects with a confirmed diagnosis of IPF received daily oral doses of 800 mg PBI-4050 with or without nintedanib or pirfenidone for 12 weeks. The biomarkers chosen for measurement can be divided into two main groups: cytokines and matrix metalloproteinases associated with fibrosis and inflammation.
Author Interviews, Pulmonary Disease / 29.05.2018

MedicalResearch.com Interview with: [caption id="attachment_42008" align="alignleft" width="149"]Kenneth R. Chapman, MD MSc FRCPC FACP FCCP, FERS Director, Asthma & Airway Centre, University Health Network, Professor of Medicine, University of Toronto, GSK-CIHR Research Chair in Respiratory Health Care Delivery, Toronto, Ontario Dr. Chapman[/caption] Kenneth R. Chapman, MD MSc FRCPC FACP FCCP, FERS Director, Asthma & Airway Centre, University Health Network, Professor of Medicine, University of Toronto, GSK-CIHR Research Chair in Respiratory Health Care Delivery, Toronto, Ontario MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Guidelines regard inhaled bronchodilators as foundational pharmacotherapy in COPD while inhaled corticosteroids are to be used sparingly.  Inhaled corticosteroids are used to reduce exacerbation tendency but come with the added risk of pneumonia, osteoporosis and other corticosteroid related adverse effects.  Although only a minority of COPD patients are exacerbation prone, many patients with COPD are treated unnecessarily with inhaled corticosteroids alongside long-acting anticholinergic and beta2 agonist bronchodilators - so-called "triple therapy".  In patients who have minimal exacerbation histories, inhaled corticosteroid withdrawal is suggested to reduce side-effects. Although studies have suggested this is a reasonable strategy, study limitations have been noted.  The best known inhaled corticosteroid withdrawal study, the WISDOM trial, recruited only 39% of patients using triple therapy regularly before inhaled corticosteroid withdrawal; the remainder were placed on triple therapy solely for the purposes of the withdrawal study. In the SUNSET trial, long term triple therapy patients with no more than one exacerbation in the preceding year were randomized to continue triple therapy or to de-escalate to a second generation dual bronchodilator therapy - indacaterol/glycopyrronium 110/50 once daily.  This one step de-escalation better mirrored clinical practice than the gradual tapering approach of the WISDOM trial.  There was no increase in exacerbations after de-escalation and although average FEV1 decreased by 26 ml in the group that de-escalated, the decrease is so small as to be immeasureable in individuals.  In a post-hoc analysis, a subset of patients with persistently elevated blood eosinophil counts (greater than 300 cells per uL) were the ones most likely to have exacerbations in follow-up or to have changes in FEV1. 
Author Interviews, Cancer Research, Gender Differences, Lung Cancer, NEJM, Smoking, Tobacco Research / 24.05.2018

MedicalResearch.com Interview with: “Woman smoking” by Pedro Ribeiro Simões is licensed under CC BY 2.0Ahmedin Jemal, DVM, PHD Scientific Vice President, Surveillance & Health Services Rsch American Cancer Society, Inc. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Historically, lung cancer rates have been higher in men than women at all ages because of the substantially higher cigarette smoking prevalence in men. However, cigarette smoking prevalences over the past few decades have become similar between young men and women. Consistent with this pattern, we previously reported the convergence of lung cancer rates between young men and young women. In this paper, we examined the lung cancer incidence rates in young women versus young men in the contemporary cohorts. We found that the historically higher lung cancer incidence rates in young men than in young women have reversed in whites and Hispanics born since the mid-1960s. However, this emerging incidence patterns were not fully explained by sex difference in smoking prevalence as cigarette smoking prevalences among whites and Hispanics were not higher in young women than young men.
Author Interviews, JAMA, Melanoma, UCLA / 24.05.2018

MedicalResearch.com Interview with: Joann G. Elmore, MD, MPH Professor of Medicine David Geffen School of Medicine at UCLA Director of the UCLA National Clinician Scholars Program Affiliate Professor of Medicine, University of Washington School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In a recent study published in 2017 in the British Medical Journal, our team found that pathologists disagreed on their diagnoses of some melanocytic skin biopsy lesions and early stage invasive melanoma more than 50% of the time. This concerning level of disagreement was particularly true for diagnoses in the middle of the disease spectrum, such as atypical lesions and melanoma in situ.  For example, Figure 1 from this paper shows the diagnoses of 36 pathologists who interpreted the same glass slide of a skin biopsy using their own microscopes; the diagnoses ranged from a benign lesion to invasive melanoma. Since that study, the American Joint Committee on Cancer has released new guidelines for melanoma staging. Given this change, we wanted to examine whether the updated guidelines improved the reliability of melanoma diagnosis. We found that using the new guidelines improved the accuracy of pathologists’ diagnoses for invasive melanoma (Elmore J, et al, JAMA Network Open 2018). 
AstraZeneca, Author Interviews, Kidney Disease, Mineral Metabolism / 24.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41990" align="alignleft" width="186"]Steven Fishbane, MD, Chief, Division of Kidney Disease and Hypertension, Northwell Health Vice President, Northwell Health for Network Dialysis Services, Northwell Health Professor of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Lead investigator of the ZS 005 study. Dr. Fishbane[/caption] Steven Fishbane, MD, Chief, Division of Kidney Disease and Hypertension, Northwell Health Vice President, Northwell Health for Network Dialysis Services, Northwell Health Professor of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Lead investigator of the ZS 005 study MedicalResearch.com: What is the background for this announcement? Would you briefly explain what is meant by hyperkalemia?What are the dangers of an elevated potassium and how does LOKELMA differ from prior standard treatments?  Response: Hyperkalemia is when the potassium in the blood rises to potentially harmful levels. High potassium is primarily harmful for the heart. As the potassium level rises the risk for abnormal electrical rhythms or disruption of the heart’s pumping occur. When severe, a high potassium level can cause death. Lokelma has been demonstrated to be effective for lowering potassium levels with a great degree of consistency. It is well tolerated and has a fairly rapid onset of potassium lowering compared to other drugs for the purpose. 
Author Interviews, Autism, Environmental Risks, Fish, OBGYNE, Toxin Research / 23.05.2018

MedicalResearch.com Interview with: “Fish” by Dhruvaraj S is licensed under CC BY 2.0Dr Caroline M Taylor Wellcome Trust Research Fellow Centre for Child and Adolescent Health Bristol Medical School, University of Bristol Oakfield House, Oakfield Grove, Bristol MedicalResearch.com: What is the background for this study? Response: Mercury is a toxic metal that is widespread in the environment. In pregnancy, mercury in the mother’ bloodstream is transferred through the placenta to the fetus, where is can affect development of the nervous system. Mercury from vaccines has been the focus of attention particularly in regard to a link with autism in children. However, the amount of mercury used in the vaccines is small in comparison with mercury from the diet and atmospheric pollution, and in the EU at least, childhood vaccines no longer contain this preservative. The fear that mercury is linked to autism has persisted, despite increasing evidence that this is not the case. The aim of our study was to look at mercury from the diet rather than vaccines – specifically from fish – in pregnant women. We measured the women’s mercury levels in their blood and asked them about how much fish they ate. We then followed up their children for 9 years and recorded how many of them had autism diagnosed within that time. We also measured how many of them had autist traits by measuring their social and communication difficulties.  The data were part of the Children of the 90s study (Avon Longitudinal Study of Parents and Children – ALSPAC), which is based in Bristol, UK.
Author Interviews, Endocrinology, Sleep Disorders, Testosterone, Urology / 23.05.2018

MedicalResearch.com Interview with: Kristen L. Knutson, PhD Associate Professor Center for Circadian and Sleep Medicine Department of Neurology Northwestern University Feinberg School of Medicine Chicago, IL  60611​Premal Patel, MD, PGY-5 Urology University of Manitoba MedicalResearch.com: What is the background for this study? What are the main findings? What should readers take away from your report? Response: Within the literature there has only been small experimental studies which looked at impaired sleep and testosterone. To our knowledge, there has been no study that has evaluated sleep and testosterone using a population dataset. We utilized the National Health and Nutrition Examination Survey to assess the association of sleep with serum testosterone. NHANES examines a nationally representative sample of about ~5000 persons each year. After performing a multivariate linear regression of numerous variables within the NHANES database (age, marital status, prior co-morbidities, number of hours of sleep, etc…) we found that a reduction in the number of hours slept, increasing body mass index and increasing age were associated with lower testosterone levels. Given that this is a cross-sectional analysis, we are unable to provide causality of this relationship but we do feel it is important to counsel patients with low testosterone about the importance of living a healthy lifestyle which includes a well-balanced diet, exercise and sufficient sleep.
Addiction, Author Interviews, Opiods, Pain Research / 23.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41977" align="alignleft" width="160"]Dr. Stuart Lustig, M.D., M.P.H National Medical Executive for Behavioral Health Cigna Dr. Lustig[/caption] Dr. Stuart Lustig, M.D., M.P.H National Medical Executive for Behavioral Health Cigna Dr. Lustig discusses Cigna’s efforts to curb the opioid epidemic. MedicalResearch.com: What is the background for the Applying American Society of Addiction Medicine Performance Measures in Commercial Health Insurance and Services Data study? Response: In 2016 Cigna announced a collaboration with the American Society of Addiction Medicine (ASAM) to improve treatment for people suffering from substance use disorders and establish performance measures and best practices for addiction treatment. Mining anonymized data from Cigna’s administrative data, Brandeis University researchers have validated a new way to hone in on trouble spots where substance use disorder treatment for opioid, alcohol and other drug dependence is suboptimal, like the way police departments use computers to identify high crime areas in need of greater scrutiny and attention. The technique uses ASAM-defined performance measures to assess substance use disorder treatment patterns, giving researchers the ability to sort through administrative data and measure to the extent to which patients being treated for opioid or alcohol use disorder are receiving and using evidenced-based medications proven to be effective in improving outcomes and retention in treatment. It also measures whether those patients received support during substance withdrawal – a critical factor in the success of addiction treatment plans. The performance measures were first tested on the Veterans’ Health Administration in 2016 and now, on data from Cigna.
Author Interviews, Cost of Health Care, End of Life Care, Geriatrics, JAMA, Medicare / 23.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41835" align="alignleft" width="125"]William B Weeks, MD, PhD, MBA The Dartmouth Institute Dr. Weeks[/caption] William B Weeks, MD, PhD, MBA The Dartmouth Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for the study is that a common narrative is that end-of-life healthcare costs are driving overall healthcare cost growth.  Growth in end-of-life care has been shown, in research studies through the mid 2000’s, to be attributable to increasing intensity of care at the end-of-life (i.e., more hospitalizations and more use of ICUs). The main findings of our study are that indeed there have been substantial increases in per-capita end-of-life care costs within the Medicare fee-for-service population between 2004-2009, but those per-capita costs dropped pretty substantially between 2009-2014.  Further, the drop in per-capita costs attributable to Medicare patients who died (and were, therefore, at the end-of-life) accounts for much of the mitigation in cost growth that has been found since 2009 in the overall Medicare fee-for-service population.
Author Interviews, JAMA, NIH / 23.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41923" align="alignleft" width="146"]Jennifer Villani, PhD, MPH Office of Disease Prevention National Institutes of Health Dr. Villani[/caption] Jennifer Villani, PhD, MPH Office of Disease Prevention National Institutes of Health MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The US Preventive Services Task Force (USPSTF) develops recommendations for the delivery of clinical preventive services based on the highest quality scientific evidence available. We performed a comprehensive assessment of the sources of funding for the research studies in this evidence base. The results showed that government agencies supported the most articles (56%), with the remaining support coming from nonprofits or universities (32%), and industry (17%). The National Institutes of Health was the single largest funder of research articles underlying the USPSTF recommendations. 
Asthma, Author Interviews, NEJM / 22.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41963" align="alignleft" width="133"]Mario Castro, M.D., M.P.H. Alan A. and Edith L. Wolff Professor of Pulmonary and Critical Care Medicine, Professor of Medicine, Pediatrics, and Radiology Washington University School of Medicine  Drr. Castro[/caption] Mario Castro, M.D., M.P.H. Alan A. and Edith L. Wolff Professor of Pulmonary and Critical Care Medicine, Professor of Medicine, Pediatrics, and Radiology Washington University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This is a confirmatory phase 3 pivotal study that assessed the efficacy and safety of dupilumab in a population of uncontrolled moderate to severe asthmatics. This was the largest phase 3 placebo controlled trial conducted in this population evaluating a biologic. It enrolled patients without any minimum requirement for any type of biomarker such as blood eosinophils. It clearly confirmed the efficacy of dupilumab in reducing severe asthma exacerbations, improving lung function, asthma control and quality of life in the overall population. It also showed that patients with evidence of type 2 inflammation (increased blood eosinophils or exhaled NO) had a greater magnitude of effect.
Addiction, Author Interviews, Opiods / 22.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41960" align="alignleft" width="200"]Christopher J. Ruhm, PhD Frank Batten School of Leadership and Public Policy University of Virginia Charlottesville, VA Dr. Ruhm[/caption] Christopher J. Ruhm, PhD Frank Batten School of Leadership and Public Policy University of Virginia Charlottesville, VA MedicalResearch.com: What is the background for this study? What are the main findings? Response: I have been interested for some time in understanding the extent to which the rise in drug fatalities can explaining the rising mortality rates of midlife whites that have been experienced since the turn of the century. The primary findings are as follows:
  1. The rise in drug mortality is sufficiently large to explain the entire growth in mortality rates and years of potential life lost experienced by 22-56 year old non-Hispanic whites (NHW) from 1999-2015. This does not imply that there are not other sources of concern related to this decline in life expectancy but indicate a key role of drug deaths.
  2. The growth in drug deaths is particularly pronounced for males in their 20s and 30s, in contrast to some earlier research focusing on NHW in their 40s and 50s.
  3. Deaths involving illicit opioids are the primary driver for young NHW males, with more equal contributions of illicit and prescription opioids for some what older NHWs. These results also indicate that prior studies focusing on persons in their 40s and 50s may provide a misleading picture of the pattern of deaths for the group experiencing the greatest increases.
Author Interviews, Brain Injury, Environmental Risks, Science, UCSF / 22.05.2018

MedicalResearch.com Interview with: “Space Shuttle Model” by terren in Virginia is licensed under CC BY 2.0Susanna Rosi, PhD Director of Neurocognitive Research Brain and Spinal Injury Center Professor in the departments of Physical Therapy and Rehabilitation Science and of Neurological Surgery UCSF MedicalResearch.com: What is the background for this study? What are the main findings? Response: NASA and private space companies like SpaceX plan to send humans to the red planet within the next 15 years — but among the major challenges facing future crewed space missions is how to protect astronauts from the dangerous cosmic radiation of deep space. In this study we identified the first potential treatment for the brain damage caused by exposure to cosmic rays — a treatment can be given after exposure and that prevents memory impairment in mice exposed to simulated space radiation.
Author Interviews, Dermatology, Environmental Risks, Melanoma / 22.05.2018

MedicalResearch.com Interview with: “Sunscreen” by Tom Newby is licensed under CC BY 2.0Carla Burns, M.S. Environmental Working Group She is one of the coauthors of the 2018 Guide to Sunscreens.  MedicalResearch.com: What is the background for the EWG report?  Response: Environmental Working Group (EWG) published its first Sunscreen Guide in 2007. When we first started the guide, many sun protection products sold in the U.S. were not as safe and used misleading marketing claims. Throughout the years, EWG has continued to find that a common sunscreen ingredient, oxybenzone, poses a hazard to human health and the environment. Despite EWG’s efforts to draw attention to the health hazards associated with this ingredient over the last 12, oxybenzone remains widely used in chemical-based sunscreens. So, this year, we are ramping up our efforts to rid the market of this ingredient by launching a campaign to urge companies and consumers to go oxybenzone-free by 2020.
Author Interviews, Dermatology, Genetic Research / 22.05.2018

MedicalResearch.com Interview with: http://www.proqr.com/team-and-boards/Daniel de Boer Founding Chief Executive Officer ProQR MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by dystrophic epidermolysis bullosa? Response: Dystrophic epidermolysis bullosa (DEB) is caused by a mutation in the COL7A1 gene which is responsible for the formation of a protein called type VII collagen (C7). This protein helps bind the inner and outer layers of the skin together. Mutations in one part of COL7A1 gene, exon 73, are the most common cause of DEB resulting in a non-functional C7 protein. ProQR's QR-313 is designed to skip exon 73 of the COL7A1 gene, leading to a shortened C7 protein called C7Δ73. The current studies are intended to determine whether C7Δ73 functions the same as normal C7 protein. This mechanism can hopefully restore normal skin function for DEB patients. DEB is a rare genetic skin disease characterized by easy blistering of the skin, poorly healing wounds and skin infections. DEB is present at birth and in severe cases leads to skin cancer, which can significantly reduce a patient’s lifespan. There are currently no treatments for DEB that target the underlying cause of the disease. The current standard of care consists of expensive time-consuming wound care, antibiotics to prevent infection and pain medications. As a result, this disease presents a huge burden to the patients themselves, as well as people who help with daily care.
Author Interviews, Genetic Research, Pediatrics, Weight Research / 22.05.2018

MedicalResearch.com Interview with: “Great Grandmother” by David Amsler is licensed under CC BY 2.0Rebecca Somerville MB BCh BAO, BMedSci, MRCPI, MPH, PhD School of Public Health, Physiotherapy and Sports Science University College Dublin Dublin, Ireland  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Rates of obesity in the Western world have increased dramatically over recent decades. The negative health consequences of obesity are well known and significant amounts of research have been conducted into the causes and possible solutions. While it is clear that there have been massive changes in diet and physical activity at a societal level that are primarily responsible for this 'obesity epidemic', it is less clear the extent to which obesity, once established, or risk factors for same, can be perpetuated down generations. Family studies lend opportunity to explore these questions, however there are few world wide which incorporate 3 generations. We therefore sought to examine patterns of central adiposity, as measured by waist circumference, between grandparents and their grandchildren, separately in maternal and paternal lines. We were able to utilize prospectively collected data from the Lifeways Cross-Generation Cohort Study. This is a longitudinal birth cohort, established in Ireland in 2001, involving up to 7 members of the same family (mother, father, child and 4 grandparents). In the 589 families where a child had a waist circumference measurement we found that, at the age of both 5 and 9, there was a direct relationship between the waist circumference of the maternal grandmother and her grandchild (both male and female). This remained after adjustment for a wide range of confounding variables including mother's waist circumference. There was no relationship seen with any of the other grandparents.
Author Interviews, Depression, Emory, Heart Disease, JAMA / 22.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41942" align="alignleft" width="150"]Viola Vaccarino, MD, PhD Department of Epidemiology and Division of Cardiology Professor, Department of Medicine Emory University School of Medicine Atlanta, Georgia Dr. Vaccarino[/caption] Viola Vaccarino, MD, PhD Department of Epidemiology and Division of Cardiology Professor, Department of Medicine Emory University School of Medicine Atlanta, Georgia  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown that people with depression tend to have lower heart rate variability (HRV), an index of autonomic nervous system dysregulation derived by monitoring the electrocardiogram over time, usually for 24 hours. Other literature, however, has pointed out that autonomic dysregulation (as indexed by reduced HRV) may also cause depression. Thus, the direction of the association between reduced HRV and depression still remains unclear. In addition, these two characteristics could share common pathophysiology, making shared familial background and genetic factors potential determinants of this association.
Annals Internal Medicine, Author Interviews, Cost of Health Care, Kidney Disease / 22.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41937" align="alignleft" width="133"]Lilia Cervantes, M.D. Internal Medicine, Hospitalist Denver Health and Hospital Authority Assistant Professor, Division of General Internal Medicine Founder, Healthcare Interest Program and Health Equity Lecture Series at Denver Health University of Colorado Health Sciences Center Dr. Cervantes[/caption] Lilia Cervantes, M.D. Internal Medicine, Hospitalist Denver Health and Hospital Authority Assistant Professor, Division of General Internal Medicine Founder, Healthcare Interest Program and Health Equity Lecture Series at Denver Health University of Colorado Health Sciences Center MedicalResearch.com: What is the background for this study? What are the main findings?  Response:  For most undocumented immigrants with kidney failure in the U.S., access to hemodialysis is limited and they can only receive it when they are critically ill and near-death.  This type of “emergency-only” hemodialysis is already known to be nearly 4-fold more costly, has 14-fold higher mortality rate, and leads to debilitating physical and psychosocial distress for these patients compared to those receiving regular hemodialysis. This study shows that clinicians who are forced to provide this substandard care are also harmed.  They experience moral distress, emotional exhaustion, and several other drives of professional burnout due to witnessing needless suffering and high mortality. 
Annals Internal Medicine, Author Interviews, Biomarkers, Heart Disease / 22.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41928" align="alignleft" width="200"]Prof. Dr. med. Konstantinos Stellos,MD, FAHA, FESC Cardiovascular Research Centre, Institute of Genetic Medicine Newcastle upon Tyne United Kingdom Prof. Stellos[/caption] Prof. Dr. med. Konstantinos Stellos,MD, FAHA, FESC Cardiovascular Research Centre, Institute of Genetic Medicine Newcastle upon Tyne United Kingdom MedicalResearch.com: What is the background for this study?   Response: Risk stratification of patients with a non-ST-segment elevation acute coronary syndrome (NSTE-ACS) remains a major challenge in clinical cardiology. Risk stratification is important to identify patients at high risk, to whom an early coronary intervention with optimal adjunctive medical therapy shall be applied to reduce that risk. Conversely, it is equally important to identify patients at low risk, to whom a potentially hazardous invasive therapy or a multi-drug administration shall be avoided. Current ACC/AHA and ESC guidelines agree in a standardized approach that uses Global Registry of Acute Coronary Events (GRACE) score, a well validated scoring system, to calculate a patient’s risk and guide triage and management decisions. Amyloid-β (Aβ) 1-40 and 1-42 peptides (Aβ40 and Aβ42), are proteolytic fragments of a larger protein, the amyloid precursor protein (APP) cleaved by β- and γ-secretases, found in typical brain amyloid deposits in Alzheimer’s disease. Many lines of evidence support a role of Aβ40 in cardiovascular disease as a peptide with pro-inflammatory and pro-thrombotic properties. Most cardiovascular risk factors seem to affect APP metabolism and thus, Aβ production and its soluble circulating APP770 isoform are elevated in patients with ACS_ENREF_15, suggesting a role for Aβ40 in the triggering and outcome of ACS in stable CAD patients. Although vascular inflammation is considered as a hallmark in the pathophysiologic pathways of coronary artery disease (CAD) and novel mechanisms are continuously recognized in its pathogenesis, no inflammatory marker is currently recommended for risk stratification of patients with NSTE-ACS individually or as a component of the GRACE score. This may partly explain the moderate discriminative ability of GRACE score in some studies, especially in older patients and those after early percutaneous coronary intervention (PCI). In this retrospective study, we used data from two independent prospective cohorts, the Heidelberg study (n=1,145) and the validation multicenter international APACE (Advantageous Predictors of Acute Coronary Syndrome Evaluation, n=734) study and determined the clinical prognostic and reclassification value of baseline circulating Aβ40 levels in the prediction of mortality over the GRACE risk score in patients with NSTE-ACS across a median follow-up of 21.9 ( Heidelberg cohort) and 24.9 months (APACE cohort), respectively.
Author Interviews, Global Health, JAMA, Leukemia / 21.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41916" align="alignleft" width="125"]Andrew J. Cowan, MD Seattle Cancer Care Alliance Division of Medical Oncology University of Washington, Seattle Dr. Cowan[/caption] Andrew J. Cowan, MD Seattle Cancer Care Alliance Division of Medical Oncology University of Washington, Seattle MedicalResearch.com: What is the background for this study? What are the main findings?   Response: Multiple myeloma (MM) is a plasma cell neoplasm with substantial morbidity and mortality. A comprehensive description of the global burden of multiple myeloma is needed to help direct health policy, resource allocation, research, and patient care. Myeloma cases and deaths increased from 1990 to 2016, with middle-income countries contributing the most to this increase. Treatment availability is very limited in countries with low socioeconomic development.
Author Interviews, Cannabis, Pediatrics / 21.05.2018

MedicalResearch.com Interview with: Natalie Castellanos Ryan, PhD École de Psychoéducation Université de Montréal Outremont Canada  MedicalResearch.com: What is the background for this study? Response: Our study followed a group of boys living in low socioeconomic neighbourhoods in Montreal (N=1030) from early childhood to 28 years of age to investigate: 1) whether the age at which one starts to use cannabis across adolescence is associated with the risk of developing drug abuse by early adulthood, when one controls for  arrange of known risk factors for cannabis use and problems assessed across development (risk factors in childhood, adolescence and early adulthood); and 2) the developmental pathways from early risk factors to drug abuse problems. To examine these associations, the study collected  self-reported cannabis use information from these boys annually from ages 13 to 17 years and drug abuse symptoms at 28 years, as well as teacher, parent and child reported information on a number of environmental (family and friend) and child characteristics (e.g., impulsivity, delinquency, school performance) across childhood and adolescence. Alcohol and other drug use was also assessed across adolescence and early adulthood.
Author Interviews, Critical Care - Intensive Care - ICUs, Opiods, University of Pittsburgh / 21.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41908" align="alignleft" width="125"]Jason Kennedy, MS Research project manager Department of Critical Care Medicine University of Pittsburgh Jason Kennedy[/caption] Jason Kennedy, MS Research project manager Department of Critical Care Medicine University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Most previous studies of opioid use in health care have focused on the outpatient setting. But opioids are often introduced during hospitalization. That’s something clinicians can control, so we looked at inpatient prescription of these drugs to identify targets that may reduce opioid use once patients are out of the hospital. We analyzed the medical records of 357,413 non-obstetrical adults hospitalized between 2010 and 2014 at 12 University of Pittsburgh Medical Center (UPMC) hospitals in southwestern Pennsylvania. The region is one of the areas of the country where opioid addiction is a major public health problem. We focused on the 192,240 patients who had not received an opioid in the year prior to their hospitalization – otherwise known as “opioid naïve” patients. Nearly half (48 percent) of these patients received an opioid while hospitalized.  After discharge, those patients receiving hospital opioids were more than twice as likely to report outpatient opioid use within 90-days (8.4 percent vs. 4.1 percent). Patients who receive an opioid for most of their hospital stay and patients who are still taking an opioid within 12 hours of being discharged from the hospital appear more likely to fill a prescription for opioids within 90 days of leaving the hospital. 
ADHD, Author Interviews, Columbia, JAMA, Toxin Research / 21.05.2018

MedicalResearch.com Interview with: Marianthi-Anna Kioumourtzoglou ScD Assistant Professor Environmental Health Sciences Mailman School of Public Health Columbia University  Marianthi-Anna Kioumourtzoglou ScD Assistant Professor Environmental Health Sciences Mailman School of Public Health Columbia University  MedicalResearch.com: What is the background for this study? Response: The prevalence of neurodevelopmental disorders, like attention deficit/hyperactivity disorder (ADHD) has been increasing. One of the hypothesized risk factors for increased risk for neurodevelopmental disorders is a class of chemicals known as endocrine disrupting chemicals (EDCs). These chemicals are known to interfere with the endocrine system, i.e. the system that uses hormones to control and coordinate metabolism, reproduction and development. Several high production volume chemicals, ubiquitously present in commercial products, are known or suspected endocrine disruptors. Because of their widespread use in consumer products, the population-wide exposure to known and suspected EDCs is very high. Recently, there has been increased attention in the potential effects of EDCs on neurodevelopment that span multiple generations. Animal studies have provided evidence that exposure to EDCs, such as phthalates and bisphenol A (BPA), alter the behavior and social interactions in mice in three to five generations after exposure. However, evidence of such multi-generational impacts of EDC exposure on neurodevelopment in humans is unavailable, likely because of the lack of detailed information on exposures and outcomes across generations. For this study we leveraged information from a nationwide cohort, the Nurses’ Health Study II (NHSII), to investigate the potential link between exposure to diethylstilbestrol (DES) and third generation ADHD, i.e. ADHD among the grandchildren of the women who used DES while pregnant. DES is a very potent endocrine disruptor that was prescribed between 1938 and 1971 to pregnant women thought to prevent pregnancy complications. In the United States, between 5 and 10 million women are estimated to have used DES, although the exact number is not known. DES was banned in 1971, when was linked to vaginal adenocarcinomas (a rare cancer of the reproductive system) in the daughters of the women who had used it during pregnancy. Since then, DES has been also linked to multiple other reproductive outcomes in DES daughters, as well as with some reproductive outcomes in the grandchildren of the women who used it, such as hypospadias and delated menstrual regularization. However, to our knowledge, no study to date has evaluated the association between DES, or any other EDC, and multigenerational neurodevelopment.
Author Interviews, Infections / 21.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41889" align="alignleft" width="125"]Christopher M. Waters PhD Departments of Microbiology and Molecular Genetics BEACON Center for The Study of Evolution in Actio Michigan State University East Lansing, MI  Dr. Waters[/caption] Christopher M. Waters PhD Departments of Microbiology and Molecular Genetics BEACON Center for The Study of Evolution in Actio Michigan State University East Lansing, MI  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our research really centers on understanding and targeting bacterial biofilms. These are multicellular communities of bacteria encased in a slimy matrix that protects them from the immune system and antibiotic treatment during infections. One of the most common types of biofilm infections is in the lungs of cystic fibrosis by the bacterium Pseudomonas aeruginosa. CF patients can become chronically colonized by P. aeruginosa, and antibiotics are not able to clear these infections. Our idea was can we find other molecules that make antibiotics more effective at killing biofilms? To this end, we screened about 6,000 compounds for those that would make tobramycin more effective at killing P. aeruginosa biofilms, and one of the best hits we found was the antimicrobial triclosan that has been widely used for decades in hand sanitizers, soaps, and tooth paste. Although neither triclosan nor tobramycin can kill biofilms alone, the combination is 100X more effective against virtually every P. aeruginosa strain tested. It also worked against other bacteria that commonly infect cystic fibrosis lungs such as Staphylococcus aureus and Burkholderia cenocepacia.
Author Interviews, Duke, Mental Health Research / 21.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41880" align="alignleft" width="125"]Maxwell Elliott Clinical psychology PhD student Working with Ahmad Hariri and the Moffitt & Caspi lab Duke University Maxwell Elliott[/caption] Maxwell Elliott Clinical psychology PhD student Working with Ahmad Hariri and the Moffitt & Caspi lab Duke University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The traditional clinical science model identifies individuals who meet specific criteria for mental illness diagnoses (e.g. Depression, Anxiety) and compares them to “healthy” controls to find brain correlates of mental illness.  However, this approach often overlooks the high rates of comorbidity and shared symptamatology across mental illnesses. Emerging research has identified a general factor of psychopathology that accounts for shared risk among internalizing, externalizing, and thought disorders across diverse samples. This general factor of psychopathology has been called the p-factor. In our study we investigate the brain correlates of the p-factor using a data-driven analysis of resting state functional connectivity. We find that higher p-factor scores and associated risk for common mental illness maps onto hyper-connectivity between visual association cortex and both frontoparietal and default mode networks.
Author Interviews, JAMA, Pulmonary Disease, Stem Cells, Transplantation / 21.05.2018

MedicalResearch.com Interview with: Emmanuel Martinod MD PhD Assistance Publique–Hôpitaux de Paris, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Paris 13, Sorbonne Paris Cité, UFR Santé, Médecine et Biologie Humaine, Bobigny, Université Paris Descartes, Fondation Alain Carpentier, Laboratoire de Recherche Bio-chirurgicale, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou Paris, France  MedicalResearch.com: What is the background for this exciting new technology and study? What are the main findings?  Response: What is the background for this exciting new technology and study? What are the main findings? Response:  The background is 10 years of research at laboratory followed by 10 years of academic clinical research. We demonstrated the feasability of airway bioengeenring using stented aortic matrices for complex tracheal or bronchial reconstruction. 
Author Interviews, JAMA, Orthopedics, Pain Research / 21.05.2018

MedicalResearch.com Interview with: “Back Pain” by betterhealthosteopathy is licensed under PDM 3.0Christine Goertz DC, PhD Vice Chancellor for Research and Health Policy Palmer College of Chiropractic MedicalResearch.com: What is the background for this study? Response: Low back pain in the leading cause of physical disability worldwide, with up to 80% of US adults seeking care for this debilitating condition at some point in their lives. Low-back pain is also one of the most common causes of disability in U.S. military personnel. Although a number of studies have previously evaluated chiropractic care for low back pain, the vast majority had small sample sizes and did not study chiropractic as part of a multi-disciplinary approach to care in real world settings, including the military.
Author Interviews, Social Issues / 21.05.2018

MedicalResearch.com Interview with: “Droid Apps Cell Phone” by Carissa Rogers is licensed under CC BY 2.0Leif Edward Ottesen Kennair  PhD Professor, Department of Psychology Norwegian University of Science and Technology  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The background is all earlier research on sexual behavior, showing both robust individual differences predictors as well as sex differences. We wished to investigate to what degree picture (PBMDA) based mobile dating apps differ from other arenas of sexual behavior.
  • How many have used or are current users:
  • Nearly half of the participants reported former or current Picture-Based Mobile Dating Apps (PBMDA) use. One in five was a current user.”
Our main prediction was confirmed:
  • We found that PBMDA-users tend to report being less restricted in their sociosexuality (as measured with the SOI-R) than participants who have never used PBMDAs
Including  specifation:
  • This effect was equally strong for men and women. Sociosexuality essentially accounted for the effects of other variables such as seeking a casual sex partner, being comfortable picking up strangers, and self-reported short-term mate value.
Sex differences were also found:
  • As predicted, women and men's reasons for using PBMDAs differed. Relative to women, men emphasized desire for sex as a reason for using PBMDAs.
The most surprising finding was as often due to a discussion with reviewer who was worried whether unrestricted sociosexuality was not more likely a result of use rather than a predictor of use. This improved the detail of our analysis and the conclusion that “When controlling for sex, age and SOI Desire there was no evidence that length of use increased lifetime casual sex partners.”