The rising incidence of early-onset cancers is likely at least partly attributable to enhanced screening and early detection. However, there...
Dr. Zhu[/caption]
Jane M. Zhu, M.D., M.P.P., M.S.H.P.
Assistant Professor of Medicine
Division of General Internal Medicine and Geriatrics
School of Medicine
Oregon Health & Science University
Portland, Oregon
MedicalResearch.com: What is the background for this study?
Response: Private equity (PE) acquisitions of physician practices are accelerating across many specialties, but there is still little robust evidence on the effects of these acquisitions. Concerns about PE involvement is predicated on the fact that these firms expect high annual returns, which require either reducing costs or increasing revenue, or both. Using PE acquisition data from 2016-2020, linked to commercial claims data, we sought to understand what common mechanisms of revenue generation were being adopted after private equity acquisition of physician practices.
Dr. den Hoed[/caption]
Marcel den Hoed, PhD
Researcher,Department of Immunology, Genetics and Pathology
Uppsala University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In this paper we performed a multi-ancestry meta-analysis of 51 genome-wide association studies, in data from over 700,000 individuals. This yielded 11 DNA regions that are robustly associated with self-reported moderate-to-vigorous intensity physical activity during leisure time (MVPA), and 88 DNA regions for self-reported leisure screen time (LST).
Around half of the identified DNA regions are also associated with objectively assessed physical activity traits in data from the UK Biobank. Causal inference using a Mendelian randomization approach subsequently showed bidirectional causal effects between LST and body mass index (BMI), with the effect of LST on BMI being 2-3-fold larger than vice versa. Less LST and more MVPA protect from diabetes, attention deficit hyperactivity disorder, depression, and earlier age at death, with all causal effects of MVPA and leisure screen time being mediated or confounded by BMI. Further analyses showed that DNA regions associated with LST are more often located close to genes whose expression in skeletal muscle is altered by strength training than expected by chance, suggesting that these genes may influence the likelihood of adopting an active lifestyle by influencing the response to training.
Dr. Mak[/caption]
Raymond H. Mak, MD
Radiation Oncology Disease Center Leader for Thoracic Oncology
Director of Patient Safety and QualityDirector of Clinical Innovation
Associate Professor, Harvard Medical School
Cancer - Radiation Oncology, Radiation Oncology
Department of Radiation Oncology
Brigham and Women's Hospital
MedicalResearch.com: What is the background for this study? What is the algorithm detecting?
Response: Lung cancer, the most common cancer worldwide is highly lethal, but can be treated and cured in some cases with radiation therapy. Nearly half of lung cancer patients will eventually require some form of radiation therapy, but the planning for a course of radiation therapy currently entails manual, time-consuming, and resource-intensive work by highly trained physicians to segment (target) the cancerous tumors in the lungs and adjacent lymph nodes on three-dimensional images (CT scans). Prior studies have shown substantial variation in how expert clinicians delineate these targets, which can negatively impact outcomes and there is a projected shortage of skilled medical staff to perform these tasks worldwide as cancer rates increase.
To address this critical gap, our team developed deep learning algorithms that can automatically target lung cancer in the lungs and adjacent lymph nodes from CT scans that are used for radiation therapy planning, and can be deployed in seconds.
We trained these artificial intelligence (AI) algorithms using expert-segmented targets from over 700 cases and validated the performance in over 1300 patients in external datasets (including publicly available data from a national trial), benchmarked its performance against expert clinicians, and then further validated the clinical usefulness of the algorithm in human-AI collaboration experiments that measured accuracy, task speed, and end-user satisfaction.
Dr. Parekh[/caption]
Samir Parekh, MBBS
Hematology-Oncology, Cancer
Director of Translational Research in Myeloma and
Co-leader of the Cancer Clinical Investigation program
The Tisch Cancer Institute
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Clinical outcomes for myeloma patients patients have improved significantly over the past decade with the introduction and success of newer immunomodulatory treatments such as CART cell therapy and bispecific antibodies. Strategies are needed to determine the best treatment options for patients relapsing or unresponsive to initial courses of these types of therapies.
We analyzed the outcomes of patients relapsing after bispecific antibody therapy for myeloma. Our data shows that sequencing of bispecific antibodies or CART after initial bispecific failure can effectively salvage patients and lead to excellent outcomes in myeloma. This provides the foundation for future studies combining this new class of immunotherapy with CART or additional bispecific antibodies to improve outcomes in myeloma.
Dr. Donahue[/caption]
Katrina E. Donahue, M.D., M.P.H.
Professor and Vice Chair of Research
Chapel Hill Department of Family Medicine
University of North Carolina
Dr. Donahue joined the U.S. Preventive Services Task Force in January 2020.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Heart disease and stroke are the leading causes of death in the U.S. The Task Force found that people who are 40 to 75 years old and at high risk for heart disease should take a statin to help protect their health.
People in this age group who are at increased risk but not high risk should make an individual decision with their healthcare professional about whether taking a statin is right for them. There is not enough research to determine whether statins are beneficial for people 76 years and older.
Dr. Amadei[/caption]
Gianluca Amadei PhD
Post-Doctoral Fellow
University of Cambridge, UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The background of this study is that we tried to build a structure that looks and develops like a real mouse embryo using different kinds of mouse stem cells.
The main findings are that the resulting structures develop the entire embryonic body axis and the extraembryonic tissues that are required to support embryonic development. Our structures develop to a stage comparable to 8.5 days of embryonic development of the natural mouse embryos and have a brain and neural tube, a beating heart-like structure, gut and primordial germ cells.
Dr. Han[/caption]
Meilan K Han MD, MS
Henry Sewall Professor of Medicine
Professor of Internal Medicine and Section Head
Division of Pulmonary and Critical Care Medicine, Medical School
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In the NIH sponsored SPIROMICS study we demonstrated that symptomatic, tobacco exposed individuals have frequent exacerbations. Many of these individuals are treated with the same inhaled medications that have shown benefit in COPD, but we don’t have any evidence basis for this practice.
Dr. Maki Inoue-Choi,[/caption]
Maki Inoue-Choi, Ph.D., M.S., R.D.
Staff Scientist
Metabolic Epidemiology Branch
National Institutes of Health
MedicalResearch.com: What is the background for this study?
Response: Tea is rich in bioactive compounds that can possibly protect against health conditions such as cancer and heart disease. A lower risk of death was seen among tea drinkers than non-drinkers in previous studies, but these were largely in populations where green tea drinking is common. In contrast, the studies in populations where black tea drinking is more common have been limited and the findings from these studies have been inconsistent.
Prof. Blankart[/caption]
Prof. Katharina Blankart, PhD
Faculty of Economics and Business Administration
University of Duisburg-Essen
Essen, Germany
MedicalResearch.com: What is the background for this study?
Response: Given the high drug prices and policy discussions, we were interested whether the US may miss opportunities from medical innovation in availability of medicines compared to Germany. Since 2011, Germany has a unique way to determine value of new medicines after regulatory approval and to negotiate prices. We aimed to find out differences in availability of medicines in these two countries and timing of availability. We evaluated the differences in timing of availability and to characterize medicines not available to one of the two countries.
Dr. Morgan[/caption]
Dr Holly Morgan M.B., B.Ch.
Clinical Research Fellow and REVIVED investigator
King's College London
MedicalResearch.com: What is the background for this study?
Response: Coronary artery disease is the commonest cause of heart failure. Whilst individually tailored pharmacological and device therapy (optimal medical therapy, OMT) is the cornerstone of management of ischemic heart failure, rates of death and hospitalization for heart failure remain unacceptably high in this population. Given the causative relationship between coronary disease and heart failure, coronary revascularization has long been considered as a treatment option for these patients. Whilst there is randomized evidence to support surgical revascularization with coronary artery bypass grafting (1), none previously existed for percutaneous coronary intervention (PCI) in stable ischemic left ventricular dysfunction. Despite this, patients are frequently offered PCI in this setting (particularly if unsuitable for surgery); driven by the belief that hibernating myocardium will improve in function if blood flow is restored, regardless of the revascularization method. This approach was supported in some international guidelines, though recommendations varied.
The REVIVED-BCIS2 trial aimed to establish whether revascularization with PCI in addition to OMT would improve event free survival in patients with ischemic left ventricular dysfunction, when compared to OMT alone (2). Inclusion criteria included a left ventricular ejection fraction of ≤35%, extensive coronary artery disease (British Cardiovascular Intervention Society jeopardy score ≥6, indicating significant stenoses in the left main coronary artery, proximal left anterior descending coronary artery, dominant circumflex artery, disease in multiple vessels or a combination of these) and viability in at least four dysfunctional myocardial segments which were amenable to PCI. The main exclusion criteria were acute myocardial infarction within 4 weeks of randomisation, angina which limited the patient’s quality of life or decompensated heart failure or sustained ventricular arrhythmia within 72 hours.
The primary composite outcome was all-cause death or hospitalization for heart failure; minimum follow up was 24 months. Key secondary outcomes included the change in left ventricular ejection fraction from baseline to follow-up at six and twelve months, myocardial infarction, unplanned revascularization and quality of life assessed with the Kansas City Cardiomyopathy Questionnaire and EQ-5D-5L.
The success found through experiments using lab rats is attributed to the amazing comparison in the physiological, anatomical, and genetic...
Prof. Steinman[/caption]
Prof. Lawrence Steinman MD
Zimmermann Professor of Neurology & Neurological Sciences, and Pediatrics
Beckman Center for Molecular Medicine Stanford University
Stanford, CA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We are publishing the results of two successful phase 3 trials in relapsing MS (multiple sclerosis).
We tested a glycoengineered antibody to B cells. The glycoengineered antibody are more potent in killing the target. They can be delivered more easily.
Prof. Duffy[/caption]
Professor Stephen Duffy
Director of the Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis
Centre Lead, Centre for Prevention, Detection and Diagnosis
Queen Mary University of London
MedicalResearch.com: What is the background for this study?
Response: The NHS Bowel Cancer Screening Programme provides 2 yearly screening to men and women aged 60-74, and it is in the process of reducing the starting age to 50 years. The screening method is faecal immunochemical testing (FIT), in which the screenee places a small sample of faeces in a container and mails this back to the lab, which tests the sample for haemoglobin, as bleeding can be a sign of cancer. The screenee is invited for colonoscopy if the level of haemoglobin is higher than 120 micrograms per gram. The system is under considerable pressure as there are limited colonoscopy resources, the programme is working towards a lower age at starting screening and we are still dealing with the backlog caused by the COVID-19 pandemic, and there may be a need to reduce the intensity of screening in order that the colonoscopy services can cope.
Prof. Crowther[/caption]
Professor Caroline Crowther MB ChB, DCH, FRANZCOG, MD, DDU, FRCOG, CMFM
Maternal Fetal Medicine Subspecialist
Professor of Maternal & Perinatal Health
Liggins Institue
Waipapa Taumata Rau | University of Auckland
MwdicalResearch.com: What is the background for this study?
Response: Gestational diabetes is a growing and significant health problem worldwide for women affected and their babies. Treatment of gestational diabetes improves maternal and infant health but it remains unclear what degree of maternal hyperglycaemia should be used to make the diagnosis. Because of this uncertainty, recommended diagnostic criteria vary around the world.
The GEMS randomised trial assessed whether use of lower glycaemic diagnostic criteria, recommended by the International Association of Diabetes and Pregnancy Study Groups would improve perinatal health, without increasing maternal risks, compared to use of higher criteria, and to assess the effects on use of the health services.
Dr. Bailey[/caption]
Michael Bailey Ph.D.
Senior Principal Engineer, Applied Physics Laboratory
Associate Professor. Mechanical Engineering
Adjunct Associate Professor Urology
MedicalResearch.com: What is the background for this study?
Response: Small (< 6 mm) kidney stones are common and often are asymptomatic. Do you do surgery or wait for them to cause a problem? Or specifically here if you are getting surgery already for other stones that are causing a problem do you take the time and possibly extra risk of cleaning out the small stone in the kidney or in the other kidney?
Dr. Verma[/caption]
Ashish Verma, MD
Assistant Professor, Nephrology
Department of Medicine
Boston University
MedicalResearch.com: What is the background for this study? Would you tell us a little about aldosterone?
Response: “Recent randomized, controlled trials have shown that a drug called finerenone is effective in delaying CKD progression and adverse cardiovascular outcomes in patients with chronic kidney disease and diabetes. However, the role of aldosterone in this process was not directly investigated and levels of the hormone were not measured,”
“Since excessive levels of aldosterone is common, yet mostly unrecognized, we hypothesized that one reason why finerenone was effective in lowering the risk of CKD progression was that it was treating unrecognized high concentrations of the hormone.”
To study this we investigated the associations between aldosterone concentrations in the blood and kidney disease progression among 3680 participants in the Chronic Renal Insufficiency Cohort study, which ran in seven clinics in the US between 2003 and 2008. The participants were aged between 21 and 74 years old.
Aldosterone is a steroid hormone secreted by the adrenal glands, which sit above the kidneys. Its main role is to regulate salt and water in the body, and so it plays a central role in controlling blood pressure. Too much of it can lead to high blood pressure, cardiovascular and kidney diseases.
Dr. Jackson[/caption]
Sarah S. Jackson PhD
Infections and Immunoepidemiology Branch
Division of Cancer Epidemiology and Genetics
National Cancer Institute
Bethesda, MD 20892
MedicalResearch.com: What is the background for this study?
Response: There are many cancers that both men and women can develop, specifically those that do not affect the reproductive tract. Men have higher rates of these nonreproductive cancers than women. There are only two nonreproductive cancer types that are more common in women: thyroid and gallbladder. Historically, we have thought this is because women are less likely to smoke or drink and are more likely to eat well and exercise than men.
This study sought to examine the sex bias in cancer incidence after controlling for those lifestyle factors to see if this explained the male predominance in cancer.
MedicalResearch.com Interview with:
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Dr. Pbert[/caption]
Lori Pbert, Ph.D Professor, Department of Population and Quantitative Health Sciences Associate chief of the Division of Preventive and Behavioral Medicine Founder and director of the Center for Tobacco Treatment Research and Training University of Massachusetts Chan Medical School Dr. Pbert joined the U.S. Preventive Services Task Force in January 2019
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Heart attacks and strokes are the number one killer of adults in the United States. Based on the evidence we reviewed, the Task Force found that some people would benefit from counseling interventions to support their cardiovascular health, however the overall benefits are small. For that reason, we continue to recommend that healthcare professionals decide together with their patients who do not have cardiovascular disease risk factors whether counseling interventions on healthy diet and physical activity might help them prevent heart attacks and strokes. This is a C grade recommendation.
MedicalResearch.com Interview with: Stig Larsen PhD Professor Emeritus Controlled Clinical Research Methodology and Statistics Norwegian University of Life Sciences Oslo, Norway
MedicalResearch.com:? What are the main findings?
Response: Osteoporosis is a major problem among elderly and malnourished people. Calcium, Vitamin D and Vitamin K are beneficial for bone health. Vitamin D stimulates calcium absorption and studies have shown that poor Vitamin K status intake is linked to low bone mass. Osteocalcin (OC) is a protein hormone found in the blood in activated and inactivated form. The activated form of Osteocalcin (cOC) binds calcium to bone tissue and plays an important role in regulating the metabolism. In addition, low levels of cOC are associated with insulin resistance, diabetes, and metabolic syndrome. It is desirable to have largest possible uOC, and vitamin K2 central in this process. The most important vitamin K2 variants in Jarlsberg® are the long-chain MK-7, -8, -9 and -9(4H), where lactic acid bacteria produce the first three, while MK-9(4H) is produced by Propionibacterium freudenreichii. The latter bacterium also produces the substance "1,4-dihydroxy-2- naphthoic acid" (DHNA), which has previously been shown to increase bone density in experimental mice. Two previous studies related to Jarlsberg® intake have been published:
The BMJ-study3: The central variables measured in this study were the serum bone turnover markers (BTM); tOC and cOC, procollagen type 1 N-terminal propeptide (PINP) and serum cross-linked C- telopeptide type I collagen (CTX). Additionally, Vitamin K2 and Vitamin K status, serum calcium and serum magnesium were recorded together with the development in glycated hemoglobin (HbA1c), lipids and protein turnover. The participants in the study were randomly divided into two groups. One group of 41 healthy volunteer women of childbearing age ate 57 grams of Jarlsberg® per day and the other group of 25 women ate 50 grams of Camembert for 6 weeks. The Camembert was manufactured with a starting culture not producing Vitamin K2. The fat, protein, and energy content of the daily consumption of Jarlsberg® and Camembert is approximately the same. After 6 weeks, Camembert was replaced with 57 grams of Jarlsberg® per day for another 6 weeks.
MedicalResearch.com Interview with: Jean Shin Department of Family Medicine Korea University College of Medicine Seoul,Republic of Korea
MedicalResearch.com: What is the background for this study?
Response: Younger age at menopause is a possible risk factor for cardiovascular diseases. However, data on the association among premature menopause, age at menopause, and the risk of heart failure and atrial fibrillation are lacking. We aimed to examine the association of premature menopause and age at menopause with the risk of heart failure and atrial fibrillation.
Dr. Seidman[/caption]
Christine Seidman, MD
Thomas W. Smith Professor of Medicine and Genetics
Director, CV Genetics Center Brigham and Women’s Hospital
Harvard Medical School
Dept of Genetics
Boston, MA 02115
MedicalResearch.com: What is the background for this study?
Response: Heart failure is a common and incurable disorder that is known to arise from many different underlying causes. By exploiting a new technology, single nuclear transcriptional analyses, we aimed to define molecular profiles in human hearts tissues that were obtained from patients with different genetic and non-genetic causes of heart failure.
Our goal was to determine if there were distinctive signatures that could provide new opportunities to develop precise treatments, based on the specific cause of heart failure.
Dr. Cosimi[/caption]
Lisa A. Cosimi, MD
Division of Infectious Diseases
Brigham and Women’s Hospital
Boston, Massachusetts
MedicalResearch.com: What is the background for this study?
Response: Response: Current CDC COVID-19 isolation guidance allows for ending isolation after day 5 for non-immunocompromised individuals if they are afebrile and with improving symptoms, or if the individual is asymptomatic from the start. It has been proposed that rapid antigen tests (RATs) may assist in determining when individuals are no longer infectious. Specifically, a negative test would be potentially reassuring for an individual not being transmissible, while a positive test could be suggestive of continued infectiousness. However, there is little data about use of RATs in this particular setting and how they may correlate with ongoing risk of transmission as they were developed to be used during the initial diagnosis of infection, not in the later phase.
Dr. Staples[/caption]
John A. Staples, MD, FRCPC, MPH
Academic General Internist
Vancouver General Hospital
Clinical Assistant Professor at UBC
MedicalResearch.com: What is the background for this study?
Response: As a hospital-based general internist, I often see patients in the emergency department after an episode of syncope. Syncope is a medical term for suddenly losing consciousness (the public generally knows this as “fainting”). As you can imagine, fainting out of the blue can be very unnerving. Patients and clinicians worry that it may happen again and wonder whether it’s safe to drive. The first time I was asked this question, I remember scouring the research literature for an answer and not finding any robust evidence to guide my advice to patients.
Dr. Wall[/caption]
Dr Emma Wall
Senior Clinical Research Fellow, UCLH-Crick Legacy study
Consultant Infectious Diseases UCLH
MedicalResearch.com: What is the background for this study?
Response: Since April 2022, both the UK and US have changed their COVID-19 isolation and testing policies. The impact these changes in the guidance and vaccination on community-acquired COVID-19 caused by recent SARS-CoV-2 variants of concern (VOC) has not been fully tested, including infections with BA.2. We aimed to characterise both symptoms and viral loads over the course of COVID-19 infection in otherwise-healthy, vaccinated, non-hospitalised adults, to assess whether current guidance remains justified. All participants were included in the UCLH-Crick Legacy study, a prospective, observational cohort study of otherwise healthy adults who have been taking part in regular workplace testing for SARS-CoV-2 in London
We sent swabs by same-day courier every other day to all adults who reported a positive PCR or lateral flow test to the study team up to day 10 after the start of each infection. We confirmed which variant caused the infection by PCR and sequencing. All participants completed linked symptom diaries.
We compared symptoms and changes in the amount of virus detected in the nose and throat during infection between study participants reporting COVID-19 caused by VOCs Delta and Omicron BA.1 and BA.2. We then analysed how many of our participants would meet current UK/US isolation guidelines.