MedicalResearch.com Interview with: Kristian Karstoft MD
The Centre of Inflammation and Metabolism and The Centre for Physical Activity ResearchDepartment of Infectious Diseases and CMRC, Rigshospitalet
Faculty of Health Sciences,
University of Copenhagen, Copenhagen, Denmark
Medical Research: What are the main findings of the study?Dr. Karstoft:Four months of Interval-walking training (IWT; five sessions/week, one hour/session) in individuals with type 2 diabetes mellitus maintained insulin secretion, improved insulin sensitivity index and disposition index in opposition to energy-expenditure and time-duration matched continuous walking training (CWT).
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Medical Research Interview with:
Lara J. Akinbami, MD
Infant, Child and Women's Health Statistics Branch
National Center for Health Statistics
Centers for Disease...
MedicalResearch.com Interview with:Dr Marc Tischkowitz MD PhD
University Lecturer (Associate Professor) and
Honorary Consultant Physician in Medical Genetics
Department of Medical Genetics, University of Cambridge
Medical Research: What are the main findings of the study?Dr. Tischkowitz: The PALB2 gene was first identified in 2006 and linked to breast cancer in 2007 but until now we have not had good breast cancer risk estimates for women who have inherited PALB2 mutations. This study was started in 2009 by an group of research institutions (The PALB2 Interest Group) in Canada, US, Europe (UK, Belgium, Greece, Italy, Finland) and Australia. We studied 362 individuals with PALB2 mutations from 154 families. We found that awomen with a PALB2 mutation will on average have a 35% risk of developing breast cancer by the age of 70, rising to 58% if there is a strong family history. Our study will help clinicians to better advise and manage such women.
There are several new aspects.
It is by far the largest study to date and provides the most accurate risk estimates for PALB2 mutation carriers.
MedicalResearch.com Interview Cristina B. Geltzeiler, MD
Knight Cancer Institute
Oregon Health & Science University
Portland, OR 97239-3098
Medical Research: What are the main findings of the study?Dr. Geltzeiler: The main findings of the study are that implementing an Enhanced Recovery After Surgery (ERAS) program at a community hospital can be successfully implemented and can allow patients to recover quicker from their surgery with ongoing safety.
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MedicalResearch.com Interview with: Dr. Richard Saitz MD MPHDepartment of Community Health Sciences
Boston University School of Public Health
Boston, Massachusetts
Medical Research: What are the main findings of the study?Dr. Saitz: We found that brief counseling interventions had no efficacy for reducing the frequency of illicit drug use or drug use consequences among primary care patients identified by screening as using drugs.
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MedicalResearch.com Interview with: James Fisher BSc (Hons) MSc PGCLT(HE)
Senior Lecturer Sports Conditioning and Fitness
IFBB Certified Weight Training Prescription Specialist
Centre for Health, Exercise and Sport Science
Faculty of Business, Sport and Enterprise
Southampton Solent University, Southampton
Medical Research: What are the main findings of the study?Answer: The study reports that pre-conceived ideas about exercise order, and rest intervals are not substantiated by evidence, and that advanced training routines such as pre-exhaustion appear to induce no greater strength adaptations than simpler training methods. Ultimately, that a single set of each exercise performed at a repetition duration which maintains muscular tension is all that is necessary to induce significant increases in strength in even trained persons.
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MedicalResearch.com Interview with: Sara Tartof, PhD, MPH
Post-doctoral research fellow
Kaiser Permanente Southern California Department of Research & Evaluation.
Medical Research: What are the main findings of the study?Dr. Tartof: Our study found that the herpes zoster vaccine continues to be effective in protecting older adults against shingles, even after they undergo chemotherapy. In particular, we found that those patients who were previously vaccinated with the vaccine were 42 percent less likely to develop shingles following chemotherapy treatment. We also found that none of our vaccinated patients underwent hospitalization for shingles, while six unvaccinated patients were hospitalized with the disease.
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MedicalResearch Interview with: Maurizio Gasparini MD
Humanitas Research Hospital
Rozzano, Italy
Medical Research: What are the main findings of the study?Dr. Gasparini: We found that a strategic programming of implantable cardioverter defibrillators which allows the non-sustained arrhythmias to self-terminate is associated with reductions in hospitalizations, length of hospital stay and cost per patient-year and an increase in the time to first hospitalization. These results were mainly driven by reduction in cardiovascular-related events.
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MedicalResearch.com Interview withJagpreet Chhatwal, Ph.D.
Assistant Professor
Department of Health Services Research
Houston, TX 77098
Medical Research: What are the main findings of the study?Dr. Chhatwal:The recent updates in hepatitis C virus (HCV) screening policy and ongoing therapeutic advances can make hepatitis C a rare disease in the US by 2036. However, more aggressive screening strategies are needed to further reduce the burden of disease. For example, 1-time universal screening further identify 487,000 chronic hepatitis C virus cases in the next 10 years, and can make hepatitis C a rare disease in the next 12 years.
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upcoming JAMA publication:
MedicalResearch.com Interview with:Shuen-Iu Hung, PhD, for the Taiwan SCAR consortium
Associate Professor, Department of Pharmacology,
National Yang-Ming University, Taipei, 112 Taiwan
Medical Research: What are the main findings of the study?Reply: Phenytoin, a widely prescribed antiepileptic drug, can cause severe cutaneous adverse reactions (SCAR) (e.g., Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) ), which carry high mortality and morbidity. The genomic basis of phenytoin-induced SCAR has not been known. This study identifies CYP2C variants, including CYP2C9*3 known to reduce drug clearance, as the key genetic factors associated with phenytoin-related severe cutaneous adverse reactions. These findings have potential to improve the safety profile of phenytoin in clinical practice and offer the possibility of prospective testing for preventing phenytoin-related SCAR.
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MedicalResearch.com: Interview with: M. Susan Ridgely, JD
Senior Policy Analyst
RAND Corporation
Santa Monica, California
Medical Research: What are the main findings of the study?Answer: We evaluated a three-year effort, coordinated by the Integrated Healthcare Association, to determine whether bundled payment could be an effective payment model for California. The pilot focused on bundled payment for orthopedic procedures for commercially insured adults under age 65. Bundled payment is a much-touted strategy that pays doctors and hospitals one fee for performing a procedure or caring for an illness. The strategy is seen as one of the most-promising ways to curb health care spending. Unfortunately, the project failed to meet its goals, succumbing to recruitment challenges, regulatory uncertainty, administrative burden and concerns about financial risk.
At the outset of the project, participants included six of the state’s largest health plans, eight hospitals and an independent practice association. Eventually, two insurers dropped out because they believed the bundled payment model in this project would not lead to a redesign of care or lower costs. Another decided that bundled payment was incompatible with its primary type of business (health maintenance organization). Just two hospitals eventually signed contracts with the three remaining health plans to use bundled payments. Hospitals that dropped out cited concerns about the time and effort involved.
The project was hurt by a lack of consensus about what types of cases to include and which services belonged in the bundle. In the end, most stakeholders agreed that the bundle definitions were probably too narrow to capture enough procedures to make bundled payment viable.
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MedicalResearch.com Interview with: Dr. John J. Sim
Division of Nephrology and Hypertension
Kaiser Permanente Los Angeles Medical Center, Los Angeles,
Medical Research: What are the main findings of the study? Dr. Sim: Among a large diverse population of treated hypertensive people, those who achieved systolic blood pressures (SBP) in the ranges of 130-139mm Hg had the lowest risk for death and end stage renal disease (kidney failure). Not surprisingly, those with SBP above 139 had incrementally greater risk, but somewhat surprising was that those with SBP under 130 also had a greater risk for death and kidney failure.
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MedicalResearch.com Interview with:Henry M. Spinelli, MD, PC
Plastic & Reconstructive Surgery
875 Fifth Avenue
New York, NY 10065
Medical Research: What are the main findings of the study?
Dr. Spinelli: Briefly, we polled approximately 26,000 plastic surgeons by way of membership in the International Society of Aesthetic Plastic Surgeons (ISAPS), American Society for Aesthetic Plastic Surgery (ASAPS) and American Society of Plastic Surgeons (ASPS) and collated this data and published it in Aesthetic Plastic Surgery (the Blue Journal), the official journal of ISAPS. This preliminary study was initiated given the current and past healthcare and cosmetic medical/surgical care climate both in the United States and worldwide. As a background, when it comes to injectables (botox and fillers) there is not a united consensus on a state by state basis in the USA and from country to country worldwide. Additionally, the regulations and laws governing the administration of botox and injectables is in a constant flux. For instance, the UK allowed beauticians in the past to administer these substances however they are now banned from legal administration of these products. Alabama, only allows physicians (dermatologists and plastic surgeons) to purchase and administer botox and injectables whereas the medical board of California states that physicians can perform the procedure or oversee licensed registered nurses, licensed vocational nurses, or physicians assistants. Similarly, dentists in some states are permitted to administer these agents. It would be a bad idea for any physician working with botox to take Advanced Botox Training to reduce the possibility of medical misdemeanors.
At the present time few studies have directly assessed the capability of various providers to administer cosmetic injections. When people schedule a consultation for plastic surgery, they are often looking for things like a younger face or a nicer body. The answer to the previous question will become more important as the demand for these procedures continues to grow and an increasing number of practitioners and different Plastic Surgeon from a variety of backgrounds enter the field to meet demand. This study aimed to help define the role of various practitioners in an increasingly more competitive environment for injectables and to explore the relationship between patient and injectable provider in order to improve patient satisfaction and outcomes.
When asked to rank patients’ perceptions of various providers according to their expertise in administering Botox and dermal fillers, responders ranked plastic surgeons and dermatologists as most capable (96%) then nurses in plastic surgery and dermatology (3%). Gynecologists (<1%), dentists (<1%) and nurses in other fields (<1%) all received nearly equivalent numbers of “most capable” rankings. When asked to rank patients’ perception of various providers according to their inability to administer Botox and dermal fillers, nurses in other fields were most frequently ranks as least capable (63%) followed by dentists (26%), gynecologists (12%), plastic surgeons and dermatologists (2%) and nurses in plastic surgery and dermatology (1%).
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MedicalResearch.com Interview with:Isaac J. Powell MD
Wayne State University/Karmanos Cancer Inst
University Health Center
Detroit, MI 48201.
Medical Research: What is the background for your study?Dr. Powell: During the PSA testing era for prostate cancer, which is responsible for early treatment, survival disparity between African Americans and European Americans has been eliminated.
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MedicalResearch.com Interview with: Dr. Sridhar Mani MD
Departments of Genetics and Medicine
Albert Einstein College of Medicine
Bronx, NY 10461
Medical Research: What are the main findings of the study?Dr. Mani: In a series of studies using cells grown in the lab and mouse studies, the researchers found that a metabolite called indole 3-propionic acid (IPA)—produced exclusively by so-called commensal bacteria —both strengthens the intestinal epithelium’s barrier function and prevents its inflammation by activating an orphan nuclear receptor, Pregnane X Receptor (PXR). Specifically, PXR activation suppresses production of an inflammatory protein called tumor necrosis factor alpha (TNF-á) while increasing levels of a protein that strengthens the junctions between intestinal epithelial cells (makes the intestines less permeable to noxious substances). Loss of PXR protein and/or IPA results in a disrupted intestinal barrier and increased propensity towards intestinal inflammation and/or toxin induced injury to the intestines.
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MedicalResearch.com Interview with: S. Mitchell Harman, M.D., Ph.D.
CAPT US Public Health Service, retired
Professor, Clinical Medicine, U of AZ College of Medicine
Interim Chief, Dept. of Internal Medicine
Chair, IRB Subcommitee
Phoenix VA Health Care System
Phoenix, AZ 85012-1892
Medical Research: What are the main findings of the study?Dr. Harman: The major findings are:
1. Neither transdermal nor oral estrogen treatment significantly accelerates or decelerates rate of change of carotid artery intimal medial thickness (CIMT) in healthy recently menopausal women.
2. Both estrogen treatments have some potentially beneficial effects on markers of CVD risk, but these differ depending on the route of estrogen delivery with improvements in LDL and HDL cholesterol seen with oral, and reduced insulin resistance with transdermal.
3. No significant effects were observed on rate of accumulation of coronary artery calcium.
4. Women reported significant relief of vasomotor (hot flush) symptoms with both estrogen treatments
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MedicalResearch.com Interview with: Dr. Bing Lu, M.D., Dr.P.H.
Division of Rheumatology
Immunology & Allergy
Brigham & Women's Hospital and Harvard Medical School
Boston, MA 02115
Medical Research: What are the main findings of the study?Dr. Lu: In two large cohorts of women, we observed that being obese increased the risk of rheumatoid arthritis in women by 40–70% depending on age and serologic status. The highest risk for rheumatoid arthritis was among women who were overweight or obese at age 18 years, emphasizing the public health importance of combating the obesity epidemic at all ages. Our study implicates being overweight or obese throughout adult life as a risk factor in the development of seropositive and seronegative RA for women diagnosed with rheumatoid arthritis at age 55 years or younger. The attenuated association between BMI and rheumatoid arthritis diagnosed at older ages may reflect differences in the pathophysiology of RA diagnosed at earlier ages compared with that diagnosed at older ages, or may be a result of the limitations of BMI as a measure of total fat mass as women age.
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MedicalResearch.com Interview with:Marianne Berwick, PhD, MPH for the GEM Study Team
Professor, Division of Epidemiology
University of New Mexico, Department of Internal Medicine
New Mexico Cancer Research Facility
University of New Mexico, Albuquerque, NM 87131
Medical Research: What are the main findings of this study?Dr. Berwick: In our study of Sun Exposure and Melanoma Survival: A GEM Study we found that there is little strong evidence that sun exposure at any time in life influences melanoma-specific survival. This study took place in Australia, Italy, Canada and the United States among 3,578 individuals newly diagnosed with melanoma, who we followed for a mean of 7.4 years.
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MedicalResearch.com Interview with: Estee L. Williams, MD
SUNY Downstate Medical Center, Brooklyn, New York
Madfes Integrated Dermatology, New York, New York
[email protected]Medical Research: What are the main findings of the study?
Dr. Williams: In our retrospective review of all melanomas diagnosed at the Veterans’ Affairs Hospital in Brooklyn since 2000, we discovered that although a majority of the melanomas (63%) were found by the dermatologist during a yearly “full body” screening examination (versus detection by the patient), melanomas found by the dermatologist were not necessarily thinner (hence, earlier, more curable) than those found by the patient.
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MedicalResearch.com Interview with: Lindsay Cohen MD
Department of Emergency Medicine
University of British Columbia
Medical Research: What are the main findings of the study?Dr. Cohen: In our systematic review of the literature, we sought to synthesize the available evidence on the effect of ketamine on clinical outcomes as compared to other sedative agents in intubated patients. Our outcomes of interest included intracranial and cerebral perfusion pressures, neurologic outcomes, ICU length of stay, and mortality. We included only randomized controlled trials and prospective controlled studies, and identified a total of ten studies that met our inclusion criteria. Due to the lack of homogeneity in the studies, data was analyzed in a qualitative manner. None of the studies reported significant differences between ketamine and other sedative agents for any of our outcomes of interest.
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MedicalResearch.com Interview with: Jana Shaw MD, MPH, FAAP
Associate Professor of Pediatrics
Pediatric Infectious Diseases
SUNY Upstate Medical University
750 East Adams Street
Syracuse, NY 13210
Medical Research: What are the main findings of the study?Dr. Shaw: In this study, we looked at exemptions to school immunization requirements in the US during 2009-2010 school year. We found that private schools have higher rates for all types of exemptions (medical, religious, and personal belief/philosophical). In addition, states that permitted personal belief exemptions had higher rates of exemptions overall compared to states that did not allow them.
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MedicalResearch.com Interview Celeste Campos-Castillo PhD
Assistant Professor
Department of Sociology
University of Wisconsin-Milwaukee
Medical Research: What are the main findings of the study?Dr. Campos-Castillo: Approximately 13% of adults in the U.S. have held back information from doctors out of privacy or security concerns. When we compare adults with the same characteristics (e.g., age and education, overall health, and health care characteristics like having insurance and seeing a doctor in the past year) based on whether their doctor uses an electronic health record (EHR) system or not, we find that those with a doctor that uses an electronic health record were more likely to hold back information than those whose doctor does not use an electronic health record.
Other studies have looked at whether electronic health records are related to withholding information out of privacy concerns, but the evidence was mixed: sometimes patients with EHRs were more likely to hold back information from doctors, other times there but sometimes there was no difference in withholding between patients of doctors who used EHRs and those who did not.
What makes our study unique is that we consider a range of factors in the analysis that can disguise the real relationship between EHRs and withholding information because of privacy concerns. In particular, we take into account how patient ratings of quality of care play a complicated role in this situation. Patients with doctors who use EHRs often rate the quality of care they receive higher than those with doctors who are not using these systems. At the same time, higher quality ratings generally mean that patients feel comfortable sharing information with doctors, even the sensitive information that we tend to keep to ourselves. Because quality ratings are associated both with EHRs and with holding back information from doctors, it is necessary to consider this in the analysis. Otherwise – as we show in the study – we would mistakenly conclude that EHRs are unrelated to holding back information. Instead, we show that when we accurately compare patients with the same characteristics, including quality ratings, patients with EHRs are more likely to withhold information from their doctors out of concerns for privacy.
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MedicalResearch.com Interview with: Supinda Bunyavanich, MD, MPH, MPhil
Department of Pediatrics- Allergy/Immunology
Department of Genetics and Genomic Sciences
Icahn Institute for Genomics and Multiscale Biology
Mindich Child Health and Development Institute
Icahn School of Medicine at Mount Sinai New York, NY 10029 USA
Medical Research: What are the main findings of the study?Dr. Bunyavanich: What is the prevalence of peanut allergy among US children? Given that 90% of US households consume peanut butter, this is an important question. We report and compare prevalence estimates of childhood peanut allergy according to varying criteria among 7-10 year-old children participating in a US birth cohort not selected for any disease. The prevalence of peanut allergy ranged from 2.0% to 5.0%, depending on definition.
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MedicalResearch.com Interview with: Effie Viguiliouk
M.Sc. Candidate, Department of Nutritional Sciences
University of Toronto
Medical Research: What are the main findings of the study?Effie Viguiliouk: This systematic review and meta-analysis of the totality of evidence from 12 randomized clinical trials in 450 participants with type 2 diabetes found that eating about 1/2 a cup of tree nuts per day (equivalent to about 60 g or 2 servings) significantly lowered the two key markers of blood sugar, HbA1c and fasting glucose, in comparison to calorically matched control diets without tree nuts.
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MedicalResearch.com Interview with: Magdalena Cerdá, DrPH MPH
Assistant Professor, Department of Epidemiology
Mailman School of Public Health
Columbia University
New York, NY 10032-3727
Medical Research: What are the main findings of the study?Dr. Cerdá: We evaluated 1,095 Ohio National Guard soldiers, who had primarily served in Iraq and Afghanistan between 2008 and 2009 to determine the effect of civilian stressors and deployment-related traumatic events and stressors on post-deployment alcohol use disorder.
Participants were interviewed three times over 3 years about alcohol use disorder, exposure to deployment-related traumatic events like land mines, vehicle crashes, taking enemy fire, and witnessing casualties, and about experiences of civilian life setbacks since returning from duty, including job loss, legal problems, divorce, and serious financial and legal problems.
We found that having at least one civilian stressor or a reported incident of sexual harassment during deployment raised the odds of alcohol use disorders. In contrast, combat-related traumatic events were only marginally associated with alcohol problems.(more…)
MedicalResearch.com Interview InvitationProf. Frank B HuDepartment of Nutrition
Department of Epidemiology
Harvard School of Public Health
Medical Research: What are the main findings of the study?Prof. Hu:We found that increasing consumption of fruits and vegetables is associated with reduced risk of mortality, especially cardiovascular mortality. The largest reduction in mortality can be achieved at 5 servings per day of fruits and vegetables.
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MedicalResearch.com Interview with: Dr Angelica Ronald
Genes Environment Lifespan (GEL) laboratory
Centre for Brain and Cognitive Development
Department of Psychological Sciences
Birkbeck, University of London
London WC1E 7HX
Medical Research: What are the main findings of the study?Dr. Ronald: Psychotic experiences, such as paranoia, hallucinations and disorganised thinking, are commonly reported by adolescents. Until now it has not been understood whether mild variations in psychotic experiences in the community are part of the same construct as more severe psychotic experiences in adolescence. Our findings suggest that they are. In our study, over 10,000 16-year-old adolescents in England and Wales were assessed on measures of psychotic experiences. The study identified a close link between normal, less frequent psychotic experiences and more severe and frequent experiences in the general population. A classic twin design was employed, which enabled us to conduct analyses investigating the role of genetic and environmental influences on psychotic experiences. The same genetic influences appeared to play a role across the spectrum of severity of psychotic experiences.
The study found that psychotic experiences are moderately heritable in adolescence in the general population. This suggests it would be worth directing molecular genetic endeavours towards this area, which has so far received very little attention in terms of causal explanations. We also show that psychotic experiences have considerable environmental influence; in fact, environmental influence appears to play a larger role in causing psychotic experiences in adolescence than for diagnosed psychotic disorders in adults, such as schizophrenia. This result suggests a fruitful avenue will be to tackle what environmental risk factors influence adolescents to have psychotic experiences.
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MedicalResearch.com Interview with Dr. John C. Lieske, MD
Mayo Clinic, Rochester, MN
Medical Research: What are the main findings of the study?Dr. Lieske:We followed 11 women before, 6 and 12 months after Roux en Y gastric bypass surgery. The patients successfully lost weight as mean BMI fell from 46 kg/m2 preoperatively to 28 kg/m2 postoperatively. Mean serum creatinine did not significantly change from baseline (0.8 mg/dl) to 12 months (0.7 mg/dl). Hence mean GFR estimated by the CKD-EPI equation (eGFR) did not significantly change from 84 ml/min/1.73 m2 (baseline) to 90 ml/min/1.73 m2 (12 months). However, GFR measured by iothalamate clearance (mGFR) significantly decreased from 108 ml/min/1.73m2 (121 ml/min) to 85 ml/min/1.73 m2 (90 ml/min).
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MedicalResearch.com Interview with: Dr. Agatha van der Klaauw, PhD
Wellcome Trust Postdoctoral Clinical Fellow
Wellcome Trust-MRC Institute of Metabolic Science
University of Cambridge Metabolic Research Laboratories
Addenbrooke's Hospital
Cambridge, United Kingdom
Medical Research: What are the main findings of the study?Dr. van der Klaauw:Obesity occurs when we eat more calories than we burn which is often easy to do as many foods are highly palatable and high in calories. Highly palatable foods such as chocolate trigger signals in the brain that give a feeling of pleasure and reward (sometimes called cravings) which can contribute to overeating. These signals are processed in the reward centres in the brain, where sets of neurons release chemicals such as dopamine. However, very little is known about whether the reward centres of the brain work differently in some people who are overweight.
In this study, we were interested in studying overweight people who had a problem with the melanocortin 4 receptor (MC4R) gene. About 1% of obese people have a problem in this gene which contributes to weight gain from a young age. We compared three groups of people: people who were overweight due to a problem in the MC4R gene, people who were overweight but the gene was normal and some people who were normal weight. We performed functional Magnetic Resonance Imaging (fMRI) scans to look at how the reward centres in the brain were activated by pictures of appetizing food such as chocolate cake compared to bland food such as rice or broccoli and non-food items such as staplers.
We found that in normal weight people, the reward centres are activated (light up) when they are shown pictures of cake or chocolate and the same was seen in overweight people with a problem in the MC4R gene. But we found that the reward centres were underactive in overweight volunteers (in whom the gene was normal).
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MedicalResearch.com Interview with:Richard J. O'Reilly, MD
Memorial Sloan Kettering Cancer Center
Medical Research: What are the main findings of the study?Dr. O'Reilly:
1. In a comparison of the results of HLA-matched sibling transplants with other established transplant approaches, including T-cell depleted half-matched parental marrow grafts, unmodified transplants from matched unrelated donors and cord blood transplants in the current era (2000-2009), transplants from donors other than HLA-matched siblings had 5 year survival outcomes similar to those of matched siblings when applied to young infants (≤ 3.5 months of age) or infants of any age that were not infected at the time of transplants. Thus any child born with SCID can now be successfully transplanted.
2. Active infection at the time of transplant significantly reduced chances of long-term survival for all infants except those who received transplants from HLA-matched siblings. Thus, infection is a dominant determinant of transplant outcome. Control of treatable infections prior to transplant should be a major clinical objective.
3. Treatment with chemotherapy containing busulfan significantly enhances the likelihood of recovering a normal ability to make antibodies and fosters better recovery of T-cells that provide cell mediated immunity, and may be an acceptable risk in uninfected infants. However, use of any chemotherapy prior to transplant in an infant who is infected, greatly decreases chances of survival. In infected patients who lack a matched sibling, T-cell depleted transplants from half matched related donors had the best outcomes.
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