Author Interviews, Cancer Research, Gender Differences, JAMA / 02.11.2019

MedicalResearch.com Interview with: Nina Niu Sanford, M.D. Assistant Professor Dedman Family Scholar in Clinical Care UT Southwestern Department of Radiation Oncology Dallas TX MedicalResearch.com: What is the background for this study? Response: Minority racial/ethnic groups present at later stages of cancer and have worse stage-specific survival rates.  Cultural competency represents a single element within the dynamic and trans-disciplinary field of health disparities, but is an important modifiable factor for both providers and health organizations that could be associated with disparities in cancer outcomes. There have been longstanding initiatives and training requirements in medical education specifically designed to improve provider cultural competency over the past couple of decades, and the American Society of Clinical Oncology (ASCO) has recently outlined goals for improving cultural competency within its policy statement on cancer disparities. Moreover, ASCO health disparity policies have recently highlighted the association between racial/ethnic disparities in cancer outcomes and a “lack of access to high-quality care that is understanding and respectful of diverse traditions and cultures plays a significant role.”  Given the above, we wished to assess access to culturally competent providers among patients with cancer by race/ethnicity. (more…)
Author Interviews, Genetic Research, JAMA, Ophthalmology / 02.11.2019

MedicalResearch.com Interview with: Professor Jeremy A. Guggenheim School of Optometry & Vision Sciences Cardiff University, UKProfessor Jeremy A. Guggenheim School of Optometry & Vision Sciences Cardiff University, UK MedicalResearch.com: What is the background for this study? Response: Near-sightedness (myopia) usually develops during childhood and necessitates the use of glasses or contact lenses to correct blurry distance vision. It is also a risk factor for sight-threatening disorders such as glaucoma, retinal detachment and macular degeneration. Promising treatments designed to slow the progression of myopia are becoming available. Building on previous research suggesting that some individuals are genetically predisposed to near-sightedness, we investigated whether a genetic test could identify children at risk of developing myopia.  (more…)
Author Interviews, Cost of Health Care, JAMA / 01.11.2019

MedicalResearch.com Interview with: Rena M. Conti, PhD, Associate Professor Department of Markets, Public Policy and Law Questrom School of Business Boston University Boston, MA 02215 Co-Authors: Sayeh S. Nikpay, PhD Melinda B. Buntin, PhD Vanderbilt University School of Medicine MedicalResearch.com: What is the background for this study? Response: The federal 340B program provides deep discounts on the acquisition cost of prescription drugs for participating hospitals and places no limits on what hospitals charge patients and insurers.  Congress intended 340B profits generated from hospital participation to subsidize the provision of safety net care for patients residing in the community. This study is the first to estimate the size of profits hospitals participating in the 340B drug discount program collect from Medicare patients for the outpatient clinic administration of prescription drugs. (more…)
Author Interviews, JAMA, Osteoporosis, Weight Research / 01.11.2019

MedicalResearch.com Interview with: Radhika Seimon, PhD Research Fellow at the University of Sydney Amanda Salis, PhD - Professor of Obesity Research at the University of Sydney Senior Research Fellow National Health and Medical Research Council of Australia  MedicalResearch.com: What is the background for this study? Response: Total meal replacement diets are severely energy-restricted diets that involve replacing all or almost all foods with nutritionally replete meal replacement products such as shakes, soups, or bars (i.e. total diet replacement). They are the most effective dietary treatment for obesity, resulting in greater short- and long-term weight loss compared with conventional food-based diets. However, there are concerns that total meal replacement diets may adversely affect body composition, notably lean mass and bone mineral density. (more…)
Author Interviews, Education, NEJM, Surgical Research / 31.10.2019

MedicalResearch.com Interview with: Ryan J. Ellis, MD MS General Surgery Resident Surgical Outcomes and Quality Improvement Center (SOQIC) Northwestern Medicine  MedicalResearch.com: What is the background for this study? Response: Burnout has emerged as a significant problem affecting the entire healthcare workforce and it has been likely to myriad downstream problems such as increases in medical errors, alcoholism, and depression. Despite the attention on clinician burnout, there are significant gaps in our understanding of how the workplace environment may lead to burnout. Moreover, there are particular concerns about the workplace environment in training, specifically with regards to abuse, discrimination, and harassment. We had the opportunity to survey all U.S. general surgery residents to comprehensively define the frequency of workplace mistreatment and its relationship with burnout and suicidal thoughts among surgical residents. (more…)
Author Interviews, Cancer Research, JAMA, Melanoma, Surgical Research, Weight Research / 30.10.2019

MedicalResearch.com Interview with: Magdalena Taube, PhD Institute of Medicine, Dept of Molecular and Clinical Medicine Sahlgrenska Academy at Gothenburg University Wallenberg laboratory Gothenburg Sweden  MedicalResearch.com: What is the background for this study? Response: Obesity is a cancer risk factor, and bariatric surgery in patients with obesity is associated with reduced cancer risk. However, evidence of an association among obesity, bariatric surgery and skin cancer is limited. In this study we used data from the Swedish Obese Subjects (SOS) study– a prospective controlled intervention trial examining bariatric surgery outcomes – to analyze the impact of bariatric surgery on skin cancer incidence. (more…)
Author Interviews, Columbia, Infections / 30.10.2019

MedicalResearch.com Interview with: Barun Mathema PhD Assistant Professor,Epidemiology Mailman School of Public Health Columbia University MedicalResearch.com: What is the background for this study? Response: In 2005 a major outbreak of extensively drug-resistant tuberculosis (XDR-TB) causing over 90% mortality was reported in rural town of Tugela Ferry, KwaZulu-Natal, South Africa. The strain that caused the outbreak was resistant to all first and most second line antibiotics. This strain has since been recovered throughout the district and accounts for over 79% of all XDR-TB. We were interested in understanding the basic epidemiological and evolutionary forces that enabled this strain to proliferate. More simply, when and where this strain emerged, and how and why it became dominant.  (more…)
Author Interviews, Heart Disease, Race/Ethnic Diversity / 30.10.2019

MedicalResearch.com Interview with: Michelle Morse, MD, MPH Founding Co-Director, EqualHealth Soros Equality Fellow Assistant Professor, Harvard Medical School Co-Founder, Social Medicine Consortium  MedicalResearch.com: What is the background for this study?
  • Response: Frontline clinicians have a unique vantage point to identify and characterize inequities in care. This study was inspired by internal medicine residents’ first-hand clinical experiences of black and Latinx patients who were frequently admitted to the general medicine service, as opposed to the cardiology service, with an ultimate diagnosis of HF.
  • Research has shown that structural inequities are pervasive throughout healthcare delivery systems and across many services, within both the inpatient and outpatient arenas. We hope other institutions and clinicians will be equally committed to addressing inequities in their own contexts, systems, and care settings and that patients will identify opportunities for self-advocacy in their care.
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Accidents & Violence, Author Interviews, JAMA, Pediatrics / 29.10.2019

MedicalResearch.com Interview with:   Carole Stipelman MD MPH Associate Professor of Pediatrics Physician Informatics Team Medical Director, University Pediatric Clinic Salt Lake City, Utah     MedicalResearch.com: What is the background for this study? What are the main findings? 
  • Guns are the second leading cause of death in children and adolescents.
  • 6 million children live in homes with at least one gun that is loaded and unlocked.
  • Safe storage of guns increases when physicians speak with parents about how to prevent children from having access to guns. However, these conversations happen infrequently.
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Author Interviews, Biomarkers, Schizophrenia / 29.10.2019

MedicalResearch.com Interview with: Dr.  Takeo Yoshikawa MD PhD RIKEN Center for Brain Science Japan MedicalResearch.com: What is the background for this study? What are the main findings?
  • Currently available drugs for schizophrenia are the dopamine D2 receptor blockers. These compounds were serendipitously discovered over half-century ago. But about 30% of schizophrenia are resistant to the dopamine D2 receptor blockers. In spite of these conditions, pharmaceutical companies have abandoned the development of new drugs. This is because we do not know the principle of drug design.
  • Therefore, we need to understand the molecular underpinning of as-yet unknown schizophrenia pathophysiology. Schizophrenia is diagnosed by only patients’ symptoms, not by biological examination. To search for biological underpinning for schizophrenia using experimental animals, we thought that we should examine an endophenotype (biological trait) relevant to schizophrenia. Then we targeted prepulse (PPI) performance.
  • Here, dampened PPI is considered as a biological marker of psychiatric disorders, typically of schizophrenia. Importantly, PPI can be measured using the same behavioral paradigm between experimental animals and human.
  • C57BL/6 (B6) inbred mouse shows higher (better) prepulse inhibition (PPI) performance, while C3H/He (C3H) inbred mouse shows lowered (worse ) PPI. We premised that C3H mouse is “schizophrenia-prone” and B6 is not. To know the molecular basis for differential PPI levels between the two inbred mouse strains, we performed comprehensive protein expression level analysis (proteomics analysis) using the brains of B6 and C3H mice.
  • The expression levels of Mpst, a hydrogen sulfide (H2S)-producing enzyme, is elevated in C3H mouse compared to B6 mouse. Biochemical analysis also supported the elevated H2S production in C3H mouse compared to B6.
  • The examination of human samples including postmortem brains, iPS-derived neural stem cells (neurospheres) and hair follicle cells, gave evidence that H2S production system is indeed up-regulated in schizophrenia.
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Addiction, Author Interviews, Mental Health Research, Technology / 29.10.2019

MedicalResearch.com Interview with: Zsolt Demetrovics PhD and Orsolya Király PhD Department of Clinical Psychology and Addiction Institute of Psychology ELTE Eötvös Loránd University MedicalResearch.com: What is the background for this study? Response: Gaming disorder has recently been recognized by the World Health Organization (WHO) as a mental disorder. Research examining gaming motivations and mental health among video gamers and in relation with gaming disorder is increasing but different types of gamers such as recreational gamers and esport gamers are not commonly distinguished. Esport is form of electronic sport and refers to playing video games in a professional (competitive) manner in sports-like tournaments. Much like in the case of traditional sports, esport players and teams are sponsored, tournaments are broadcasted and followed by large audiences and have large financial prizes. Therefore, being an esports player in now a real career opportunity for teenagers and young adults who like playing video games.  (more…)
Author Interviews, Exercise - Fitness, Heart Disease, Hip Fractures, JAMA, Menopause / 28.10.2019

MedicalResearch.com Interview with: Jean Wactawski-Wende PhD Dean, SUNY Distinguished Professor Department of Epidemiology and Environmental Health School of Public Health and Health Professions University of Buffalo MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study included data from the Women’s Health Initiative, a prospective study of postmenopausal women from across the United States. We assessed physical activity in 77,206 women over an average of 14 years of follow-up. Approximately 1/3 of these women (average age 63.4 years) had at least one fracture occur. Higher physical activity levels were associated with  lower risk of hip and total fracture. Even levels of activity that were moderate, including regular walking and doing household chores, were beneficial.  (more…)
Author Interviews, Mental Health Research / 26.10.2019

massage-therapyThousands of people are diagnosed with a psychiatric disorder each year. The National Alliance on Mental Illness estimates that 18.5% percent of the adult population in the U.S. experiences a mental condition in any given year. As the epidemic of mental disorders threatens to engulf many more, those affected are resorting to holistic treatment approaches like meditation and massage therapy. In the following post, we’ll explain how massage is being used to treat psychiatric disorders and the resulting benefits. (more…)
Author Interviews, Dermatology / 25.10.2019

MedicalResearch.com Interview with: Dr. Stephan Weidinger, MD, MaHM Professor of Dermatology Christian-Albrechts-Universit Kiel  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Relatively little is known about the epidemiology and burden of Atopic Dermatitis (AD) in children, adolescents and adults, however, there is increasing evidence that the disease is highly prevalent also in these age groups. Further, very little is known about the disease severity strata. Severity, however, largely defines treatment needs. The EPI-CARE (EPIdemiology of Children with Atopic dermatitis Reporting on their Experience) study was a cross-sectional web-based study of the prevalence and burden of AD in both children and adolescents. It was performed globally across Europe, North America (US, Canada), Latin America (Argentina, Brazil, Colombia, Mexico), Asia (Japan, Taiwan), the Middle East (Israel, Kingdom of Saudi Arabia, Turkey, the United Arab Emirates) and Russia, and used very stringent definitions of AD and the same methodology across age groups. We first analyzed the adolescent data, and it turned out that the prevalence of active Atopic Dermatitis is higher than expected, ranging from 9.29% in the US and 14.7% in Europe. Of note, almost 50% of the adolescents with current AD reported an overall moderate to severe disease activity, and the majority reported a multidimensional burden that includes not only the skin symptoms associated with AD, but also sleep disturbances, symptoms of anxiety/depression, and reductions in quality‐of‐life and productivity. Adolescents also reported a high burden of coexisting atopic diseases that increased with AD severity – 68.6% of those with moderate AD and 81% of those with severe AD reported at least one coexisting atopic disease. atopic dermatitis substantially affects the life of patients and their families, and this burden is higher with greater AD severity. (more…)
Author Interviews, Environmental Risks, Occupational Health, Pulmonary Disease / 24.10.2019

MedicalResearch.com Interview with: Orianne Dumas, PhD INSERM Aging and Chronic Diseases, Epidemiological and Public Health Approaches,Villejuif, University de Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux France  MedicalResearch.com: What is the background for this study? Response: Exposure to cleaning products and disinfectants is common at work and at home and remains more frequent among women. Exposure levels are particularly high in the health care industry. The respiratory health risks associated with exposure to cleaning products and disinfectants are increasingly recognized. Although investigators have primarily focused on asthma, the irritant properties of many chemicals contained in disinfectants support the study of a broader range of respiratory effects, such as chronic obstructive pulmonary disease (COPD). (more…)
Author Interviews, Environmental Risks, Pediatrics, Smoking, Tobacco, Tobacco Research / 24.10.2019

MedicalResearch.com Interview with: Melody Kingsley, MPH Epidemiologist, Massachusetts Department of Public Health  MedicalResearch.com: What is the background for this study? Response: The majority of youth who use tobacco use flavored products, which are available in thousands of distinct flavors with youth appeal.[i] In response, communities in states across the country, including Massachusetts, have passed flavored tobacco restriction policies which restrict sales of flavored tobacco; the Food and Drug Administration has proposed increased restrictions on the sale of flavored tobacco nationwide as well. To date, a few studies have found that flavored tobacco restriction policies reduce sales and availability of flavored tobacco, but to our knowledge, no prior evidence exists on the short-term impact of FTRPs on youth tobacco use. Timely evaluation of these policies is important to ensure that FTRPs are an effective strategy for curbing youth tobacco use. (more…)
Author Interviews, Cognitive Issues, Environmental Risks, OBGYNE, Pediatrics / 24.10.2019

MedicalResearch.com Interview with: Eva Tanner, PhD, MPH, Postdoctoral Researcher Department of Environmental Medicine and Public Health Icahn School of Medicine at Mount Sinai Carl-Gustaf Bornehag, PhD Professor at Karlstad University MedicalResearch.com: What is the background for this study? Response: Most prior research on health risks from chemical exposure study one chemical at a time. However, we are exposed to a multitude of chemicals every day in the air we breathe, food and water we consume, and things we touch. This is supported by global biomonitoring data showing that humans in general have a high number of chemicals identified in their bodies, i.e., in blood, urine, breast milk, saliva, etc. Unfortunately, we don’t know how such single chemicals act in complicated mixtures and impact our health, or the health of future generations. We conducted this study to help understand how prenatal exposure to mixtures of proven or suspected endocrine disrupting chemicals - found in common consumer products - during the earliest part of life may impact a child’s brain development and cognition in school age. (more…)
Author Interviews, Cost of Health Care, Emergency Care / 24.10.2019

MedicalResearch.com Interview with: Murtaza Akhter, MD Assistant Professor Department of Emergency Medicine University of Arizona College of Medicine Phoenix MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent years have brought a significant increase in emergency department visits, and therefore also a boon in openings of freestanding emergency departments (FrEDs). However, it is has been unclear whether the opening of FrEDs reduces healthcare costs. Our study showed that in increase in FrEDs was associated with an increase in spending per Blue Cross Blue Shield enrollee. (more…)
Author Interviews, Cancer Research, Genetic Research, Pharmaceutical Companies / 23.10.2019

MedicalResearch.com Interview with: Ambry GeneticsRachid Karam, MD, PhD Ambry Genetics Aliso Viejo, California MedicalResearch.com: What is the background for this study? Response: DNA genetic testing is a powerful tool used to tailor medical care based on an individual’s cancer risk. However, even medical grade DNA genetic testing can produce inconclusive results, finding a change in our DNA to be a variant of unknown significance (a VUS) and failing to determine whether it increases cancer risk. When this happens, healthcare providers might not have the information needed to recommend appropriate preventive and early detection steps, or certain cancer treatments, and relatives may not be referred for genetic testing for their own care. In this study, investigators from Ambry, Dana-Farber Cancer Institute, Cedars-Sinai Medical Center, Rutgers Cancer Institute, and University of Kansas Cancer Center demonstrated that performing both DNA and RNA genetic testing reduces inconclusive results enabling clinicians to offer cancer screening and treatment resources to the right patients. (more…)
Author Interviews, Cancer Research, Lung Cancer / 23.10.2019

MedicalResearch.com Interview with: Li C. Cheung, PhD Staff Scientist, Biostatistics Branch Division of Cancer Epidemiology & Genetics NCI National Cancer Institute MedicalResearch.com: What is the background for this study? Response: Using individualized risk prediction models to select individuals for lung-cancer screening will prevent more lung cancer deaths than current USPSTF guidelines (ages 55-80y; 30+ pack-years; smoke in past 15y). However, risk-based screening would lead to screening even more older smokers with comorbidities, for whom the harms of screening may outweigh the benefits. (more…)
Author Interviews, JAMA, Pediatrics, Smoking, Tobacco / 23.10.2019

MedicalResearch.com Interview with: Andrea Villanti, PhD, MPH Associate Professor Department of Psychiatry Vermont Center on Behavior and Health University of Vermont  MedicalResearch.com: What is the background for this study? Response: Our earlier work documented a significant association between first use of a flavored tobacco product and current tobacco use (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522636/) in a cross-sectional sample. The goal of this study was to examine whether there was a prospective relationship between first use of a flavored tobacco product and subsequent use of that product in longitudinal data..  (more…)
Author Interviews, Cannabis, JAMA, UCSD / 23.10.2019

MedicalResearch.com Interview with: John W. Ayers, PhD, MA Vice Chief of Innovation | Assoc. Professor Div. Infectious Disease & Global Public Health University of California San Diego MedicalResearch.com: What is the background for this study? Response: Touted as a “cure all,” researchers have documented unfounded claims that  cannabidiol (CBD) treats acne, anxiety, opioid addiction, pain, and menstrual problems. You can buy CBD droplets, massage oils, CBD gummies, or even ice cream. But public health leaders have been mostly silent on the subject because they lacked data that demonstrates just how popular CBD is and the future trajectory might be. To fill this data-gap we analyzed Google search queries that mentioned “CBD” or “cannabidiol” emerging from the United States from January 2004 through April 2019 and forecasted searches through December 2019. Rather than relying on self reports, where some might not be willing to discuss CBD openly, our strategy allowed us to directly observed millions of instances of people seeking out information or even shopping for CBD online. (more…)
Author Interviews, Cognitive Issues, Exercise - Fitness, Mental Health Research, Pediatrics / 22.10.2019

MedicalResearch.com Interview with: Adam Bohr, PhD Postdoctoral researcher Department of Integrative Physiology University of Colorado Boulder  MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​Recent population studies of former football players from the 1950's did not observe a relationship between participation in football and adverse cognitive outcomes in late adulthood. We were able to replicate this finding in a more recently ascertained cohort from the National Longitudinal Study of Adolescent to Adult Health (Add Health). We did not observe a relationship between participation in contact sports/football in the mid-1990s and impaired cognitive ability or mental health in early adulthood. (more…)
Author Interviews, Cost of Health Care, Health Care Systems / 22.10.2019

MedicalResearch.com Interview with: David S Buck, MD, MPH Associate Dean of Community Health Professor, Clinical Sciences University of Houston - College of Medicine Houston, TX 77204  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: High-Needs, High-Cost (HNHC) patients account for 5% of the general population and cost 50% of the healthcare spending. In Harris County, one patient alone costed $439,600 in a year when he visited multiple medical, social and behavioral agencies for care. This was a result of siloed systems working independently of each other leading to inefficient care for the patient. By providing coordinated care, using patient-centered goals and values, we are able to better engage and provide a holistic approach to patient care.  This paper introduces a novel ‘values-based’ intervention mechanism for the HNHC patients, in addition to a coordinated care management approach, through a single record system. The findings indicate an improved daily functioning of the HNHC patients over 4 months, improved relationship between the providers and the patients and moderate well-being scores. (more…)
Author Interviews / 22.10.2019

MedicalResearch.com Interview with: Mwenya Mubanga, MD, PhD Postdoctoral Researcher Department of Medical Epidemiology and Biostatistics  | Karolinska Institutet Childhood Allergy and Asthma Stockholm MedicalResearch.com: What is the background for this study? Response: In a previous study we showed that dog ownership was associated with a lower risk of composite cardiovascular death and all-cause death as compared to non-dog owners.1 In this follow-up, we assessed the hypothesis that dog ownership was associated with better survival after either an acute myocardial infarction or an ischemic stroke. Using the rich Swedish national registers, we identified more than 300,000 adults aged 45 to 80 and linked their individual-level health records to information on socio-economic, demographic and death data. (more…)
Allergies, Author Interviews, JAMA, Nutrition, Pediatrics / 22.10.2019

MedicalResearch.com Interview with: Mitsuyoshi Urashima MD, PhD, MPH Professor of Molecular Epidemiology Jikei University School of Medicine Tokyo, JAPAN MedicalResearch.com: What is the background for this study? Response: IgE-mediated food allergy is becoming a global concern, because its prevalence and severity are worsening. Many Japanese maternity wards encourage breastfeeding, but allow mothers or nurses to supplement breastfeeding with cow’s milk formula, e.g., approximately 6 to 10 hours after birth or even earlier, based on maternal preferences, but not based on clinical evidence. However, more than 20 to 30 years ago, sugar water was given instead of cow’s milk formula supplement at birth. Thus, we hypothesized that early exposure to cow’s milk formula at birth is, at least in part, associated with the recent increase in children with food allergy. Therefore, a randomized clinical trial, named ABC (Atopy induced by Breast feeding or Cow's milk formula), was conducted to assess whether the risk of cow’s milk formula sensitization and food allergy is decreased by either avoiding or supplementing cow’s milk formula at birth. Immediately after birth, newborns were randomly assigned (1:1 ratio) to either breastfeeding with or without amino acid-based elemental formula for at least the first 3 days of life (breastfeeding ± elemental formula), or breastfeeding supplemented with cow’s milk formula (≥5 mL/day) from the first day of life to 5 months of age (breastfeeding + cow's milk formula). (more…)
Author Interviews, Dental Research / 22.10.2019

MedicalResearch.com Interview with: Robert Margolskee, MD, PhD Director and President Monell Center Adjunct Professor, Department of Systems Pharmacology and Translational Therapeutics University of Pennsylvania Perelman School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: We found chemical-sensing cells in the gums that protect the mouth by standing guard against infections that damage soft tissue and destroy the bone that supports the teeth. With the help of bitter taste receptors that also detect byproducts from harmful bacteria, these special gum cells trigger the immune system to control the amount and type of bacteria in the mouth. This knowledge could one day lead to personalized dental treatments against gum disease. Periodontitis is a serious gum disorder caused by an imbalance in the bacteria and other microorganisms of the mouth. We hope that our new information can help to combat this sixth-most prevalent infectious disease and most common cause of tooth loss worldwide. (more…)
Author Interviews, Heart Disease, Pharmaceutical Companies, Pulmonary Disease / 21.10.2019

MedicalResearch.com Interview with: Olivier Sitbon, MD, PhD Université Paris–Sud  MedicalResearch.com: What is the background for this study? How does this treatment competition differ from other treatments for PAH?  Response:  Pulmonary arterial hypertension (PAH) is a complex, progressive and potentially fatal disease with no cure. Over the past decades, advances in understanding the pathophysiology of PAH have led to major prognostic improvement and developments of new treatment guidelines and therapies. Current treatment guidelines recommend initial combination therapy for these patients to target multiple PAH-associated pathways in parallel. OPTIMA was a prospective, multicenter, single-arm, open-label, Phase IV trial designed to evaluate the efficacy, safety and tolerability of initial oral combination therapy with macitentan and tadalafil in patients with newly diagnosed PAH. Treatment with macitentan 10 mg once-daily and tadalafil 20 mg once-daily was initiated on the same day. After 8±3 days, tadalafil dose was increased to 40 mg once-daily. Safety and tolerability findings were consistent with previous clinical trials that supported the approval and use of macitentan 10 mg once-daily. Efficacy outcomes were assessed at Week 16 and safety continued to be monitored until study closure. The results from the OPTIMA analysis suggest that initial treatment with macitentan in combination with tadalafil is associated with hemodynamic improvement in newly diagnosed patients with pulmonary arterial hypertension (more…)
Author Interviews, Ophthalmology, Technology / 21.10.2019

MedicalResearch.com Interview with: Louis R. Pasquale, MD Professor of Ophthalmology Icahn School of Medicine at Mount Sinai; Site Chair of the Department of Ophthalmology at The Mount Sinai Hospital and Mount Sinai Queens; Vice Chair of Translational Ophthalmology Research Mount Sinai Health System  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Individual visual field tests provide a 52-point array of functional information about a glaucoma patient but it does not give us a handle on how functionally disabled they might be. A series of visual field tests need to be assessed for functional progression but current conventional algorithms for doing so are governed by ad hoc rules and the various algorithms available for assessing progression do not agree with one another. Finally, in managed care setting where one might be responsible for allocating resources for large numbers of glaucoma patients, it would be valuable to quickly visualize which patients are progressing rapidly and which ones are stable. This could allow for proper allocation of resources and perhaps inquiry into why a subset of patients are doing poorly. We wanted to develop an easy to use tool to quickly visualize how individual glaucoma patients and how groups of glaucoma patients are doing from a functional perspective. (more…)
Author Interviews, Dermatology, JAMA, Melanoma, Technology / 21.10.2019

MedicalResearch.com Interview with: https://skin-analytics.com/about-us/ Dr. Helen Marsden PhD Skin Analytics Limited London, United Kingdom MedicalResearch.com: What is the background for this study? Response: In this technology age, with the explosion of interest and applications using Artificial Intelligence, it is easy to accept the output of a technology-based test - such as a smartphone app designed to identify skin cancer - without thinking too much about it. In reality, technology is only as good as the way it has been developed, tested and validated. In particular, AI algorithms are prone to a lack of “generalisation” - i.e. their performance drops when presented with data it has not seen before. In the medical field, and particularly in areas where AI is being developed to direct a patient’s diagnosis or care, this is particularly problematic. Inappropriate diagnosis or advice to patients can lead to false reassurance, heightened concern and pressure on NHS services, or worse. It is concerning, therefore, that there are a large number of smartphone apps available that provide an assessment of skin lesions, including some that provide an estimate of the probability of malignancy, that have not been assessed for diagnostic accuracy. Skin Analytics has developed an AI-based algorithm, named: Deep Ensemble for Recognition of Malignancy (DERM), for use as a decision support tool for healthcare providers. DERM determines the likelihood of skin cancer from dermoscopic images of skin lesions. It was developed using deep learning techniques that identify and assess features of these lesions which are associated with melanoma, using over 7,000 archived dermoscopic images. Using these images, it was shown to identify melanoma with similar accuracy to specialist physicians. However, to prove the algorithm could be used in a real life clinical setting, Skin Analytics set out to conduct a clinical validation study. (more…)