Dr. Yount[/caption]
Jacob S. Yount, PhD
Associate Professor
Department of Microbial Infection and Immunity
The Ohio State University, College of Medicine
Co-Director, Viruses and Emerging Pathogens Program
OSU Infectious Diseases Institute
MedicalResearch.com: What is the background for this study?
Response: Genetic defects in a human protein known as IFITM3 are linked to hospitalization and death upon influenza virus infections. IFITM3 is an immune system protein that can inhibit virus entry into cells and it is produced as an early response to virus infections. In order to better study the role of IFITM3 during infections, we engineered a mouse model that lacks this protein.
Dr. Tong[/caption]
Dr Tammy Y N Tong PhD
Cancer Epidemiology Unit
Nuffield Department of Population Health
University of Oxford, Oxford, UK
MedicalResearch.com: What is the background for this study?
Response: Vegetarian and vegan diets have become increasingly popular in recent years, partly due to the perceived health benefits, but also concerns about the environment and animal welfare. However, the full extent of the potential health benefits and hazards of these diets is not well understood. Previous studies have suggested that vegetarians have a lower risk of coronary heart disease than non-vegetarians, but data from large studies are limited, and little has been reported on the difference in risk of stroke.
Dr. Sepehrvand[/caption]
Nariman Sepehrvand, MD
Research Associate & PhD Candidate
Canadian VIGOUR Centre, and Department of Medicine,
University of Alberta, Edmonton, Canada
Medical Research: Can you tell us a little bit about the background of this study?
Dr. Sepehrvand: As you know the traditional randomized clinical trials (RCT) have been criticized from time to time for the lack of generalizability, high costs and lengthy processes. Pragmatic trials with the primary goal of informing patients, clinicians, healthcare administrators and policy-makers about the effectiveness of biomedical and behavioral interventions have the potential to address those shortcomings by enrolling a population representative of the populations in which the intervention will be eventually applied to and by streamlining and simplifying the trial-related procedures. We knew about the challenges that trialists encounter in the design and implementation of pragmatic trials, so we were wondering how pragmatic or explanatory are cardiovascular (CV) RCTs and if there has been any change over time!
Dr. Elizabeth D. Kantor[/caption]
Elizabeth D. Kantor, PhD MPH
Department of Epidemiology and Biostatistics
Memorial Sloan Kettering Cancer Center
NY, NY
MedicalResearch.com: What is the background for this study?
Response: There has been recent interest in understanding how exposures in childhood and adolescence relate to later-life health outcomes.
Although inflammation is thought to play a role in the etiology of various diseases, little is known about the long-term implications of inflammation in early life. We therefore sought to evaluate how erythrocyte sedimentation rate (ESR), a marker of inflammation, measured among ostensibly healthy men in late adolescence, relates to subsequent cause-specific mortality.
We found that men with high inflammation in late adolescence experienced increased mortality due to cancer and cardiovascular disease.
Dr. Hanchate[/caption]
Amresh D Hanchate, PhD
Research Assistant Professor
Department of Medicine, School of Medicine
Boston University
MedicalResearch.com: What is the background for this study?
Response: National guidelines require EMS transportation to the nearest suitable hospital. To what extent this occurs and whether this varies by the race and ethnicity of the patient is unknown since there is little to no prior research on destination patterns of EMS-transported patients to hospitals.
Dr. Jordana Cohen[/caption]
Jordana Cohen, MD, MSCE
Assistant Professor of Medicine and Epidemiology
Renal-Electrolyte and Hypertension Division
Center for Clinical Epidemiology and Biostatistics
Perelman School of Medicine
University of Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: In the June 18, 2019 issue of Annals of Internal Medicine, we published a systematic review and meta-analysis evaluating the cardiovascular risks of white coat hypertension (WCH; i.e. elevated office blood pressure and normal out-of-office blood pressure). The goal of the meta-analysis was to clarify previous mixed results regarding the risks of untreated WCH and treated WCH. The meta-analysis examined 27 studies – including 64,273 patients – and demonstrated that untreated WCH is associated with an increased risk of cardiovascular events (36%), all-cause mortality (33%), and cardiovascular mortality (109%) compared to normotension. This risk was strongest in studies with a mean age ≥55 years or that included participants with cardiac risk factors, such as diabetes and chronic kidney disease. We found no increased cardiovascular risk associated with treated white coat hypertension.
Prof. Dominic Furniss, DM MA MBBCh FRCS
Nuffield Department of Orthopaedics, Rheumatology,
and Musculoskeletal Science
University of Oxford
MedicalResearch.com: What is the background for this study?
Response: We knew that there was a genetic component to handedness. Twin studies estimated that around 25% of the variation in handedness seen in the human population is down to genetic factors. Genetic factors associated with left handedness had been shown in specific patient populations, but this study has found factors in the general population and correlated them with functional brain imaging to shed more light on this fascinating subject.
We have used both genetic and imaging data from the UK Biobank study to discover genetic variants that are related to left handedness. We have correlated these variants with changes in brain imaging, in particular showing increased functional connectivity between the language processing areas of the brain in left handers. The genetic variants that are associated with left handedness are also near to genes involved in forming the internal skeleton of neurons, and important in brain development, suggesting that being left handed is in part caused by a difference in brain development. It is clear, however, that there are also many non-genetic influences on whether a person is left handed or not. In addition, we confirmed previous observations that being left handed is associated with other neurological problems, such as schizophrenia, and protective of others, such as Parkinson's disease, and showed that this is related to shared genetic factors, and likely reflects differences in brain development.
Dr. Deepak L. Bhatt[/caption]
Deepak L. Bhatt, MD, MPH, FACC, FAHA, FSCAI, FESC
Professor of Medicine, Harvard Medical School
Executive Director of Interventional Cardiovascular Programs,
Brigham and Women’s Hospital Heart & Vascular Center
MedicalResearch.com: What is the background for this study?
Response: Dual antiplatelet therapy (DAPT) is known to improve outcomes in patients with acute coronary syndromes (ACS), prior myocardial infarction (MI), or recent coronary stenting. What was unknown is whether patients with diabetes and stable coronary artery disease – a group generally believed to be at high ischemic risk – would benefit from initiation of long-term DAPT with low-dose aspirin plus ticagrelor versus low-dose aspirin (plus placebo). This is what THEMIS was designed to test, with THEMIS-PCI designed prospectively to examine those patients specifically who had a history of previous percutaneous coronary intervention (PCI).
Dr. Zeig-Owens[/caption]
Rachel Zeig-Owens, Dr.P.H., MPH
FDNY
Research Assistant Professor
Albert Einstein Medical Center
MedicalResearch.com: What are the main findings?
Response: We found that the most exposed members, those who arrived first at the World Trade Center (WTC ) site—when the air-borne dust was thickest—have a 44% increased risk of cardiovascular disease (CVD) compared to those who arrived later in the day. This is a level risk that was similar to other known risk factors for CVD.
Dr. Xygalatas[/caption]
Dimitris Xygalatas, PhD
Assistant Professor, Anthropology (Affiliate)
Institute for Collaboration on Health, Intervention, and Policy (InCHIP)
UCONN
MedicalResearch.com: What is the background for this study?
Response: Ever since I was a graduate student, I have been intrigued by the performance of ritual practices that involve pain, bodily harm, and other forms of suffering. These rituals carry obvious risks, including health risks, but despite these risks they are performed voluntarily by millions of people around the world. And even more intriguing is the fact that in various contexts such rituals are often culturally prescribed remedies for a variety of maladies. When I was doing my doctoral fieldwork, I studied the fire-walking rituals of the Anastenaria in Northern Greece, and I heard several people describing their experience of participation as one that involved both suffering and healing. And of course I am not the first anthropologist to document this link. But these observations seemed puzzling to me. Some years later, I met one of the co-authors of this paper, Sammyh Khan, who was asking very similar questions.
We got a grant to design this study, and put together a team of researchers that spent two months in the field collecting data for this project. We studied the Hindu kavadi ritual, which involves piercing the body with numerous needles, hooks, and skewers, and various other forms of suffering. Our study took place in the island of Mauritius, where I have been conducting research over the last decade, but this ceremony is performed by millions of Hindus around the world. We used portable health monitors as well as interviews and survey instruments to document the effects of this ritual of psycho-physiological health and wellbeing.
Dr. Vivian Ho[/caption]
Vivian Ho, PhD
The James A. Baker III Institute Chair in Health Economics
Director of the Center for Health and Biosciences
Rice's Baker Institute for Public Policy
MedicalResearch.com: What is the background for this study?
Response: In 2003, approximately 29% of U.S. hospitals employed physicians, a number that rose to 42% by 2012. The share of physician practices owned by hospitals rose from 14% in 2012 to 29% in 2016. Economists refer to these relationships between hospitals and physicians as vertical integration, because they represent hospitals exerting more control over physicians as an essential part of inpatient care.
As hospitals gain more control over physicians, they may incentivize delivery of more services but not necessarily higher quality care. When we launched this study, we hypothesized that tighter integration of physicians with hospitals would improve care coordination.
Dr. Nicolau[/caption]
Jose Carlos Nicolau, MD PhD
Heart Institute
University of Sao Paulo Medical School,
Sao Paulo, Brazil
MedicalResearch.com: What is the background for this study?
Response: There are few evidence about the late phase (1-3 years) of patients with diabetes and myocardial infarction, especially regarding quality of life (qol) and health resource utilization. Our study showed that the population with diabetes (dm), compared with the population without diabetes, have worse quality of life, more hospitalizations, and when hospitalized showed a longer hospital stay. Additionally, as expected, dm population have worse outcomes, including the composite of cv death, myocardial infarction or stroke, and all-cause death.
Prof. John McMurray[/caption]
Prof. John McMurray
Professor of Cardiology
Institute of Cardiovascular & Medical Sciences
University of Glasgow
MedicalResearch.com: What is the background for this study?
Response: SGLT2 inhibitors prevent the development of heart failure (HF) in patients with type 2 diabetes (T2D) – can they be used to treat patients with established heart failure? Also, although introduced as a glucose-lowering treatment for T2D, experimental evidence suggests these drugs may have non-glucose mediated benefits. So, might they be a treatment for HF even in patients without diabetes?
Prof. Danchin[/caption]
Nicolas Danchin MD, FESC
Professor of Medicine, Consultant Cardiologist
Intensive Cardiac Care Unit
Hôpital Européen Georges Pompidou
Paris, France
MedicalResearch.com: What is the background for this study?
Response: FAST-MI is a programme of nationwide French surveys, carried out every 5 years in France since 2005 in patients hospitalised with STEMI or NSTEMI. Patients are included consecutively for one month and 10-year follow-up is organized. We can thus analyse patients' outcomes in relation with their profile. Knowing that diabetic patients represent a large proportion of patients with AMI, we thought it would be worthwhile determining whether they suffered specific complications, and in particular, heart failure, both at the acute stage and in the subsequent months.
Dr. Morgan Philbin[/caption]
Morgan Philbin, PhD MHS
Assistant Professor
Department of Sociomedical Sciences
Columbia University School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Marijuana is the most frequently used substance in the United States (US) after alcohol and tobacco. In 2017, 15.3% of the US population ages 18 and up reported past-year marijuana use (MU) and 9.9% past month use. Individuals who identify as lesbian, gay, or bisexual (LGB), also report higher levels of marijuana use and marijuana use disorder than their heterosexual counterparts. Researchers have begun to explore potentially modifiable factors, such as state-level marijuana policies, that affect marijuana use and related outcomes at the population-level and within subgroups—though as of yet not among sexual minority populations.
We therefore examined whether LGB individuals living in states with medical marijuana laws (MMLs) have higher levels of marijuana use and marijuana use disorder compared to LGB individuals in states without MMLs.
Dr. Rahman[/caption]
Md Momotazur Rahman PhD
Associate Professor of Health Services, Policy and Practice
[caption id="attachment_51158" align="alignleft" width="125"]
Margot Schwartz[/caption]
Margot Schwartz MPH
Doctoral program
Brown University
MedicalResearch.com: What is the background for this study?
Response: Although one third of Medicare beneficiaries are currently enrolled in Medicare Advantage (MA), it is difficult to assess the quality of healthcare providers that serve MA beneficiaries, or to compare them to providers that serve Traditional Medicare (TM) beneficiaries.
While Medicare Advantage plans are required to cover the same minimum healthcare services as TM, MA beneficiaries receive care from their plan’s network of preferred providers, while TM beneficiaries may select any Medicare-certified provider. The objective of this study is to compare the quality of Home health Agencies (HHAs) that serve Medicare Advantage and TM beneficiaries. Approximately 3.5 million Medicare beneficiaries receive home health care annually.
Dr. Edwin H. Kim[/caption]
Edwin H. Kim, MD, MS
Assistant Professor of Medicine & Pediatrics, Division of Rheumatology
Allergy & Immunology
Program Director, UNC Allergy and Immunology Fellowship Program
Director, UNC Food Allergy Initiative
Medical Director, UNC Allergy & Immunology Clinic
UNC School of Medicine
Chapel Hill, NC
MedicalResearch.com: What is the background for this study?
Response: In 2011, Kim and colleagues – including Wesley Burks, MD, dean of the UNC School of Medicine – conducted a small study of 18 patients to show that sublingual immunotherapy (SLIT) was safe and effective over the course of one year. Since then, Kim and colleagues followed 48 patients in the SLIT protocol of 2 mg daily for five years. In the JACI paper, the researchers showed that 67 percent of these patients were able to tolerate at least 750 mg of peanut protein without serious side effects. About 25 percent could tolerate 5000 mg
Prof. Dr. Christoph Kaleta
Institute for Experimental Medicine
Institute for Experimental Medicine, Kiel University
Kiel, Germany
MedicalResearch.com: What is the background for this study?
Response: Even though Metformin is the first-line treatment option in type-2 diabetic patients, its specific mechanism of action has remained elusive so far. Moreover, metformin is of particular interest as an anti-aging drug since it's usage has been shown to be associated with a lower incidence of several aging diseases in type-2 diabetic patients taking metformin when compared to matched healthy controls.
While previous work was able to show pronounced changes in the microbiota of patients taking metformin and a health-promoting effect of metformin-adapted microbiota, how this beneficial effect could be mediated has remained unclear.
Dr. Smith-Bindman[/caption]
Rebecca Smith-Bindman, MD
Professor, Department of Radiology and Biomedical Imaging,
Epidemiology and Biostatistics
Philip R. Lee Institute for Health Policy Studies
University of California, San Francisco
MedicalResearch.com: What is the background for this study?
Response: Medical imaging increased rapidly from 2000 to 2006. The rise in imaging can be attributed to improvements in technical aspects of imaging, strong physician and patient demand, and strong financial incentives. While imaging contributes to accurate disease diagnosis and improved treatment, imaging can also increase costs and patient harms, such as incidental findings, overdiagnosis, anxiety, and radiation exposure associated with increased risk of cancer. Potential overuse of diagnostic testing has been addressed by the American Board of Internal Medicine Foundation’s Choosing Wisely Campaign and initiatives by payers to reduce imaging through payment reductions, but there remains uncertainty in the impact of these initiatives on imaging rates.The objective of our study was to evaluate recent trends in medical imaging.
Our study assessed imaging from 2000 through 2016 among individuals enrolled in diverse U.S. integrated healthcare systems and among individuals residing in Ontario, Canada and assessed changes in medical imaging utilization over time by country, health system, and patient demographic factors.
Dr. McDevitt[/caption]
Christopher A. McDevitt B.Sc. (Hons) Ph.D , Associate Professor
Group Leader, ARC Future Fellow
The Peter Doherty Institute for Infection and Immunity
Melbourne | Victoria | Australia
MedicalResearch.com: What is the background for this study?
Response: Zinc-deficiency affects nearly one-third of the world’s population and is associated with an increased susceptibility to respiratory and enteric infections. The foremost global respiratory disease is pneumonia, which kills more than 1 million people per year with young children and the elderly being at greatest risk. This study investigated how zinc-deficiency affected Streptococcus pneumoniae infection, the primary bacterial cause of pneumonia.
Dr. Bishal Gyawali[/caption]
Bishal Gyawali, MD, PhD
Department of Medicine
Brigham and Women’s Hospital
MedicalResearch.com: What is the background for this study?
Response: Cancer drugs are prescribed to the patients based on results from trials. Usually, these are superiority trials meaning the cancer drugs prove that they are better than the treatment we already have.
Recently, more and more cancer drugs are approved on the basis of non-inferiority trials. In these trials, the cancer drugs only prove that they are not worse than the treatment we already have ( instead of proving they are better). Such an approach is considered justified if the new drug provides any other benefit such as lower cost, easy to administer or improved quality of life.
Dr. Birnbaum[/caption]
Angela Birnbaum, Ph.D., FAES
Professor, Director of Graduate Studies
Experimental and Clinical Pharmacology
College of Pharmacy
University of Minnesota
MedicalResearch.com: What is the background for this study?
Response: Little was known about the effect food has on the amount of cannabidiol (CBD) that is actually absorbed into the body. Because of various state laws, CBD preparations vary from state to state. In Minnesota, however, the law only allows pure forms of cannabidiol providing a consistent supply of product including a purified CBD capsule formulation. Due to its pharmacological properties a low amount of a CBD dose reaches the blood stream and the effect of food had not been well described.
Our study was done to determine the amount of cannabidiol
that is absorbed with food as compared to an empty stomach at doses used in epilepsy patients, which can be higher than the dose often used for other conditions.
Dr. Papa[/caption]
Linda Papa, MD
Emergency Physicians of Central Florida
Orlando Health
Orlando, Florida
MedicalResearch.com: What is the background for this study?
Response: In 2018 serum biomarkers Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-terminal hydrolase (UCH-L1) were FDA-approved in adults to detect abnormalities on CT scan in mild to moderate traumatic brain injury. However, they have not been approved to detect concussion and they have not been approved for use in children.
Previous studies have focused on detecting lesions on CT in more severely injured patients. However, not having brain lesions on a CT scan does not mean there is no brain injury or concussion. Therefore, this study focused on patients with concussion who looked well and likely had normal-appearing CT scans of the brain.
This study includes THREE groups of trauma patients:
Dr. Neprash[/caption]
Dr. Hannah T. Neprash, PhD
Assistant Professor, Division of Health Policy and Management
School of Public Health
University of Minnesota
MedicalResearch.com: What is the background for this study?
Response: Physicians play a pivotal role in the opioid epidemic and it's important to understand what factors that drive opioid prescribing. Variation in opioid prescribing across physicians has been well-documented, but there’s very little research on variation within physicians…which is surprising, given the widespread concern about time pressure and cognitive fatigue having a potentially detrimental effect on the quality of care provided by physicians.
Dr. Mangione[/caption]
Dr. Carol Mangione, M.D., M.S.P.H., F.A.C.P.
Division Chief of General Internal Medicine and Health Services Research
Professor of Medicine
Barbara A. Levey, MD, and Gerald S. Levey, MD, endowed chair in Medicine David Geffen School of Medicine University of California, Los Angeles (UCLA)
Professor of public health at the UCLA Fielding School of Public Health.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Every year, too many American women are faced with the challenge of dealing with a cancer diagnosis related to potentially harmful mutations of the BRCA1 and BRCA2 genes. However, the Task Force found that there are several steps women can take to determine if they’re potentially at increased risk for BRCA gene mutations – and if genetic counseling and BRCA testing are needed.
It is important to note that while some women can benefit from risk assessment, counseling, and testing, these services are not for everyone.
Dr. Windham[/caption]
Gwen Windham, MD MHS
Professor of Medicine
Memory Impairment & Neurodegenerative Dementia (MIND) Center
University of Mississippi Medical Center
MedicalResearch.com: What is the background for this study?
Response: Silent infarctions are a primary cause of strokes in the brain, but they are also common in people without a history of a stroke. Infarctions are generally only reported if they are larger (at least 3mm) and are ignored clinically if they are smaller (less than 3mm).
We examined 20 years of cognitive decline among stroke free, middle-aged people with and without smaller, and larger infarctions. The comparison groups included participants as follows: those with
(1) no infarctions, the reference group;
(2) only smaller infarctions;
(3) only larger infarctions
4) both smaller and larger infarctions