Author Interviews, Education, JAMA, Outcomes & Safety, UCSF / 12.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30135" align="alignleft" width="225"]Charlie M. Wray, DO, MS Assistant Clinical Professor of Medicine University of California, San Francisco | Department of Medicine San Francisco VA Medical Center Dr. Charlie Wray[/caption] Charlie M. Wray, DO, MS Assistant Clinical Professor of Medicine University of California, San Francisco Department of Medicine San Francisco VA Medical Center MedicalResearch.com: What is the background for this study? Response: Since the establishment of residency duty hour regulations in 2010, which subsequently lead to increased discontinuity of inpatient care and more resident shift work, educators and researchers have attempted to establish which shift handoff technique(s) or strategies work best. National organizations, such as the ACGME, AHRQ, and the Joint Commission have made specific recommendations that are considered "best practice". In our study, using an annual national survey given to Internal Medicine Program Directors, we examined the degree of implementation of these recommended handoff strategies and the proportion of Program Director satisfaction with each of the respective strategies.
Author Interviews, Diabetes, Diabetes Care, Exercise - Fitness, Lifestyle & Health / 12.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30507" align="alignleft" width="161"]Bernard M Duvivier Department of Human Biology and Movement Science NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre Maastricht, the Netherlands Dr. Bernard M Duvivier[/caption] Bernard M Duvivier  Department of Human Biology and Movement Science NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre Maastricht, the Netherlands MedicalResearch.com: What is the background for this study?  What are the main findings? Response: The health benefits of exercise have been well established but sitting is a risk factor for health, independent of exercise. As many people with type 2 diabetes don’t like to exercise we investigated whether replacing sitting time with light-intensity activities (standing and light walking) is equally effective to exercise when energy expenditure is comparable. Our results suggest that for people with type 2 diabetes, light-intensity activities (light walking and standing) can be an alternative to exercise to improve glucose regulation. In addition we showed that too much sitting has negative effects on insulin sensitivity which could not be fully compensated by 1 hour of exercise per day.
Author Interviews, BMJ, Dermatology, Herpes Viruses, HIV, Infections, STD / 12.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30448" align="alignleft" width="165"]E. Charles Osterberg, M.D. Assistant Professor of Surgery Genitourinary Reconstruction and Trauma University of Texas- Dell Medical School Dell-Seton Medical Center / University Hospital Dr. Osterberg[/caption] E. Charles Osterberg, M.D. Assistant Professor of Surgery Genitourinary Reconstruction and Trauma University of Texas- Dell Medical School Dell-Seton Medical Center / University Hospital MedicalResearch.com: What is the background for this study? Response: Pubic hair grooming has become an increasingly common practice among men and women. Perceptions of genital normalcy have changed as modern society’s definition of attractiveness and feelings of femininity and masculinity have changed. Pubic hair grooming has been shown to increase morbidity such as genital injuries, however little is known about the relationship between grooming practices and sexually transmitted infections.
Author Interviews, Breast Cancer, Genetic Research, JAMA / 12.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30290" align="alignleft" width="160"]Dr. Adrian Lee PhD Professor, Department of Pharmacology and Chemical Biology Director, Women's Cancer Research Center University of Pittsburgh Cancer Institute Dr. Adrian Lee[/caption] Dr. Adrian Lee PhD Professor, Department of Pharmacology and Chemical Biology Director, Women's Cancer Research Center University of Pittsburgh Cancer Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The goal of this study was to understand molecular changes which occur when breast cancers metastasize to the brain, with the eventual of identifying new therapeutic strategies. Brain metastases occur in 10-15% of patients with metastatic breast cancer and are a major clinical challenge. Limited therapeutic options exist for patients with brain metastases. We analyzed molecular changes in pairs of patient-matched primary breast cancers and brain metastases. We found that brain metastases tended to have the same intrinsic subtype as the primary breast cancer, however, there were many genes which changes in gene expression and may represent therapeutic targets. The most common change was an increase in ErbB2/HER2 which can be targeted clinically.
Author Interviews, Biomarkers, Infections, JAMA, Neurological Disorders / 12.12.2016

MedicalResearch.com Interview with: Zanusso Gianluigi M.D.Ph.D. Department of Neurosciences, Biomedicine and Movement Sciences University of Verona Verona, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: To determine RT-QuIC assay sensitivity and specificity in cerebrospinal fluid and olfactory mucosa in a large group of patients with a clinical diagnosis of probable, possible or suspect Creutzfeldt–Jakob disease (CJD) and controls. In these patients, RT-QuIC testing of CSF and olfactory mucosa provided a specificity and sensitivity of 100%. A softer swab for olfactory mucosa sampling provided the same sensitivity as using a brush .
Author Interviews, Genetic Research, Leukemia, NYU/NYMC / 11.12.2016

MedicalResearch.com Interview with: Jason Saliba PhD Perlmutter Cancer Center New York University Langone Medical Center New York, NY MedicalResearch.com: What is the background for this study? What are the main findings? Response: The outcome for children with acute lymphoblastic leukemia (ALL) has improved dramatically over the last four decades, but the prognosis for those who relapse remains dismal, especially for those who relapse while on therapy. In fact, relapsed disease remains a leading cause of cancer related mortality in children. To date, various studies have discovered a number of somatic alterations that contribute to driving relapse and have provided profound insight into the selective forces that lead to clonal outgrowth of drug resistant populations. However, the timing of the initial emergence of the driving mutations along with the speed of clonal outgrowth is unknown. Whole exome sequencing (WES) was run on available diagnosis, germline (remission), and relapse samples collected from thirteen pediatric ALL patients treated according to Nordic NOPHO ALL protocols. Analyses were then performed to find somatic missense mutations enriched in the relapse samples versus their patient matched diagnosis and/or germline samples. Candidate relapse driving missense mutations were identified as present at high levels (>20%) in the relapse sample, but were undetectable in germline or low to absent in the diagnosis sample. Eight of the thirteen patients contained mutations in genes previously reported to be enriched at relapse. Interestingly, a majority of the patients contained novel candidate relapse specific genes involved in a wide array of cellular processes such as cell adhesion/migration, RNA polymerase II/transcription, circadian rhythm, the unfolded protein response, RNA transport, epigenetic regulation, DNA methylation, and kinases.
Author Interviews, BMJ, Imperial College, Nutrition / 10.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30430" align="alignleft" width="180"]Dr. Dagfinn Aune Department of Epidemiology and Biostatistics School of Public Health Imperial College London St. Mary's Campus London UK Dr. Dagfinn Aune[/caption] Dr. Dagfinn Aune Department of Epidemiology and Biostatistics School of Public Health Imperial College London St. Mary's Campus London  UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a growing body of evidence suggesting that intake of nuts may reduce the risk of coronary heart disease, but the relation between nut intake and other diseases like cancer and stroke, and the relation with mortality and less common causes of death is not clear. Also it is not clear how much nuts are needed to reduce the risk. So our current meta-analysis reviewed the data from 20 studies (29 publications) on nut intake and different health outcomes. We found that a nut intake of approximately one serving per day (28 g/d or a handful) was associated with a reduced risk of coronary heart disease (by 30%), total cancer (15%), all-cause mortality (22%) and mortality from respiratory disease (50%), diabetes (40%), and infections (75%), although there were few studies in the latter three analyses. We found that most of the benefit was observed up to an intake of around 20 grams per day. Similar results were found for total nuts, tree nuts and peanuts (which are botanically defined as legumes), but peanuts were also associated with reduced risk of stroke, while only tree nuts were associated with reduced cancer risk. We also calculated the number of deaths that potentially could be avoided, under the assumption that the observed associations are causal, and arrived at 4.4 million deaths in North and South America, Europe, Southeast Asia and the Western Pacific (unfortunately we did not have data on nut intake from West Asia and Africa so we were not able to include those areas).
Author Interviews, Hematology, Memory, Pediatrics, Technology / 09.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30413" align="alignleft" width="200"]Steven J. Hardy, PhD Licensed Clinical Psychologist Divisions of Hematology and Oncology Children’s National Health System Assistant Professor of Pediatrics and Psychiatry & Behavioral Sciences George Washington School of Medicine and Health Sciences Washington, DC Dr. Steven J. Hardy[/caption] Steven J. Hardy, Phd Licensed Clinical Psychologist Divisions of Hematology and Oncology Children’s National Health System Assistant Professor of Pediatrics and Psychiatry & Behavioral Sciences George Washington School of Medicine and Health Sciences Washington, DC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Children with sickle cell disease exhibit neurocognitive deficits as a consequence of either silent or overt cerebral infarction or disease-related non-infarct central nervous system effects (likely resulting from chronic anemia and hypoxic events). These complications often lead to impairment in executive functioning (e.g., working memory, attention, inhibition, cognitive flexibility), which can make it difficult to focus in class, plan for long-term school projects, remember and carry out multi-step tasks or assignments, and stay organized. The literature on interventions to reduce neurocognitive sequelae of sickle cell disease is extremely limited. Our research team investigated a promising home-based, computerized cognitive training program (Cogmed) involving repeated practice on performance-adapted exercises targeting working memory with a sample of youth (ages 7 – 16) with sickle cell disease. Of the participants who have enrolled in the study (n = 70), 49% exhibited working memory deficits (<25% in the general population have a working memory deficit) and were randomized to an eight-week waitlist or to begin Cogmed immediately. Participants who used Cogmed demonstrated significant improvements on multiple measures of working memory, while those randomized to the waitlist group only exhibited such improvements after receiving Cogmed. Approximately 25% of participants completed the recommended number of Cogmed sessions (20 – 25 sessions). However, analyses revealed that participants who completed at least 10 sessions (about 50% of the participants) showed comparable levels of working memory improvement.
Author Interviews, Education, JAMA, Outcomes & Safety / 09.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30402" align="alignleft" width="133"]Joshua L Denson MD Pulmonary and Critical Care Medicine University of Colorado School of Medicine Dr. Joshua Denson[/caption] Joshua L Denson MD Pulmonary and Critical Care Medicine University of Colorado School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Miscommunication during physician transition in care has been associated with adverse patient events and medical errors; however, an understudied topic is the transition in care that occurs each month when resident physicians switch clinical rotations, also called an end-of-rotation transition. During this handoff, hospitalized patients (up to 10-20) are handed over to an oncoming physician who has never met the patients. We sought to investigate if this type of transition was associated with worse patient outcomes, specifically mortality. On July 1, 2011, the Accreditation Council for Graduate Medical Education (ACGME) duty-hour regulations limited first-year resident physicians (interns) to 16 continuous hours of work. Although these rules do not appear to have affected overall patient safety outcomes, they have been associated with an increase in shift-to-shift handoffs among training physicians. Given this, we wanted to study how they might impact patient outcomes surrounding end-of-rotation transitions in care.
Author Interviews, Genetic Research, Nature, NIH, Weight Research / 09.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30390" align="alignleft" width="200"]Audrey Chu, Ph.D. Division of Intramural Research of the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health Dr. Audrey Chu[/caption] Audrey Chu, Ph.D. Division of Intramural Research National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Body shape reflects the underlying adipose tissue distributed throughout different compartments of the body (ectopic fat). Variation in ectopic fat is associated with diabetes, hypertension and heart disease. This is mostly independent of overall adiposity. Ectopic fat can be measured using special x-rays procedures such as CT (“CAT scans”) or MRI and can give more information about fat distribution. Fat distribution characteristics can run in families, suggesting that a person’s genes can help determine the amount of fat that can accumulate in different parts of the body. Identifying genes that are associated with ectopic fat can provide insight into the biological mechanisms leading to differences in cardiometabolic disease risk. In order to understand which genes might be involved, we examined genetic variants across the genome and their association with ectopic fat in the largest study of its kind including over 18,000 individuals of four different ancestral backgrounds. Several new genetic regions were identified in association with ectopic fat in addition to confirming previously known regions. The association of the new regions was specific to ectopic fat, since the majority of the regions were not associated with overall or central adiposity. Furthermore, most of these regions were not associated with type 2 diabetes, lipids, heart disease or blood pressure. The major exception was the region surrounding the UBE2E2 gene, which was associated with diabetes.
Author Interviews, FASEB, Microbiome, OBGYNE, Stanford / 09.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30400" align="alignleft" width="155"]Carlos Simón, M.D., Ph. D. Professor of Obstetrics & Gynecology. Valencia University, Spain Scientific Director, Igenomix SL. Adjunct Clinical Professor, Department of Ob/Gyn, Stanford University, CA Adjunct Professor, Department of Ob/Gyn, Baylor College of Medicine, TX Dr. Carlos Simón[/caption] Carlos Simón, M.D., Ph. D. Professor of Obstetrics & Gynecology. Valencia University, Spain Scientific Director, Igenomix SL. Adjunct Clinical Professor, Department of Ob/Gyn, Stanford University, CA Adjunct Professor, Department of Ob/Gyn, Baylor College of Medicine, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: The main findings of this study reside in the concept that the uterine cavity, which has been classically considered as a sterile organ, possess its own microbiome and that the composition of this uterine microbiome have a functional impact on the reproductive outcome of IVF patients.
Author Interviews, Heart Disease / 09.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30382" align="alignleft" width="200"]Dr Nima Gunness, PhD Australian Research Council Centre of Excellence in Plant Cell Walls Centre For Nutrition and Food Sciences The University of Queensland Australia Dr Nima Gunness[/caption] Dr Nima Gunness, PhD Australian Research Council Centre of Excellence in Plant Cell Walls Centre For Nutrition and Food Sciences The University of Queensland Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Soluble dietary fibres (SDFs) such as B-glucan from oat are known to lower blood cholesterol, however their mechanisms of action are unknown. It has previously been hypothesised that they bind to bile acids in the small intestine causing an excess excretion in the faeces. To replenish this loss the body synthesises more bile acid from blood cholesterol, its sole precursor. However, evidence for this mechanism is not convincing. In our study we’ve used pigs, as a model to study human digestion and relate the findings to diet related diseases such as obesity, type 2 diabetes and cardiovascular disease. We found that the SDF lowered blood total and LDL cholesterol but with a decrease in the circulating levels of bile acids. We also measured a decrease in the diffusion of cholesterol and bile acids across small intestinal epithelial tissue. In the colon we saw enhanced production of a therapeutic ursodeoxycholic acid, suppression of toxic lithocholic acid and transformation of cholesterol into coprostanol, a non-absorbable sterol.
Author Interviews, Brain Injury, MRI, Pediatrics / 09.12.2016

MedicalResearch.com Interview with: Eman S. Mahdi, MD, MBChB Pediatric Radiology Fellow [caption id="attachment_30368" align="alignleft" width="133"]Catherine Limperopoulos, PhD Director, Developing Brain Research Laboratory Co-Director of Research, Division of Neonatology Diagnostic Imaging and Radiology Children’s National Health System Washington, DC Dr. Catherine Limperopoulos[/caption] Catherine Limperopoulos, PhD Director, Developing Brain Research Laboratory Co-Director of Research, Division of Neonatology Diagnostic Imaging and Radiology Children’s National Health System Washington, DC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Premature birth is a major public health concern in the United States affecting 1 in 10 infants each year. Prematurity-related brain injury is very common and associated with a high prevalence of brain injury and accompanying lifelong neurodevelopmental morbidities. Early disturbances in systemic and cerebral hemodynamics are thought to mediate prematurity-related brain injury. The extent to which cerebral blood flow (CBF) is disturbed in preterm birth is poorly understood, in large part because of the lack of monitoring techniques that can directly and non-invasively measure cerebral blood flow. We report for the first time early disturbances in global and regional cerebral blood flow in preterm infants following brain injury on conventional magnetic resonance imaging (MRI) over the third trimester of ex-uterine life using arterial spin labelling images. In terms of regional differences, we saw a marked decrease in blood flow to the thalamus and the pons, regions known to be metabolically active during this time.
Author Interviews, Nature, Stem Cells / 09.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30362" align="alignleft" width="200"]Professor Jan Karlseder Molecular and Cell Biology Laboratory Donald and Darlene Shiley Chair Salk Institute for Biological Studies Prof. Jan Karlseder[/caption] Professor Jan Karlseder Molecular and Cell Biology Laboratory Donald and Darlene Shiley Chair Salk Institute for Biological Studies MedicalResearch.com: What is the background for this study?  Response: Telomeres are repetitive stretches of DNA at the ends of each chromosome whose length can be increased by an enzyme called telomerase. Our cellular machinery results in a little bit of the telomere becoming lopped off each time cells replicate their DNA and divide. As telomeres shorten over time, the chromosomes themselves become vulnerable to damage. Eventually the cells die. The exception is stem cells, which use telomerase to rebuild their telomeres, allowing them to retain their ability to divide, and to develop (“differentiate”) into virtually any cell type for the specific tissue or organ, be it skin, heart, liver or muscle—a quality known as pluripotency. These qualities make stem cells promising tools for regenerative therapies to combat age-related cellular damage and disease.
Author Interviews, Breast Cancer, Chemotherapy, Immunotherapy / 09.12.2016

MedicalResearch.com Interview with: Vince Giranda, M.D., PH.D. Project Director AbbVie Oncology Development MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this Phase 2 study, called BROCADE 2, veliparib combined with the platinum chemotherapy regimen carboplatin and paclitaxel showed positive trends in overall survival (OS) and progression-free survival (PFS), although these were not statistically significant. Importantly there were no meaningful increase in side effects with the addition of veliparib to carboplatin and paclitaxel. The veliparib combination regimen also demonstrated a significantly higher objective response rate.
Author Interviews, Depression, JAMA, McGill, Pharmacology, Stroke / 09.12.2016

MedicalResearch.com Interview with: Christel Renoux, MD, PhD Assistant Professor, Dept. of Neurology & Neurosurgery McGill University Centre For Clinical Epidemiology Jewish General Hospital - Lady Davis Research Institute Montreal  Canada MedicalResearch.com: What is the background for this study? Response: Selective serotonin reuptake inhibitors (SSRIs) increase the risk for abnormal bleeding, in particular, gastrointestinal tract bleeding. Previous studies also suggested an increased risk for intracranial hemorrhage (ICH) in patients treated with SSRIs compared to non users. However, even if this risk exists, the comparison with a non-treated group may exaggerate the strength of a potential association and the comparison with a group of patients treated with other antidepressants may help better delineate the risk. The potential bleeding effect of antidepressants is linked to the strength of serotonin inhibition reuptake, and antidepressants that are strong inhibitors of serotonin reuptake have been associated with the risk for gastrointestinal or abnormal bleeding compared with weak inhibitors but the risk of ICH is unclear.
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Primary Care / 09.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30342" align="alignleft" width="200"]Dr. Ateev Mehrotra Associate professor, Department of Health Care Policy Harvard Medical School and a hospitalist at Beth Israel Deaconess Medical Center Boston, Massachusetts Dr. Ateev Mehrotra[/caption] Dr. Ateev Mehrotra MD Associate professor, Department of Health Care Policy Harvard Medical School and a hospitalist at Beth Israel Deaconess Medical Center Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: More people in the US are using price transparency websites to shop for care. Some have wondered whether using the information on these websites to choose a doctor will help them actually save money. A relatively small difference in price for visits on the website translated into hundreds of dollars.
Addiction, Author Interviews, CDC, Opiods / 09.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30338" align="alignleft" width="142"]Cyprian Wejnert, Ph.D. National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention CDC Dr. Cyprian Wejnert[/caption] Cyprian Wejnert, Ph.D. National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our country is dealing with a devastating epidemic of opioid misuse and overdose that affects individuals, families and communities. We have long known that sharing needles and syringes is an incredibly efficient route for HIV, hepatitis and other infections to spread. Yet, about 10% of annual HIV diagnoses in the United States occur among people who inject drugs, and there are clusters of hepatitis C infections across the country. These infections can be prevented when people who inject drugs use sterile needles, syringes and other injection equipment. One of the main findings of this study is that use of syringe services programs (SSPs) has increased substantially during the past decade, but most people who inject drugs still don’t always use sterile needles. The analysis finds that more than half (54%) of people who inject drugs in 22 cities with a high number of HIV cases reported in 2015 they used an SSP in the past year, compared to only about one-third (36%) in 2005. Although syringe services program use has increased, findings indicate that too few people who inject drugs use only sterile needles. One in three (33%) reported in 2015 that they had shared a needle within the past year – about the same percentage that reported sharing a decade ago (36% in 2005). The report also highlights some successes in HIV prevention among African Americans and Latinos who inject drugs, as well as concerning trends in whites who inject drugs. From our study of 22 urban areas, it appears that fewer African Americans are injecting drugs. However, it also appears there has been an increase in white Americans injecting drugs.
Author Interviews, Heart Disease, JACC / 09.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30321" align="alignleft" width="161"]Wayne C. Levy, MD Division of Cardiology University of Washington Seattle, Washington Dr. Wayne Levy[/caption] Wayne C. Levy, MD Division of Cardiology University of Washington Seattle, Washington MedicalResearch.com: What is the background for this study? Response: There is uncertainty how effective ICDs are outside of clinical trials in real world patients who are often older with more comorbidities. The recent DANISH ICD only reiterates provider and patient concerns regarding the effectiveness of an ICD, that may be life saving, but does not improve heart failure symptoms or reduce hospitalizations. Many patients die without ever having an ICD shock, so the ICD was not necessary for the patient. We postulated that the effectiveness of an ICD is not driven by the absolute risk of sudden death (event rate/year) but rather the proportion of all deaths that are due to sudden death vs non sudden death. If a patient has a 3% annual risk of sudden death and this is decreased to 1% with an ICD (a 67% reduction in sudden death), the patient benefit will be much greater if the non sudden death rate is 1%/year than if it is 12%/year. In the first scenario the absolute mortality is decreased from 4% to 2% (a 50% reduction) whereas in the second patient, the mortality would be decreased from 15% to 13% (a 13% benefit). We developed the Seattle Proportional Risk Model (SPRM) using 10 clinical variables that had a differential impact on the mode of death, sudden vs. non sudden, in ~10,000 patients with ~2,500 deaths. Sudden death was more common in younger patients, male, without diabetes mellitus, NYHA 1 or 2 vs. 3 or 4, lower EF, SBP closer to 140, normal sodium and creatinine, higher BMI, and digoxin use.
Author Interviews, Diabetes, Parkinson's, Science / 09.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30315" align="alignleft" width="200"]Patrik Brundin, M.D., Ph.D. Director, Center for Neurodegenerative Science Van Andel Research Institute Dr. Patrik Brundin[/caption] Patrik Brundin, M.D., Ph.D. Director, Center for Neurodegenerative Science Van Andel Research Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The investigational drug at the heart of our study, MSDC-0160, has been in development to treat type 2 diabetes by improving cellular metabolism. In Parkinson’s, reductions in cellular metabolism slow down vital housekeeping processes that clear out toxic proteins that otherwise accumulate with age. If these proteins aren’t removed, they clump together, leading to the damage and cell death that causes Parkinson’s hallmark symptoms, such as rigidity and tremor. MSDC-0160 helps keep these housekeeping processes working, ultimately protecting the brain. We demonstrated that MSDC-0160 has strong, reproducible, positive effects across multiple models of Parkinson’s disease—it rescued dopamine-producing cells, improved behavioral deficits in mouse models and reversed inflammation. Overall, we believe it is a strong candidate for repurposing as a potential treatment that actually may slow the disease’s progression, rather than only mitigating symptoms.
Author Interviews, OBGYNE, Pediatrics, Social Issues / 09.12.2016

MedicalResearch.com Interview with: Jonathan Y. Bernard, PhD Inserm UMRS 1153 – Centre for research in Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS) Team ORCHAD: early Origin of the Child Health And Development Hôpital Paul Brousse MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite the World Health Organization’s recommendations promoting breast feeding, wide variations in breast feeding initiation rates are observed among Western countries: some reach >95%, while others remain <80%. Many individual-level determinants of breast feeding are known, including maternal age, education, ethnicity, smoking and employment status. Less is known regarding cultural determinants, such as religion, which could be underlying and explain rate differences between and within countries. We aimed at comparing countries’ breast feeding rates with the proportions of Catholics and Protestants. We thus carried out an ecological study by collating publicly available online data for 135 countries. We additionally gathered within-country data for 5 Western nations: France, Ireland, the UK, Canada and the USA. We found that, in Western countries, the proportion of Catholics was negatively correlated with the rate of breast feeding. This was also observed within countries in France, Ireland, the UK and Canada. In the USA, where breast feeding rates vary hugely between states, race was an important confounder. Interestingly, we also found the correlation in non-Hispanic whites. All our findings hold even when we account for wealth indicators, such as gross domestic product per capita.
Author Interviews, Heart Disease / 09.12.2016

MedicalResearch.com Interview with: Juhani Airaksinen, MD, PhD Professor, Chief of Cardiology Directork Heart Center Turku University Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Electrical cardioversion (ECV) is an essential part of rhythm control strategy in patients with paroxysmal atrial fibrillation (AF). There is limited information on unsuccessful outcome of ECV (i.e. failure of cardioversion or early recurrence of AF) for acute AF. Our study shows that the risk of unsuccessful outcome of ECV can be predicted using five simple clinical variables. These variables were used to derivate and validate a novel risk stratification tool (the AF-CVS Score) for predicting unsuccessful ECV outcome. Study patients with high AF-CVS Score points (>5) had a high incidence of ECV failure or early AF recurrence.
Aging, Author Interviews, Genetic Research, JAMA, Macular Degeneration, Ophthalmology / 08.12.2016

MedicalResearch.com Interview with: dr-anneke-i-den-hollanderAnneke I. den Hollander, PhD Department of Ophthalmology and Department of Human Genetics Donders Institute for Brain, Cognition, and Behaviour Radboud University Medical Center Nijmegen, the Netherland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Age-related macular degeneration is caused by a combination of genetic and environmental factors. Rare genetic variants in the complement system have been described in AMD, but their effect remains largely unexplored. In this study we aimed to determine the effect of rare genetic variants in the complement system on complement levels and activity in serum. MedicalResearch.com: What are the main findings? Response: Carriers of CFI variants showed decreased FI levels, carriers of C9 Pro167Ser had increased C9 levels, while C3 and FH levels were not altered. Carriers of CFH and CFI variants had a reduced ability to degrade C3b, which for CFI was linked to reduced serum FI levels.
Author Interviews, Dermatology, Electronic Records, JAMA, Outcomes & Safety, Surgical Research / 08.12.2016

MedicalResearch.com Interview with: Sophia Akhiyat M.D. Candidate, Class of 2017 The George Washington University School of Medicine and Health Sciences METEOR Fellowship MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study was inspired by one of Choudhry et al,1 in which patients' preferences for skin biopsy result disclosure was surveyed at melanoma clinics affiliated with several academic institutions. We sought to broaden participant inclusion criteria by evaluating patients' preferences at a general dermatology clinic at an academic center. Our findings support that the highest ranked patient-preferred method for receiving skin biopsy results was through an online portal. Patients also reported that the most important factors when selecting a modality for communication were the amount of information given and time available to discuss results. We also observed a relationship between a younger patient age range and online portal experience as well as a preference for biopsy notification via online portal. 1Choudhry A, Hong J, Chong K, et al. Patients' Preferences for Biopsy Result Notification in an Era of Electronic Messaging Methods. JAMA Dermatol. 2015;151(5):513-521.
ADHD, Author Interviews, Education, JAMA, UCSF / 08.12.2016

MedicalResearch.com Interview with:  

Lisa Meeks , PhD Director, Medical Student Disability UCSF Medical Center

[caption id="attachment_30304" align="alignnone" width="171"]Lisa Meeks , PhD Director, Medical Student Disability UCSF Medical Center Dr. Lisa Meeks[/caption]

MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was the first study to include students with AD/HD, learning, psychological, and chronic health conditions. This study found that the prevalence of students with disabilities is up to four times higher than previous studies indicated.

AD/HD, learning, and psychological disabilities were the most prevalent, suggesting that most students with disabilities in medicine have non-apparent disabilities. Within MD granting programs, the number of students self-reporting disability varied between 0% and 12%. Explanations for the high variability between programs are unknown, however, anecdotal reports suggest the degree to which programs have dedicated resources and inclusive practices for students with disabilities influence student disclosure.
Author Interviews, Dermatology, JAMA, Pediatrics / 07.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30293" align="alignleft" width="120"]Steve Xu MD, MSc Resident Physician Department of Dermatology Northwestern Feinberg School of Medicine Dr. Steve Xu[/caption] Steve Xu MD, MSc Resident Physician Department of Dermatology Northwestern Feinberg School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Given the limited data on the effectiveness or safety of the different moisturizers examined in the study, how much do you think parents should decide what to use on their babies based on the "cost-effectiveness" determined in this study? Would you just say cheapest is best since we don't know how well these things work? Or what's the message? Price. Petrolatum is an extremely effective moisturizer. It also happens to be one of the most affordable. Unlike adults, I don't suspect newborns will complain too much about the greasiness of petrolatum. They're less concerned that their work clothes will get ruined. They are less likely to care about cosmetic elegance. I also will say that petrolatum is less likely to include any artificial fragrances, preservatives that could serve as irritants or allergens in the future. That's an added bonus.
Author Interviews, Neurological Disorders / 07.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30297" align="alignleft" width="150"]Dr. Paul Davies PhD Tufts University School of Medicine Department of Neuroscience Boston, MA 02111 Dr. Paul Davies[/caption] Dr. Paul Davies PhD Tufts University School of Medicine Department of Neuroscience Boston, MA 02111 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Inhibition in the brain regulates neuronal action potential generation, too little inhibition can directly cause conditions such as epileptic seizures, neurodevelopment disorders, and neurodegenerative disorders. The main type of inhibition in the mammalian brain occurs when the neurotransmitter γ-aminobutyric acid (GABA) binds to the GABA type A receptors (GABAARs), a ligand-gated ion channel. Once bound with GABA, the receptor changes shape to open the ion channel allowing negative charged chloride ions to flow through into the cell and inhibiting excitation steaming from positive charged ions flowing through opposing excitatory ion channels. GABAARs mediate both synaptic (phasic) and extrasynaptic (tonic) inhibitory neurotransmission in the CNS and are the sites of action of benzodiazepines, barbiturates, general anesthetics and neuro-active steroids. We have been focused on the extrasynaptic GABAARs that mediate tonic inhibition. In the dentate gyrus of the hippocampus, neocortex, striatum and the thalamus tonic inhibition is largely dependent on GABAARs composed of α4, β2/3, and δ subunits. Neuro-active steroids play a central role in regulating behavior via their ability to allosterically enhance GABAARs, particularly extrasynaptic α4-containing GABAARs. Allosteric enhancement means that neuro-active steroids bind to GABAARs and cause a further change in the structure of the ion channel allowing it to remain open for longer. For the last few decades, allosteric enhancement of GABAARs by neuro-active steroids has been the prevailing explanation for how the steroids increase inhibition in the brain. However, recently we described a new mechanism where the neuro-active steroid, THDOC, increased the association of protein kinase C (PKC) with extrasynaptic α4β3 subunit-containing GABAARs. The increase in PKC-mediated phosphorylation of α4 and β3 subunits leads to an increase in membrane insertion from intracellular stores, an increase in GABAAR stability in the membrane, and a prolonged increase of tonic inhibition, even after when the neuro-active steroids have been removed. For this present study we asked whether other neuro-active steroids demonstrated the same metabotropic activity. We tested another endogenous neuro-active steroid, allopregnanolone (ALLO), and the synthetic neuro-active steroid, ganaxolone. In collaboration with SAGE Therapeutics, we also tested another synthetic neuro-active steroid, SGE-516. We found that all the neuro-active steroids tested were able to allosterically potentiate both synaptic and, to a lesser degree, extrasynaptic GABAARs. Short 15-minute exposures to neuro-active steroids resulted in significantly increase in phosphorylation of β3 subunits, and long lasting enhancement of tonic current. These increases were metabotropic in nature, being dependent upon PKC mediated phosphorylation. Following this short 15-minute exposure we saw a change in synaptic currents only with SGE-516 suggesting a selectivity of this metabotropic pathway to extrasynaptic GABAARs. Although ganaxolone was an effective allosteric modulator, it did not produce a metabotropic enhancement of tonic current suggesting that not all neuroactive steroids work through this pathway.