Author Interviews, Critical Care - Intensive Care - ICUs, Infections, JAMA / 12.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44416" align="alignleft" width="200"]Patrick Harris FRACP Staff Specialist Microbiology | Pathology Queensland | Health Support Queensland Postdoctoral Research Fellow University of Queensland, UQ Centre for Clinical Research (Paterson Group) Dr. Harris[/caption] Patrick Harris FRACP Staff Specialist Microbiology | Pathology Queensland | Health Support Queensland Postdoctoral Research Fellow University of Queensland, UQ Centre for Clinical Research (Paterson Group MedicalResearch.com: What is the background for this study? Response: Increasingly, common bacterial pathogens such as E. coli or Klebsiella have acquired genes known as extended-spectrum beta-lactamases (ESBLs), which mediate resistance to many of our most important antibiotics. Despite their clinical importance, we have limited information derived from randomised clinical trials on the best antibiotic treatments for life-threatening infections caused by these ESBL-producers. We aimed to compare two readily available antibiotics, meropenem (a carbapenem drug, as the “standard of care”) and piperacillin-tazobactam (which may be an alternative to meropenem). Many ESBL-producing bacteria test susceptible to piperacillin-tazobactam in the laboratory, yet clinical efficacy has been uncertain.  Some observational studies have suggested that piperacillin-tazobactam may be effective against ESBL-producers, but the data have been contradictory.  The theory has been that piperacillin-tazobactam may be less likely to select for resistance to carbapenems - which, when it occurs, can result in infection with bacteria that are almost untreatable.
Accidents & Violence, Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Surgical Research / 12.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44411" align="alignleft" width="200"]Adil Haider, MD, MPH, FACS Kessler Director for the Center for Surgery and Public Health Brigham and Women’s Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health Deputy Editor of JAMA Surgery Dr. Haider[/caption] Adil Haider, MD, MPH, FACS Kessler Director for the Center for Surgery and Public Health Brigham and Women’s Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health Deputy Editor of JAMA Surgery MedicalResearch.com: What is the background for this study? Response: Firearm-related mortality is a public health issue. However, in the US, due in part to lack of funding, there is not enough research to inform the debate about firearms. The question our group sought to answer was to understand if the presence of a semi-automatic weapon increased the number of victims killed or hurt during an active shooter incident. We chose to focus on these incidents given the availability of an FBI database detailing these active shooter incidents based on a strict definition and the similarities between such incidents that make a comparison valid.
Author Interviews, Diabetes, JAMA, OBGYNE / 12.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44401" align="alignleft" width="133"]Boyd E Metzger, MD Professor Emeritus of Medicine (Endocrinology) Feinberg School of Medicine Northwestern University Dr. Metzger[/caption] Boyd E Metzger, MD Professor Emeritus of Medicine (Endocrinology) Feinberg School of Medicine Northwestern University MedicalResearch.com: What is the background for this study? Response: The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study showed that higher levels of a mother’s blood sugar during pregnancy are associated with higher risks of increased birthweight, fatter babies, delivery by Cesarean Section, low blood sugar in newborn babies and high levels of insulin in the cord blood at birth. It is not clear whether levels of a mother’s blood sugar during pregnancy are associated with risk obesity later in life as is known to occur in offspring or pre-existing maternal diabetes mellitus. With funding from the National Institutes of Health, the HAPO Follow Up Study addressed this in a subset of nearly 5,000 mothers and their children from the original HAPO Study 10-14 years later (average 11.4 years).
Alzheimer's - Dementia, Author Interviews / 12.09.2018

MedicalResearch.com Interview with: Elena LeychenkoElena Leychenko is a senior research associate at PIBOC (G.B. Elyakov Pacific Institute of Bioorganic Chemistry which is the Far Eastern Branch of the Russian Academy of Sciences), assistant professor, and lecturer at the chair of bioorganic chemistry and biotechnology of the School of Natural Sciences Far Eastern Federal University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Sea anemones are the main object for study in the laboratory for peptide chemistry of PIBOC. These marine dwellers are very interesting for scientists because of a wide range of biologically active compounds, which are the main components of their venom. The development of modern research methods allows us to receive both major and minor components of that poison, and to study their medical properties. Interestingly, inhibitors of Kunitz-type proteinases, which are also content in sea anemones, can be used as anti-inflammatory compounds. In particular, in complex therapy, it could be applied in the treatment of Alzheimer's disease. 
Author Interviews, JAMA, Ophthalmology, Primary Care, University of Michigan / 11.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44400" align="alignleft" width="142"]Joshua Ehrlich, MD, MPH Assistant Professor of Ophthalmology and Visual Sciences University of Michigan Dr. Ehrlich[/caption] Joshua Ehrlich, MD, MPH Assistant Professor of Ophthalmology and Visual Sciences University of Michigan  MedicalResearch.com: --Describe the “important role” that primary care providers play in promoting eye health? Response: Primary care is the entryway into the health system for many individuals. The poll suggests that when primary care providers discuss vision with their patients, they are more likely to get eye exams. It also suggests that primary care providers are having these conversations most often with those who have certain risk factors for eye disease, such as diabetes or a family history of vision problems, as well as those with fewer economic resources. Promoting these kinds of conversations could bolster this trend, increasing the number of diabetics and other high risk individuals who get appropriate eye care.
Author Interviews, Biomarkers, Cancer Research, Immunotherapy, Melanoma, Nature / 11.09.2018

MedicalResearch.com Interview with: [caption id="attachment_39763" align="alignleft" width="200"]Melanoma CDC/ Carl Washington, M.D., Emory Univ. School of Medicine; Mona Saraiya, MD, MPH This image depicts the gross appearance of a cutaneous pigmented lesion, which had been diagnosed as superficial spreading malignant melanoma (SSMM).  Reminder: Melanoma can take many forms. Not all look like this. Have your skin examined for skin cancer.[/caption] Dr. Noam Auslander PhD National Cancer institute and the Center for Bioinformatics and Computational Biology University of Maryland, College Park MedicalResearch.com: What is the background for this study? Response: Immunotherapy – specifically immune checkpoint blockage (ICB) therapy – has been shown to be very effective in treating melanoma. However, only some patients with advanced tumors currently benefit from ICB therapies, while others are completely resistant and hence can be spared from the associated side effects and costs. Hence, predicting which patients are most likely to respond is an important challenge that can have great clinical benefits.  
Author Interviews, Leukemia / 11.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44407" align="alignleft" width="172"]Hans van Eenennaam, Ph.D. Executive vice president antibody research and site head Aduro Biotech Europe Dr. van Eenennaam[/caption] Hans van Eenennaam, Ph.D. Executive vice president antibody research and site head Aduro Biotech Europe MedicalResearch.com: What is the background for this study? Response: A PRoliferation Inducing Ligand (APRIL) is a member of the tumor necrosis factor superfamily and has been shown to stimulate the proliferation and survival of healthy B-lymphocytes. Malignant B-lymphocytes, such as multiple myeloma, use APRIL primarily in the bone marrow to support its proliferation and survival. Studies have shown that APRIL is overproduced in patients with multiple myeloma and mediates primarily via binding to B-cell maturation antigen (BCMA) to stimulate a wide variety of responses that promote multiple myeloma growth and survival, as well as suppressing the immune system so that the tumor cells are protected and sustained in the bone marrow and can escape current available treatments.
Aging, Author Interviews, Exercise - Fitness, Geriatrics, JAMA / 10.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44379" align="alignleft" width="200"]Peter A. Harmer, PhD., MPH., ATC., FACSM Professor - Department of Exercise & Health Science Willamette University Dr. Harmer[/caption] Peter A. Harmer, PhD., MPH., ATC., FACSM Professor - Department of Exercise & Health Science Willamette University MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Falls in older adults have long been a significant healthcare problem associated with loss of independence, premature morbidity and mortality, and considerable financial strain on individuals and healthcare systems. With the demographic impact of the Baby Boom generation aging into retirement, this issue is becoming even more critical. Among potential prevention strategies, exercise has been proposed to be beneficial. However, establishing what types of exercise are suitable to the task has been problematic. More importantly, identifying differences in the effectiveness of various exercise approaches has been lacking.
Addiction, Author Interviews, JAMA, Mental Health Research, University of Michigan / 10.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44382" align="alignleft" width="133"]Lauren B. Gerlach, D.O. Clinical Lecturer Department of Psychiatry University of Michigan Dr. Gerlach[/caption] Lauren B. Gerlach, D.O. Clinical Lecturer Department of Psychiatry University of Michigan MedicalResearch.com: What is the background for this study?  Response: In this study we used data from the Supporting Seniors Receiving Treatment and Intervention or SUSTAIN program. The program provides a supplement to a Pennsylvania medication coverage program for low-income older adults. It provides behavioral health and case management services by phone across the state. This included detailed interviews to screen for mental health issues including anxiety, depression, sleep issues, and pain, as well as analysis of prescription records and other clinical data. Among older adults prescribed a new benzodiazepine prescription by a non-psychiatric provider, we determined how many then went on to long-term use of the medication and what patient and clinical characteristics predicted long-term use over the following year.
Addiction, Author Interviews, JAMA, Opiods, Pediatrics / 10.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44348" align="alignleft" width="200"]Scott E. Hadland, MD, MPH, MS Assistant Professor of Pediatrics Boston Medical Center / Boston University School of Medicine Dr. Hadland[/caption] Scott E. Hadland, MD, MPH, MS Assistant Professor of Pediatrics Boston Medical Center / Boston University School of Medicine MedicalResearch.com: What is the background for this study? Response: Amidst a worsening overdose epidemic in the United States, adolescents and young adults have not been spared. Although evidence-based medications like buprenorphine, naltrexone, and methadone are recommended for adolescents and young adults, the extent to which youth receive these medications — and whether these medications help retain youth in addiction treatment — isn’t yet known.
Author Interviews, Cancer Research, Dermatology, Heart Disease, JAMA, Vaccine Studies / 10.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44374" align="alignleft" width="134"]Jeffrey Rapaport Dr. Rapaport[/caption] Dr. Jeffrey Rapaport MD, PA Emeritus head of Dermatology Teaneck's Holy Name Hospital. Dr. Rapaport discusess a case recently reported in JAMA: In 2016: A 97-year-old female patient was suffering from multiple squamous cell carcinomas varying from small to incredibly large in size on both of her legs. She was injected with the HPV vaccine commonly known as Gardasil, which is also used to treat warts and oral papilloma. She was first injected in her arm, and then after a period of six weeks, the vaccine was directly injected into her tumors. It was observed that this treatment eventually killed off almost all the tumors on her legs. According to recent press coverage, she is now looking forward to celebrating her 100th birthday in fall 2018. MedicalResearch.com: What is the background for this study?Is HPV thought be a trigger for some cutaneous squamous cell carcinomas? Response: The link between skin cancers and HPV vaccinations has normally been investigated in patients who have received organ transplants. Due to the immune-suppressant drugs these patients must take, it is incredibly common to find cases of skin cancer in patients who have undergone transplants. The relaxed immune system, which would normally eliminate cancers caused by the HPV virus, would open the floodgates for multiple skin tumors to emerge. In this case of the 97 year old, I would assume her immune system was healthy. There is, however, growing evidence that receiving multiple vaccines for the HPV virus is necessary even in patients with healthy immune systems. So, regardless of immune health, I believe we need to expand the frequency of the HPV vaccine, even beyond the current three-tiered system for women below 26 and men below 21.
Author Interviews, JAMA, OBGYNE, STD, USPSTF / 09.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44364" align="alignleft" width="170"]Melissa A. Simon, M.D., M.P.H. Member, U.S. Preventive Services Task Force George H. Gardner professor of clinical gynecology, Vice chair of clinical research Department of Obstetrics and Gynecology Professor of preventive medicine and medical social sciences Northwestern University Feinberg School of Medicine Dr. Simon[/caption] Melissa A. Simon, M.D., M.P.H. Member, U.S. Preventive Services Task Force George H. Gardner professor of clinical gynecology, Vice chair of clinical research Department of Obstetrics and Gynecology Professor of preventive medicine and medical social sciences Northwestern University Feinberg School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The number of babies born with syphilis is increasing, mirroring the recent increase of syphilis among women. Syphilis infection passed from a pregnant woman to her baby, also known as congenital syphilis, can lead to serious health complications for the baby including premature birth, low birthweight, birth defects, and even death. The Task Force recommends that all pregnant women be screened for syphilis as early in pregnancy as possible to prevent congenital syphilis. 
Author Interviews, Cost of Health Care, JAMA, University of Pennsylvania / 09.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44314" align="alignleft" width="180"]Amol Navathe, MD, PhD Assistant Professor, Health Policy and Medicine Perelman School of Medicine Penn Leonard Davis Institute of Health Economics Dr. Navathe[/caption] Amol Navathe, MD, PhD Assistant Professor, Health Policy and Medicine Perelman School of Medicine Penn Leonard Davis Institute of Health Economics MedicalResearch.com: What is the background for this study? What are the main findings? Response: Medicare’s voluntary Bundled Payments for Care Improvement (BPCI) initiative for lower extremity joint replacement (LEJR) surgery has been associated with reduced episode spending and stable-to-improved quality. However, BPCI may create unintended effects by prompting participating hospitals to increase the overall volume of episodes covered by Medicare. This could potentially eliminate Medicare-related savings or prompt hospitals to shift case mix to lower-risk patients. Among the Medicare beneficiaries who underwent LEJR, BPCI participation was not significantly associated with a change in market-level volume (difference-in-differences estimate . In non-BPCI markets, the mean quarterly market volume increased 3.8% from 3.8 episodes per 1000 beneficiaries before BPCI to 3.9 episodes per 1000 beneficiaries after BPCI was launched. In BPCI markets, the mean quarterly market volume increased 4.4% from 3.6 episodes per 1000 beneficiaries before BPCI to 3.8 episodes per 1000 beneficiaries after BPCI was launched. The adjusted difference-in-differences estimate between the market types was 0.32%. Among 20 demographic, socioeconomic, clinical, and utilization factors, BPCI participation was associated with changes in hospital-level case mix for only one factor, prior skilled nursing facility use in BPCI vs. non-BPCI markets. 
Author Interviews, JAMA, Pain Research, Surgical Research / 09.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44355" align="alignleft" width="133"]David A. Shaye, M.D., FACS Instructor in Otolaryngology Harvard Medical School  Dr. Shaye[/caption] David A. Shaye, M.D., FACS Instructor in Otolaryngology Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cosmetic and functional rhinoplasty (nasal surgery) is the most common procedure we perform and traditionally post operative pain medication includes opioids. In light of the recent opioid epidemic, we wished to investigate if patients pain was being treated over-treated by surgeons. Of 173 Rhinoplasties that we performed, the majority of patients received post operative opioid tablets (an average of 28 tablets).  However 11% of patients did not fill these prescriptions at all, and only 2 of the 178 patients required refills. We believe patients experienced less pain than surgeons anticipated.
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Supplements / 09.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44351" align="alignleft" width="146"]Pieter Cohen, M.D. Associate Professor of Medicine Cambridge Health Alliance Assistant Professor of Medicine Harvard Medical School Dr. Cohen[/caption] Pieter Cohen, M.D. Associate Professor of Medicine Cambridge Health Alliance Assistant Professor of Medicine Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Dietary supplements lead to an estimated 23,000 emergency department visits each year in the United States (US), and weight loss and sports supplements contribute to a disproportionately large number of these emergency department visits. It is not known which ingredients in weight loss and sports supplements pose the greatest risk to consumers, but there are stimulants found in botanical remedies that might pose risks. In the current study, we investigated the presence and quantity of higenamine a stimulant found in botanicals and available in sports and weight loss supplements sold in the US.
Author Interviews, CDC, Heart Disease / 07.09.2018

MedicalResearch.com Interview with: “Cardiovascular Disease” by Sharon Sinclair is licensed under CC BY 2.0Hilary K. Wall, MPH Division for Heart Disease and Stroke Prevention CDC  MedicalResearch.com: What is the background for this study? Response: Despite decades-long reductions in cardiovascular disease (CVD) mortality, CVD mortality rates have recently plateaued and even increased in some subgroups, and the prevalence of CVD risk factors remains high. Million Hearts 2022, a 5-year initiative with a goal of preventing one million heart attacks, strokes and other acute cardiovascular events by 2022, was launched in 2017 to address this burden. This report establishes a baseline for the CVD risk factors targeted for reduction by the initiative during 2017–2021 and highlights recent changes over time. These risk factors include: the “ABCS” of cardiovascular disease prevention: Aspirin when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation; combustible tobacco product use; physical inactivity; and mean daily sodium intake.
Author Interviews, Cost of Health Care, NEJM, Outcomes & Safety / 07.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44305" align="alignleft" width="142"]Prof-Bruce Guthrie Head of Population Health Sciences Division Professor of Primary Care Medicine and Honorary Consultant NHS Fife Prof. Guthrie[/caption] Prof. Bruce Guthrie PhD Head of Population Health Sciences Division Professor of Primary Care Medicine and Honorary Consultant NHS Fife  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The UK Quality and Outcomes Framework (QOF)) is a primary care pay for performance programme (P4P) implemented in 2004. QOF was and still is the largest healthcare P4P programme in the world, initially having ~150 indicators and accounting for ~20% of practice income. QOF has been reduced in scale and scope over time, with 40 indicators retired in 2014. It was abolished in Scotland in 2016 and is due to be further reformed in England. There is some evidence that P4P (and QOF itself) is associated with modest improvements in quality when introduced, but little evidence about what happens when financial incentives are withdrawn. Our study examined what happened when incentives were withdrawn in 2014 for 12 indicators where there is good before and after data. There were immediate reductions in documented quality of care, which were similar in size to improvements observed when incentives were introduced. These reductions were small to modest (~10%) for indicators relating to care that is already systematically delivered (eg routine diabetes, hypertension and cardiovascular disease) and large for indicators which has historically been less systematically delivered (eg lifestyle advice).
Author Interviews, JAMA, Outcomes & Safety / 07.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44298" align="alignleft" width="128"]Dr Maria Panagioti| Senior Research Fellow Division of Population Health, Health Services Research & Primary Care University of Manchester Manchester Dr. Panagioti[/caption] Dr Maria Panagioti, Senior Research Fellow Division of Population Health Health Services Research & Primary Care University of Manchester Manchester  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several studies have shown that the demanding work environment has alarming consequences on the well-being of physicians. Over 50 percent of physicians experience significant signs of burnout across medical specialities. However, the consequences of burnout on patient care are less well-known. This is the largest meta-analysis to date which pooled data from 43,000 doctors to examine the relationship between burnout in physicians and patient safety, professionalism and patient satisfaction. We found that burnout in physicians is associated with two times increased risk for patient safety incidents, reduced professionalism and lower patient satisfaction. Particularly in residents and early career physicians, burnout was associated with almost 4 times increased risk for reduced professionalism. 
Author Interviews, Hematology, NEJM / 07.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44276" align="alignleft" width="200"]Dr. Johnny Mahlangu  MBBCh Faculty of Health Sciences University of the Witwatersrand and National Health Laboratory Service Johannesburg, South Africa Dr. Mahlangu[/caption] Dr. Johnny Mahlangu  MBBCh Faculty of Health Sciences University of the Witwatersrand and National Health Laboratory Service Johannesburg, South Africa MedicalResearch.com: What is the background for this study? What are the main findings? Response: Current unmet needs in patients with haemophilia without inhibitors are the high disease burden imposed by the frequent injections which have to be given intravensously . Emicizumab which is given subcutaneously weekly or fortnightly aims to address these unmet needs.
Author Interviews, CDC, Cost of Health Care, JAMA, OBGYNE / 07.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44286" align="alignleft" width="128"]Michelle H. Moniz, MD, MSc Assistant Professor Department of Obstetrics and Gynecology Ann Arbor, MI 48109-2800 Dr. Moniz[/caption] Michelle H. Moniz, MD, MSc Assistant Professor Department of Obstetrics and Gynecology Ann Arbor, MI 48109-2800 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to examine whether Medicaid expansion in Michigan was associated with improved access to birth control/family planning services in our state.  We conducted a survey of enrollees in the Michigan Medicaid expansion program (called "Healthy Michigan Plan"). We found that 1 in 3 women of reproductive age reported improved access to birth control/family planning services after joining HMP.  Women who were younger, who were uninsured prior to joining HMP, and those who had recently seen a primary care clinician were most likely to report improved access. 
Author Interviews, Gastrointestinal Disease, Infections, JAMA, Pediatrics, Vaccine Studies / 07.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44279" align="alignleft" width="166"]Chuanxi Fu, MD.PhD. Professor of Epidemiology, School of Public Health Zhejiang Chinese Medical University Associate editor, Human Vaccines & Immunotherapeutics Dr. Chuanxi Fu[/caption] Chuanxi Fu, MD.PhD. Professor of Epidemiology, School of Public Health Zhejiang Chinese Medical University Associate editor, Human Vaccines & Immunotherapeutics  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Since 2000, the Lanzhou lamb rotavirus vaccine has been exclusively licensed in China for voluntary rotavirus gastroenteritis prevention, however, the effects of the vaccination on population health, including any indirect impact to unvaccinated individuals have not been evaluated. In the study enrolled 33 407 patients with rotavirus gastroenteritis from 2007 to 2015 seasons in southern China shows vaccination effects in which the median age at onset increased by 4 months, and onset, peak, and cessation of incidence were delayed. The incidence rate ratio among children younger than 4 years and among children ineligible for vaccination decreased as citywide vaccination coverage increased, and the adjusted odds ratio for rotavirus gastroenteritis among unvaccinated infants decreased in areas with higher vaccination coverage. 
Author Interviews, ENT, Environmental Risks, Occupational Health / 06.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44250" align="alignleft" width="173"]Beatrice Golomb, MD, PhD Director of the Golomb Research Group Professor of Medicine University of California, San Diego Dr. Golomb[/caption] Beatrice Golomb, MD, PhD Director of the Golomb Research Group Professor of Medicine University of California, San DiegoResponse: MedicalResearch.com: What is the background for this study? How was the radiation emitted? Response: Possibilities include surveillance devices (or things to jam them), electronic weapons, or, less likely, “innocent” communications devices. MedicalResearch.com: What are the main findings? Response: That all key features of diplomats’ experiences comport with pulsed radiofrequency/ microwave (RF/MW) radiation.
  1. The nature of the “sounds” heard – chirping, clicking, ringing, grinding/buzzing – are known “sounds” produced via the “microwave auditory effect” aka Frey effect.  Different sounds are heard by different people, because the character of the sound heard depends on head dimensions (as well as pulse characteristics). Sounds were primarily heard at night: consistent with the microwave auditory effect, which requires low ambient noise. Some diplomats reported that sounds were spatially localized with “laserlike” specificity – said to defy known physics. This defies the physics of sound, but not radiation. The “sound” was reported to follow a diplomat as he walked, within the territory in which it was heard. Sound from a fixed source does not seem to follow people – but the microwave auditory affect does, often perceived as being located just behind (or in some cases just above, or inside) the head of the person, irrespective of the person’s orientation relative to the radiation source.
  2. The symptoms reported following these experiences also fit. Rates of reported symptoms in diplomats – headache, cognitive and sleep problems dominating, then dizziness, tinnitus, anxiety, nausea at lesser but still high rates – match closely with rates of the same symptoms reported in a 2012 Japanese study of people who report health effects from radiation, typically including pulsed RF/MW. Hearing loss is a relatively distinctive and prominent symptom in both diplomats, and RF/MW affected civilians. In both groups, some reportedly experience speech problems, balance problems, nosebleed, and strange sensations of vibration and pressure.
Reports of symptoms with RF/MW exposures date at least to the 1920s, affecting radio amateurs and shipboard radio operators as well as others working with radar or microwaves in occupational settings. By 1971/72, a Naval report with over 2300 citations (many from Russia and Eastern Europe), assessing effects of low intensity RF radiation, had whole sections devoted to each of a number of the symptoms diplomats report.
  1. Hundreds (if not thousands) of studies have illuminated mechanisms by which these effects may arise, centered on oxidative stress (the kind of injury that antioxidants help to defend against) – and many downstream effects of oxidative stress (membrane damage, blood brain barrier impairment with potential for brain swelling, inflammation, voltage gated calcium (and other) channel effects (which can also lead to oxidative stress), mitochondrial impairment, autoimmune activation, etc.)
Affected persons are a minority (in both settings), and in the nondiplomat setting, vulnerability has been tied to genetic variants less adept at defending against oxidative stress; and low concentrations of a critical antioxidant. In both groups, brain imaging studies resemble traumatic brain injury; and in both, at least some of those affected had prior head injury. Head injury may be a predisposing factor, as well as possible consequence. Reprising findings also shown for research on other lucrative products with potential to cause harm in some, there is a powerful tie between study results and financial conflict of interest (e.g. source of study funding or conflicts by authors).
  1. There is precedent for use of microwaves in the diplomat setting. It is known that the US embassy in Moscow was microwaved for several decades beginning in the early 1950s (with some embassy staff citing – disputed - health problems). A 1976 NY Times story (“Moscow rays linked to U.S. bugging”) referenced speculation these were for surveillance; the Soviets claimed their purpose was to thwart U.S. listening devices on the roof of the embassy.
Author Interviews, JAMA, Pain Research, Technology / 06.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44273" align="alignleft" width="150"]Richard L Kravitz, MD, MSPH Professor, General Internal Medicine Director, UC Center Sacramento Dr. Kravitz[/caption] Richard L Kravitz, MD, MSPH Professor, General Internal Medicine Director, UC Center Sacramento MedicalResearch.com: What is the background for this study? What are the main findings?  Response:  The study was designed to address tso problems. The first is that many patients with chronic pain struggling to find a workable regimen. The second is more general. Patient sometimes I hesitate to participate in clinical research because they right away do not see the relevance I directly to them selves. And have one trials are away I’m addressing both problems. 
Aging, Alzheimer's - Dementia, Author Interviews, CMAJ, Genetic Research / 06.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44262" align="alignleft" width="200"]Ruth Frikke-Schmidt, Professor, Chief Physician, MD, DMSc, PhD Department of Clinical Biochemistry Rigshospitalet, Blegdamsvej & Deputy Head Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Dr. Frikke-Schmidt[/caption] Ruth Frikke-Schmidt, Professor, Chief Physician, MD, DMSc, PhD Department of Clinical Biochemistry Rigshospitalet, Blegdamsvej & Deputy Head Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen MedicalResearch.com: What is the background for this study?   Response: Alzheimer’s disease and other forms of dementia are devastating, neurodegenerative disorders affecting more than 47 million people in 2015, a number projected to triple by 2050 (1,2). Available curative treatments are lacking, and no useful risk prediction tools exist. The potential for prevention is however substantial, emphasized by the recently observed incidence decline in Western societies, likely caused by improved treatment and prevention of vascular risk factors (1,3,4). Population growth and aging, will however triple dementia prevalence by 2050, if no action is taken. Acting now with ambitious preventive interventions, delaying onset of disease by five years, is estimated to halve the prevalence globally (1,5). Despite important preventive efforts over the last decades - resulting in decreased smoking, lower blood pressure and lower cholesterol levels in the general population - physical inactivity, overweight, and diabetes remain threats for our health care system, and in particular for cardiovascular disease and dementia. Intensifying preventive efforts in general is thus of crucial importance, and especially for those patients at highest risk who most likely will benefit the most from early and targeted prevention. Risk stratification and specific treatment goals according to the estimated absolute 10-year risk, has been implemented in cardiovascular disease for years (6,7). There is an un-met need for similar strategies in dementia, underscored by the publication of several randomized multicomponent trials that seem to improve or maintain brain function in at-risk elderly people from the general population (8-10)
Author Interviews, JAMA, Smoking, Tobacco, Tobacco Research / 06.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44259" align="alignleft" width="144"]Dorothy K. Hatsukami, Ph.D. Forster Family Professor in Cancer Prevention Professor of Psychiatry Associate, Director Masonic Cancer Center University of Minnesota Dr. Hatsukami[/caption] Dorothy K. Hatsukami, Ph.D. Forster Family Professor in Cancer Prevention Professor of Psychiatry Associate, Director Masonic Cancer Center University of Minnesota  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The U.S. Food and Drug Administration is considering a rule that would reduce nicotine in all cigarettes and possibly other burned tobacco products sold in the U.S. to minimally addictive levels.   Reducing nicotine in cigarettes does not make the cigarette safer, but because nicotine is the addictive chemical in tobacco, nicotine reduction would reduce the progression towards tobacco dependence and make it easier for smokers to quit smoking.  We recently published a study in JAMA that adds to the accumulating evidence to support reducing nicotine in cigarettes and addresses if a gradual reduction or a targeted immediate reduction in nicotine in cigarettes is the best approach. In a large clinical trial involving 1,250 smokers across 10 academic institutions, immediate reduction of nicotine was compared to a gradual nicotine reduction approach. These two groups were also compared to smokers who continued to smoke usual nicotine content cigarettes. Key findings showed that immediate nicotine reduction is likely to result in more rapid positive public health effects.  That is, smokers in the immediate reduction group experienced significantly less exposure to toxic cigarette smoke chemicals and reported smoking fewer cigarettes per day, less dependence on cigarettes and greater number of days that they were smoke-free compared to the other two groups. On the other hand, smokers in the immediate nicotine reduction group experienced more severe but transient withdrawal symptoms and greater drop-outs. 
AACR, Author Interviews, Biomarkers, Colon Cancer / 05.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44230" align="alignleft" width="200"]Andrea Sottoriva, PhD, MSc Reader in Cancer Evolutionary Dynamics | Evolutionary Genomics & Modelling Lab Centre for Evolution and Cancer | The Institute of Cancer Research London Dr. Sottoriva[/caption] Dr. Andrea Sottoriva, PhD Centre for Evolution and Cancer, The Institute of Cancer Research, London, United Kingdom MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by a liquid biopsy? Response: Cetuximab is a targeted treatment available for metastatic colorectal cancer patients. Unfortunately, although many patients benefit from Cetuximab, after an initial response to the treatment many patients relapse and become resistant to the drug. We know that this resistance is due to the tumour evolving and adapting to therapy. Liquid biopsies allow to look for residual cancer DNA in the blood of a patient and hence monitor the emergence of resistance over time. We used blood samples take every 4 weeks (quite frequently for this type of study) to monitor the evolution of the cancers under treatment and see if there were some measurements that would predict if and when patients will relapse.
Author Interviews, Brain Injury, CDC, JAMA, Pediatrics / 05.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44283" align="alignleft" width="174"]Matt Breiding, PhD Team Lead, Division of Unintentional Injury Prevention Center for Disease Control and Prevention Dr. Breiding[/caption] Matt Breiding, PhD Team Lead, Division of Unintentional Injury Prevention Center for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: Caused by a bump, blow or jolt to the head or body, a mild traumatic brain injury (mTBI) can lead to short- or long-term problems that can affect how a child thinks, acts, feels, and learns. CDC’s Pediatric mTBI Guideline is based on the most comprehensive review of the science on pediatric mTBI diagnosis and management to date—covering 25 years of research. The guideline consists of 19 sets of clinical recommendations that cover diagnosis, prognosis, and management and treatment. These recommendations are applicable to healthcare providers who care for pediatric patients with mTBI in all practice settings and outline actions healthcare providers can take to improve the health of their patients with this injury. The CDC Pediatric mTBI Guideline outlines specific actions healthcare providers can take to help young patients and includes 5 key recommendations.  Specifically, they recommend that physicians:
  1. Refrain from routinely imaging pediatric patients to diagnose mTBI.
  2. Use validated, age-appropriate symptom scales to diagnose mTBI.
  3. Assess for risk factors for prolonged recovery, including: history of mTBI or other brain injury, severe symptom presentation immediately after the injury, and personal characteristics and family history (such as learning difficulties and family and social stressors).
  4. Provide patients with instructions on returning to activity customized to their symptoms.
  5. Counsel patients to return gradually to non-sports activities after no more than a 2-3 days of rest.
Author Interviews, Dermatology, Education, Gender Differences, JAMA / 03.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44309" align="alignleft" width="200"]Prof-Lia E. Gracey Prof. Gracey[/caption] Lia E. Gracey, MD, PhD Department of Dermatology Baylor Scott & White Health Austin, Texas  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The co-authors and I were interested in this issue as new parent leave (or the lack thereof) is increasingly being examined in many professions.  As a mother who had children during dermatology residency, I felt the pressure to take a short new parent leave to avoid having to make up time at the end of my training. I came back to work only 3 ½ weeks after having my first baby. Anecdotally, other new parent residents (both men and women) reported similar concerns and we noticed a lack of data about new parent leave policies in dermatology residency training programs. We distributed surveys to dermatology residency program directors and residents and were struck by a basic lack of awareness by residents for whether their institution even offered new parent leave.  Less than 50% of surveyed residents were aware of a written new parent leave policy for their residency program, yet over 80% of program directors stated they had a policy in place. We also found discrepancies between resident and program director perceptions of sufficiency of new parent leave and the availability of pumping facilities for breastfeeding mothers. 
Author Interviews, Cost of Health Care, JAMA, Surgical Research, Technology / 03.09.2018

MedicalResearch.com Interview with: A robotically assisted surgical system: WikipediaChris Childers, M.D. Division of General Surgery David Geffen School of Medicine at UCLA 10833 Le Conte Ave., CHS 72-247 Los Angeles, CA 90095 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The robotic surgical approach has gained significant traction in the U.S. market despite mixed opinions regarding its clinical benefit. A few recent randomized trials have suggested there may be no clinical benefit of the robotic approach for some surgical procedures over the more traditional open or laparoscopic (“minimally-invasive”) approaches. Previous studies have also suggested the robotic approach is very expensive, but until our study, there was no benchmark for the true costs (to the hospital) of using the robotic platform. Our study analyzed financial statements from the main supplier of robotic technology. We found that the use of robotic surgery has increased exponentially over the past decade from approximately 136 thousand procedures in 2008 to 877 thousand procedures in 2017. The majority of these procedures were performed in the United States. While most people think of the robotic approach in urologic and perhaps gynecologic surgery, the fastest growing segment has been general surgery, for procedures such as colorectal resections, hernia repairs and gallbladder removals. In total, over 3 billion dollars was spent by hospitals to acquire and use robotic platforms in 2017 with 2.3 billion dollars in the United States. This equates to nearly $3,600 per procedure performed.