Author Interviews, Environmental Risks, JAMA, Pediatrics, Toxin Research / 29.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44119" align="alignleft" width="135"]Joseph M. Braun, MSPH, PhD  Associate Professor of Epidemiology Epidemiology Master's Program Director  Brown University School of Public Health Dr. Braun[/caption] Joseph M. Braun, MSPH, PhD Associate Professor of Epidemiology Epidemiology Master's Program Director Brown University School of Public Health MedicalResearch.com: What is the background for this study? Response: Childhood lead poisoning continues to be a problem in the United States and residential lead hazards are the major source of Pb exposure in young children. However, no studies have attempted to prevent exposure to lead hazards through primary prevention. Thus, we randomized 355 pregnant women to a comprehensive residential intervention and followed their children for up to 8 years to determine if childhood lead poisoning and associated cognitive deficits and behavior problems can be prevented.
Author Interviews, Heart Disease, JAMA, Surgical Research / 27.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44187" align="alignleft" width="128"]Amine Mazine, MD, MSc Associate Editor, BMC Surgery PGY-4 Cardiac Surgery PhD Candidate, Institute of Biomaterials and Biomedical Engineering McEwen Center for Regenerative Medicine Surgeon-Scientist Training Program  University of Toronto Dr. Mazine[/caption] Amine Mazine, MD, MSc Associate Editor, BMC Surgery PGY-4 Cardiac Surgery PhD Candidate, Institute of Biomaterials and Biomedical Engineering McEwen Center for Regenerative Medicine Surgeon-Scientist Training Program University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We performed this study to compare two methods of replacing a diseased aortic valve in young and middle-aged adults: using an artificial mechanical valve (mechanical aortic valve replacement) versus using the patient’s own pulmonary valve (Ross procedure). The study was a meta-analysis of existing literature that included more than 3,500 adult patients. It found that those who underwent the Ross procedure were 46 per cent less likely to experience death from any cause than patients who underwent mechanical aortic valve replacement. Patients in the Ross group were also less likely to suffer from a stroke or major bleeding, and had better quality of life. Patients who underwent the Ross procedure were more likely to need late reoperation, but this did not negatively impact their survival.
Author Interviews, Critical Care - Intensive Care - ICUs, Heart Disease, Karolinski Institute / 27.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44179" align="alignleft" width="128"]Robin Hofmann, MD PhD Senior consultant cardiologist and researcher Department of clinical science and education Södersjukhuset, at Karolinska Institute Dr. Hofmann[/caption] Robin Hofmann, MD PhD Senior consultant cardiologist and researcher Department of clinical science and education Södersjukhuset, at Karolinska Institute MedicalResearch.com: What is the background for this study? Response: Oxygen has been used to treat patients suffering a heart attack for more than a century, despite the fact that such treatment has not had any scientifically proven effect on patients who have normal oxygen levels in their blood. Since the turn of the millennium, researchers worldwide have started to question whether oxygen therapy for heart attacks is ineffective – or may even be harmful.
Author Interviews, Cannabis, Pediatrics, Pediatrics, UCSD / 27.08.2018

MedicalResearch.com Interview with: [caption id="attachment_40908" align="alignleft" width="200"]“Cannabis sativa” by Manuel is licensed under CC BY 2.0 cannabis[/caption] Christina Chambers, PhD, MPH Principal investigator Professor in the Department of Pediatrics UC San Diego School of Medicine Drector of clinical research at Rady Children's Hospital San Diego  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although cannabis is one of the most common recreational drugs used by pregnant and breastfeeding women, there is little current research regarding potential exposure of the breastfed infant.  As a result, pediatricians are lacking concrete evidence to help support advice to breastfeeding mothers who use cannabis.  This is particularly important as cannabis products available today are substantially more potent than products available in years past. Our group in the Department of Pediatrics at the University of California San Diego (UCSD) Center for Better Beginnings was interested in first determining how much if any of the ingredients in cannabis actually transfer into breastmilk and how long these metabolites might stay in the milk after the mom’s last use.  We invited mothers who are participating in our UCSD Human Milk Research Biorepository from across the U.S. and Canada to respond to questions about use of cannabis products over the previous 14 days and to provide a breast milk sample. Fifty mothers participated in the study.  Samples were analyzed by investigators from the UCSD Skaggs School of Pharmacy. Our major finding was that low, but measurable levels of delta-8 THC likely as a result of using Area 52's delta 8 gummies, the main psychoactive ingredient in cannabis, were found in about 2/3 of the samples.  Although the number of hours after mother’s last use of cannabis that THC was still measurable varied widely, the longest time since mother’s last use that THC was still present was about 6 days. 
Author Interviews, Heart Disease, NEJM, Surgical Research / 27.08.2018

MedicalResearch.com Interview with: Jean François Obadia Adult Cardiovascular Surgery and Transplantation Louis Pradel HospitalJean François Obadia MD PhD Adult Cardiovascular Surgery and Transplantation Louis Pradel Hospital MedicalResearch.com: What is the background for this study? -By definition a secondary MR concerns a normal valve or sub normal valve inside a dilated heart with poor LV function in a population of Heart failure patients. It is perfectly established today that secondary MR is a predictor of poor clinical outcomes of thissevere population. -Therefore,it has been proposed to treat those regurgitation either by surgery (mainly the downsizing anuloplasty) or by percutaneous technique like the mitraclipwhich has been used more and more frequently recently. -However, a beneficial effect on hardclinical outcomes has never been provedandwe still don’t know if those regurgitations need to be corrected or not, We still don’t Know if the regurgitation is the cause, the consequence or just a marker of poor prognosis. -In this context according to the guidelines, there is a low level of evidence to support those treatments, and Europe and US Guidelines call for prospective randomized studies in this severe population.​ And this excatly what we have done with MITRA-FR
Author Interviews, Heart Disease, Infections, JAMA / 27.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44113" align="alignleft" width="200"]Sheep tick - vector for Coxiella burnetii, the cause of the disease known as Q fever CDC image Sheep tick - vector for Coxiella burnetii, the cause of the disease known as Q fever CDC image[/caption] Pr. Didier Raoult Directeur de l'IHU Méditerranée-Infection Marseille  MedicalResearch.com: What is the background for this study? What are the main findings? Response: This work represents the sum of data accumulated over several decades of studies on Q fever. Our reference center contacts each of the physicians in charge and ensures patient follow-up, which allows obtaining data, that is not comparable to those used automatically in databanks. Four people exclusively dedicated their time to manage these specific data on Q fever. The main data confirm the need to perform a cardiac ultrasound for all patients with Q fever and acute endocarditis (to detect valvulopathy) and to give a prophylactic treatment to avoid fixation on the heart in patients with valvulopathy. This work helps clarify the evolution of Q fever by eliminating the term of chronic Q fever, which is based on non-clinical elements, and defining persistent Q fever for which there is an identifiable focus of infection. Furthermore, this work makes it possible to recommend systematic detection of antiphospholipid antibodies in order to limit the risk of thrombosis and the risk of cardiac fixation.
Aging, Author Interviews, Genetic Research, JAMA / 27.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44163" align="alignleft" width="110"]Yi Zeng, Ph.D.| Professor, Center for Study of Aging and Human Development and Geriatrics Division, School of Medicine, Duke University Professor, National School of Development, Chief Scientist of Raissun Institute for Advanced Studies, Peking University Distinguished Research Scholar, Max Planck Institute for Demographic Research Foreign member of the Royal Netherlands Academy of Arts and Sciences Dr. Yi Zeng[/caption] Yi Zeng, Ph.D.| Professor, Center for Study of Aging and Human Development and Geriatrics Division, School of Medicine, Duke University Professor, National School of Development, Chief Scientist of Raissun Institute for Advanced Studies, Peking University Distinguished Research Scholar, Max Planck Institute for Demographic Research Foreign member of the Royal Netherlands Academy of Arts and Science MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sex differences in genetic associations with human longevity remain largely unknown; investigations on this topic are important for individualized healthcare.
Author Interviews, CT Scanning, Heart Disease, NEJM / 25.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44122" align="alignleft" width="150"]Prof David Newby FRSE FMedSci Personal Chair - BHF John Wheatley Chair of Cardiology University of Edinburgh Prof. Newby[/caption] Prof David Newby FRSE FMedSci Personal Chair - BHF John Wheatley Chair of Cardiology University of Edinburgh MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many tests that can try and determine whether a patient has heart disease. All are imperfect and do not directly see if the heart arteries are diseased. This study used a CT heart scan to see if there was any heart disease in patients who presented to the outpatient clinic with chest pains that could be due to coronary heart disease. The doctor use the scan result to decide whether they had heart disease and how to manage the patient. The study has found that if you use a CT heart scan then you are less likely to have a heart attack in the future. In the first year, you may require treatment with an angiogram and heart surgery (stent or heart bypass) but after the first year, you are less likely to need these treatments because the disease has already been treated promptly.
Author Interviews, Blood Pressure - Hypertension, Diabetes, Pediatrics, Weight Research / 25.08.2018

MedicalResearch.com Interview with: “Chinese baby laying on a bed” by simpleinsomnia is licensed under CC BY 2.0Wanghong Xu, MD, PhD Professor of Epidemiology School of Public Health Fudan University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Developmental Origins of Health and Disease (DOHaD) hypothesis proposes that cardiovascular diseases and other chronic conditions in adulthood may be a consequence of an unfavorable intrauterine life, a relationship that is further modified by patterns of postnatal growth, environment, and lifestyle. Based on the two large-scale cohort studies, the Shanghai Women’s Health Study and the Shanghai Men’s Health Study, we observed nonlinear associations for birth weight with baseline body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), and low birth weight was linked with lower BMI, smaller WC, but larger WHR and WHtR. An excess risk of T2DM and hypertension was observed for low birth weight (<2500 g) versus birth weight of 2500-3499 g since baseline and since birth. The results support the DoHad hypothesis, and indicate the importance of nutrition in early life on health in Chinese population. 
Author Interviews, Compliance, JAMA, Macular Degeneration, Ophthalmology / 25.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44092" align="alignleft" width="200"]Picture of the back of the eye showing intermediate age-related macular degeneration Picture of the back of the eye showing intermediate age-related macular degeneration: Wikipedia image[/caption] Jason Hsu, MD Retina Service, Wills Eye Hospital Associate Professor of Ophthalmology Thomas Jefferson University Mid Atlantic Retina Anthony Obeid MD MPH School of Public Health The University of Sydney · MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Neovascular age-related macular degeneration (nAMD) is a vision-threatening disease that often afflicts elderly patients. The introduction of intravitreal anti-vascular endothelial growth factor treatment drastically improved the prognosis of eyes with nAMD. Despite its efficacy, patients require consistent follow-up (sometimes as often as monthly), with ongoing injections to maintain the visual benefits of the drug. Unfortunately, few studies have reported the number of patients that do not follow-up with recommended guidelines. Moreover, there remains limited evidence on the risk factors associated with loss to follow-up. Our study, consisting of 9007 patients with a history of nAMD receiving treatment between 2012 and 2016, evaluated both these parameters. We defined loss to follow-up as having at least one injection without a subsequent follow-up visit within 12 months post-treatment. Using this definition, we found that over 20% of patients are lost to follow-up over the entire study period. We further identified key risk factors associated with loss to follow-up, which included patients of older age, race, patients residing in a region of a lower average adjusted gross income, patients living at greater distances from clinic, patients with active nAMD in only one eye, and patients with worse visual acuity.
Allergies, Author Interviews, CDC, Infections, Pediatrics / 25.08.2018

MedicalResearch.com Interview with: Maribeth C. Lovegrove, MPH Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Atlanta, GA 30333). MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a lot of recent attention on reducing unnecessary antibiotic prescribing in order to reduce antibiotic resistance (a longer-term harm).  However, antibiotic use also can lead to shorter-term harms like allergic reactions and other side effects.  With this analysis, we wanted to focus on the acute harms to individual pediatric patients from antibiotic use in order to help target prevention efforts.  Specifically, we used data from two national data sources to identify the antibiotics with the highest numbers of emergency department visits for adverse drug events and the highest rates of emergency department visits for adverse drug events (accounting for amount of antibiotic prescriptions dispensed) and to identify the pediatric patients with the highest risks.
Author Interviews, Breast Cancer, Cancer Research, JAMA, Mammograms / 25.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44044" align="alignleft" width="142"]Lisa A Newman, MD Director of the Breast Oncology Program for the multi-hospital  Henry Ford  Health System Dr. Newman[/caption] Lisa A Newman, MD Director of the Breast Oncology Program for the multi-hospital Henry Ford  Health System MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In 2009 the United States Preventive Services Task Force published a guideline recommending that American women at average risk for breast cancer defer undergoing screening mammography until they reach the age of 50 years. Prior to this publication, women were widely-encouraged to initiate annual mammography at age 40 years. Women that have a history of breast cancer are automatically considered to be at increased risk for developing a new breast cancer, and so routine screening mammography guidelines do not apply to them. These women require annual mammography regardless of age, unless they have undergone a bilateral mastectomy. We utilized data from Michigan Blue Cross/Blue Shield to evaluate patterns of mammography utilization among women age 40-49 years, comparing rates before versus after 2009, when the USPSTF guideline was published. We analyzed women that had a prior history of breast cancer separately from those that had no history of breast cancer, and we excluded women that underwent bilateral mastectomy. Disturbingly, we found that mammography utilization rates declined among women with a history of breast cancer as well as among those with no history of breast cancer in the post-2009 timeline. This suggested to us that changes in screening recommendations may have had the unintended consequence of generating confusion and misunderstandings regarding the value of mammography among women that undeniably benefit from this imaging, such as those with a history of breast cancer. 
Author Interviews, Neurology / 24.08.2018

MedicalResearch.com Interview with: MedicalResearch.comCaroline Schlüter, M.Sc. Psychologie Fakultät für Psychologie AE Biopsychologie Ruhr-Universität Bochum MedicalResearch.com: What is the background for this study? What are the main findings? Response: Individuals differ in their ability to initiate intended actions. While some people tend to put tasks off, others easily manage to tackle them directly. Although interindividual differences in what we call ‘action control’ make a major contribution to our everyday life by affecting our physical and mental health as well as our academic and occupational performance, their neural foundation was mostly unknown. Our study is the first to use both structural and functional neuroimaging methods to investigate the neural correlates of action control. We were able to show that poorer action control is significantly related to greater amygdala volume. The amygdala is considered to be a neuroanatomical hub for fear-motivated behavior. It processes sensory information in order to evaluate a given situation, behaviour or outcome. Hence, it is conceivable that individuals with a larger amygdala tend to evaluate future actions and their possible consequences more extensively. This, in turn, might lead to greater concern and hesitation, as observed in individuals with poorer action control. Further, we were able to show that weaker functional resting-state connectivity between the amygdala and the dorsal anterior cingulate cortex (dACC) is significantly associated with lower action control scores, which are typical for procrastinators. Previous studies indicate that the dACC has reciprocal connections with the amygdala, playing a significant role in purposive behaviour and self-control mechanisms. Thus, a weaker functional connection between both brain areas might hinder successful action control, as interfering negative emotions and 
Author Interviews, Microbiome, Pediatrics, Probiotics / 23.08.2018

[caption id="attachment_44109" align="alignleft" width="117"]Hariom Yadav, PhD Assistant Professor, Molecular Medicine Comprehensive Cancer Center Center on Diabetes, Obesity, and Metabolism Redox Biology & Medicine Ctr Sticht Center on Aging Dr. Yadav[/caption] MedicalResearch.com Interview with: Hariom Yadav, PhD Assistant Professor, Molecular Medicine Comprehensive Cancer Center Center on Diabetes, Obesity, and Metabolism Redox Biology & Medicine Ctr Sticht Center on Aging MedicalResearch.com: What is the background for this study? What are the main findings? Response: Currently, the use of probiotics is increasing for health benefits of consumers, however the source of probiotics available in the market remains scarcely known. According to scientific community and regulatory standpoint, human-origin probiotics are highly recommended. Hence, we isolated these probiotics from baby diapers, because infant microbiome carries large number of beneficial bacteria. In addition, we optimized our probiotics to produce higher amount of short-chain fatty acids (SCFAs; beneficial metabolites produced by the gut microbiome), because the levels of SCFAs decreases in several human diseases like obesity, diabetes, cancer, autoimmune and inflammatory bowel diseases. Hence, our probiotics can be used to bring back SCFAs levels and may benefit people suffering from these diseases.
Alcohol, Author Interviews, Prostate Cancer / 23.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44104" align="alignleft" width="200"]Emma H. Allott, PhD Research Assistant Professor of Nutrition UNC GILLINGS SCHOOL OF GLOBAL PUBLIC HEALTH  University of North Carolina, Chapel Hill  Dr. Emma Allott[/caption] Emma H. Allott, PhD Research Assistant Professor of Nutrition UNC GILLINGS SCHOOL OF GLOBAL PUBLIC HEALTH University of North Carolina, Chapel Hill  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prostate cancer development may span decades. In addition, the prostate grows rapidly during puberty and therefore may be particularly susceptible to dietary or lifestyle factors during this time. Our study found that heavier alcohol intake earlier in life, as well as higher cumulative alcohol intake across the lifespan, was associated with an increased odds of being diagnosed with an aggressive (clinically significant) prostate cancer in later life. However, current alcohol intake at the time of prostate cancer diagnosis was unrelated to tumor aggressiveness.
Author Interviews, Diabetes, Pediatrics / 23.08.2018

MedicalResearch.com Interview with Sherry L. Voytik-Harbin Weldon School of Biomedical Engineering Purdue UniversitySherry L. Voytik-Harbin Weldon School of Biomedical Engineering Purdue University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Type 1 diabetes (T1D) is a major health problem affecting over 1.25 children and adults in the United States alone. It also affects our beloved companion animals, with 1 out of every 100 dogs and cats having this condition. T1D results from an autoimmune condition, where the patient’s body, by mistake, attacks and destroys cells in the pancreas (β cells) that are responsible for regulating blood glucose levels by producing insulin. While injectable insulin represents the standard of care for these patients, it provides an inferior control system relative to functional β cells, leaving the majority of patients at risk for life-threatening complications. Although transplantation of pancreatic islets, which contain replacement β cells, via portal vein injection into the liver, is an attractive therapeutic alternative for these patients, persistent risks and challenges preclude its more widespread clinical adoption. These include rapid destruction and loss of function of the majority of donor cells upon transplantation and the need for life-long immunosuppression. This study evaluated a novel packaging strategy for the delivery and maintenance of functional donor islets beneath the skin, resulting in rapid and extended reversal of T1D in diabetic mice. 
Author Interviews, Gender Differences, Heart Disease, Women's Heart Health / 23.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44096" align="alignleft" width="142"]Brad N. Greenwood PhD Associate Professor Information & Decision Sciences Carlson School of Management University of Minnesota–Twin Cities, Minneapolis MN  Dr. Greenwood[/caption] Brad N. Greenwood PhD Associate Professor Information & Decision Sciences Carlson School of Management University of Minnesota–Twin Cities, Minneapolis MN MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been growing work in medicine which suggests both that a) women are more skilled physicians across a variety of ailments and b) women are particularly challenging heart attack patients (for a variety of reasons ranging from delays in seeking treatment to atypical presentation). When you coupled this with the deep literatures in economics, sociology, and political science which suggests that advocatees experience better outcomes when they share traits with their advocates, it seemed plausible that there might be differences in outcomes. The key finding is that gender concordance matters most for female patients:  female patients are about 0.7-1.2% more likely to die if treated by a male doctor, relative to a female doctor.  This number seems small.  But, if the survival rate among the female heart attack patients treated by male doctor was the same as the survival rate among female heart attack patients treated by female doctors, about 1,500-3,000 fewer of the female heart attack patients in our sample would have passed away. Our sample covers the state of Florida from 1991-2010.  Florida is about 10% of the US population.
Author Interviews, Biomarkers, Cancer Research, Journal Clinical Oncology, Lymphoma, Stanford / 23.08.2018

MedicalResearch.com Interview with: Dr. David Kurtz, MD/PhD, Instructor and Dr. Ash Alizadeh MD/PhD, Associate Professor Division of Oncology, Department of Medicine Stanford University Medical Center  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This work investigates the utility of circulating tumor DNA - a type of liquid biopsy - in diffuse large B-cell lymphoma, the most common blood cancer in adults. Liquid biopsies are an emerging technology to track cancers from a simple blood draw. Here, using a cohort of over 200 patients from 6 centers across North America and Europe, we asked if circulating tumor DNA could be used to detect lymphoma in patients, and more importantly, could it be used to identify responders and non-responders. 
Author Interviews, Gender Differences / 22.08.2018

MedicalResearch.com Interview with: “Nurse gives flu jab” by NHS Employers is licensed under CC BY 2.0Katharina Block, M.A. Phd Student - Social Psychology The University of British Columbia  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Healthcare workers and teachers are incredibly central to how we function as a society. We are having trouble filling these positions, and especially men are underrepresented in them. In the U.S. men represent only about 10% of nurses and 4% of pre-school and kindergarten teachers. We wanted to know how men’s more basic values play into this. Our main finding is that tend men see less importance in care-oriented careers then women do, and we find that this could be tied to the more basic values feel are important to them personally. 
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA / 22.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44084" align="alignleft" width="135"]Chana A. Sacks, MD, MPH Program On Regulation, Therapeutics, And Law (PORTAL) Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital Dr. Sacks[/caption] Chana A. Sacks, MD, MPH Program On Regulation, Therapeutics, And Law (PORTAL) Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Combination pills combine multiple medications into a single dosage form. There have been case reports in recent years of high prices for certain brand-name combination drugs – even those that are made up of generic medications. Our study looks at this phenomenon in a systematic way using recently released Medicare spending data. We evaluated 29 combination drugs and found that approximately $925 million dollars could potentially have been saved in 2016 alone had generic constituents been prescribed as individual pills instead of using the combination products. For example, Medicare reported spending more than $20 per dose of the combination pill Duexis, more than 70 times the price of its two over-the-counter constituent medications, famotidine and ibuprofen. The findings in this study held true even for brand-name combination products that have generic versions of the combination pill. For example, Medicare reported spending more than $14 for each dose of brand-name Percocet for more than 4,000 patients, despite the existence of a generic combination oxycodone/acetaminophen product.
Author Interviews, Breast Cancer, Cancer Research, Chemotherapy, Radiation Therapy / 22.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44079" align="alignleft" width="200"]Kathleen Horst, MD Associate Professor of Radiation Oncology (Radiation Therapy) Stanford University Medical Center Dr. Kathleen Horst[/caption] Kathleen Horst, MD Associate Professor of Radiation Oncology (Radiation Therapy) Stanford University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: We were interested in focusing on young women with breast cancer as this is a high-risk patient population that is not studied on its own in clinical trials. Furthermore, the available data on treating breast cancer with neoadjuvant chemotherapy (NAC) does not include detailed outcomes for women under the age of 40 years. Because most women who are diagnosed with breast cancer in this age group will have aggressive disease, most of them will be treated with NAC followed by surgery. From prospective randomized trials we know that women with breast cancer who attain a pathologic complete response (PCR) to neoadjuvant chemotherapy fare significantly better than those who do not. In addition, existing data suggest that a complete response in the lymph nodes also portends a better prognosis. This is the foundation for the currently ongoing NSABP B-51/RTOG 1304 trial, which is evaluating the role of nodal irradiation in those women who attain a pathologic complete response in the lymph nodes after NAC. We wanted to know whether differences in pathologic response in the breast versus lymph nodes led to different clinical outcomes in this patient group. We evaluated outcomes following neoadjuvant chemotherapy for breast cancer in 155 women age 40 and younger. We focused on pathologic response in the breast and lymph nodes as predictors of disease recurrence and survival. We found that any residual disease in either the breast or lymph nodes lessened the chance of cure significantly. Importantly, women who attained a complete response in the lymph nodes but continued to have residual disease in the breast fared just as poorly as those who remained lymph node positive following neoadjuvant chemotherapy. 
Aging, Author Interviews, Cannabis, Mental Health Research, Schizophrenia / 22.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44041" align="alignleft" width="194"]Dr. Daniel G. Amen MD Amen Clinics, Inc., Founder Costa Mesa, CA Dr. Daniel Amen[/caption] Dr. Daniel G. Amen MD Amen Clinics, Inc., Founder Costa Mesa, CA MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the largest known brain imaging study, scientists evaluated 62,454 brain SPECT (single photon emission computed tomography) scans of more than 30,000 individuals from 9 months old to 105 years of age to investigate factors that accelerate brain aging. SPECT was used to determine aging trajectories in the brain and which common brain disorders predict abnormally accelerated aging. It examined these functional neuroimaging scans from a large multi-site psychiatric clinic from patients who had many different psychiatric disorders, including bipolar disorder, schizophrenia and attention deficit hyperactivity disorder (ADHD).  Researchers studied 128 brain regions to predict the chronological age of the patient. Older age predicted from the scan compared to the actual chronological age was interpreted as accelerated aging.  The study found that a number of brain disorders and behaviors predicted accelerated aging, especially schizophrenia, which showed an average of 4 years of premature aging, cannabis abuse (2.8 years of accelerated aging), bipolar disorder (1.6 years accelerated aging), ADHD (1.4 years accelerated aging) and alcohol abuse (0.6 years accelerated aging).  Interestingly, the researchers did not observe accelerated aging in depression and aging, which they hypothesize may be due to different types of brain patterns for these disorders.
Author Interviews, JAMA, Mental Health Research, Pediatrics / 22.08.2018

MedicalResearch.com Interview with: [caption id="attachment_43982" align="alignleft" width="128"]Dr Alexandra Rouquette MD PhD Center for Research in Epidemiology and Population... French Institute of Health and Medical Research Paris Dr. Rouquette[/caption] Dr Alexandra Rouquette MD PhD Center for Research in Epidemiology and Population... French Institute of Health and Medical Research Paris MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is a growing number of clues in the literature that suggest that the onset of adult psychopathologic disorders can be traced back to behavioral or emotional symptoms observed in childhood or adolescence. Targeting early childhood symptoms might thus be effective in preventing future mental disorders. However, these interventions are challenging to implement because we lack knowledge on which specific childhood symptoms have predictive associations with adult psychopathologic disorders. In our study, we used a novel methodologic approach, the network perspective, in which symptoms are conceptualized as distinct entities that can causally influence each other, be self-reinforcing and are thus part of causal chains which can culminate in disorders. We investigated longitudinally the network structure among a broad range of emotional and behavioral symptoms (symptoms of attention deficit, symptoms of hyperactivity, disruptive symptoms, internalizing symptoms, prosocial symptoms) collected in elementary school girls (6-10 years) included in the Quebec Longitudinal Study of Kindergarten Children. We showed that symptoms “irritable”, “blames others”, “not liked by other children”, “often cries”, and “solitary” retained a distinctive position in the network because most of the direct relationships between the disruptive and internalizing symptom clusters transited through them. These symptoms have been termed bridge symptoms in the network perspective, as they constitute pathways that can connect different disorders. We then investigated the relationships between this emotional and behavioral symptoms network in childhood and the occurrence of anxiety disorders at age 15 and 22 years. Importantly, the bridge symptoms (particularly “not liked by other children” and “irritable”) exhibited the strongest relationships with future anxiety disorders.
Author Interviews, Memory, Pediatrics, Sleep Disorders / 22.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44069" align="alignleft" width="200"]Dr. Rebecca Spencer PhD Associate Professor Department of Psychological and Brain Sciences University of Massachusetts Dr. Rebecca Spencer[/caption] Dr. Rebecca Spencer PhD Associate Professor Department of Psychological and Brain Sciences University of Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that in young adults, sleep contributes to emotion processing. We wondered if naps work similarly for preschool children.  To look at this, we had children learn an emotional memory task and then either take a nap or stay awake.  We then tested their memory after that interval and again the next day. We found that when children napped, they had better memory for those items the next day than if they did not nap.  That the naps seem to support memory (even if in a delayed fashion) seems consistent with the observation of parents and preschool teachers that children are often emotionally dysregulated if they do not nap.
Author Interviews, Cost of Health Care, JAMA, Medicare, NYU/NYMC, Prostate Cancer / 22.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44063" align="alignleft" width="200"]Danil V. Makarov, MD, MHS Department of Urology and Department of Population Health New York University Langone School of Medicine VA New York Harbor Healthcare System, Robert F. Wagner Graduate School of Public Service Cancer Institute, New York University School of Medicine, New York Dr. Makarov[/caption] Danil V. Makarov, MD, MHS Department of Urology and Department of Population Health New York University Langone School of Medicine VA New York Harbor Healthcare System, Robert F. Wagner Graduate School of Public Service Cancer Institute, New York University School of Medicine, New York MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Reducing prostate cancer staging imaging for men with low-risk disease is an important national priority to improve widespread guideline-concordant practice, as determined by the National Comprehensive Cancer Network guidelines. It appears that prostate cancer imaging rates vary by several factors, including health care setting. Within Veterans Health Administration (VHA), physicians receive no financial incentive to provide more services. Outside VHA, the fee-for-service model used in Medicare may encourage provision of more healthcare services due to direct physician reimbursement. In our study, we compared these health systems by investigating the association between prostate cancer imaging rates and a VA vs fee-for-service health care setting. We used novel methods to directly compare Veterans, Medicare Recipients, and Veterans that chose to receive care from both the VA at private facilities using Medicare insurance through the Choice Act with regard to rates of guideline-discordant imaging for prostate cancer. We found that Medicare beneficiaries were significantly more likely to receive guideline-discordant prostate cancer imaging than men treated only in VA. Moreover, we found that men with low-risk prostate cancer patients in the VA-only group had the lowest likelihood of guideline-discordant imaging, those in the VA and Medicare group had the next highest likelihood of guideline-discordant imaging (in the middle), and those in the Medicare-only group had the highest likelihood of guideline-discordant imaging. 
Author Interviews, Neurology, Social Issues / 22.08.2018

MedicalResearch.com Interview with: [caption id="attachment_43852" align="alignleft" width="124"]Prof. Carmen Sandi Director, Brain Mind Institute Laboratory of Behavioral Genetics Brain Mind Institute Ecole Polytechnique Federale de Lausanne Lausanne, Switzerland  Prof. Sandi[/caption] Prof. Carmen Sandi Director, Brain Mind Institute Laboratory of Behavioral Genetics Brain Mind Institute Ecole Polytechnique Federale de Lausanne Switzerland  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Social hierarchies are pervasive and social status has deep consequences for health, wellbeing and societal organizations. Socially dominant individuals have priority access to resources and are more likely to become leaders. Although there are drastic differences in the predisposition of individuals to attain or strive for dominance, very little is known regarding the factors that predispose individuals to attain dominance. Does dominance become visible only in social context? Here, we performed five behavioral experiments and consistently found that individuals high in dominance are faster than less dominant ones to respond in choice situations, though not less accurate, which suggests that promptness to respond may predispose individuals to become dominant. Strikingly, using high-density EEG, we find that promptness to respond in dominant individuals is reflected in a strongly amplified brain signal at approximately 240 ms post-stimulus presentation. At this latency, participants’ reaction times were negatively correlated with activity in the cingulate cortex. Our results may open a new research approach using EEG signatures as a measure for dominance, independent of social context.
Alcohol, Author Interviews, Neurology / 22.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44053" align="alignleft" width="133"]Erica Grodin, Ph.D. Postdoctoral Fellow Dept. of Psychology and Psychiatry  University of California Dr. Grodin[/caption] Erica Grodin, Ph.D. Postdoctoral Fellow Dept. of Psychology and Psychiatry University of California  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The hallmark of addictive disorders, including alcohol use disorder, is drug use that continues despite negative consequences. This pattern of use is referred to as “compulsive” and is one of the major barriers to treating addiction. We don’t yet fully understand what brain regions are responsible for compulsive alcohol use. Our study used a neuroimaging method called functional magnetic resonance imaging which allows us to see which areas of the brain are more active when an individual is performing a task. To investigate what brain regions are involved in compulsive alcohol seeking, we designed a task during which study participants could try to earn alcohol and food points at the risk of receiving a negative consequence, an electric shock. Study participants were light drinkers (men who drank <15 drinks/week and women who drank <10 drinks/week) and heavy drinkers (men who drank ≥20 drinks/week and women who drank ≥15 drinks/week). We found that heavy drinking individuals were more likely to try to earn alcohol points that were paired with a potential negative consequence than light drinkers were. This behavior of compulsive alcohol seeking was associated with increased brain activation in the medial prefrontal cortex, anterior insula, and ventral and dorsal striatum. 
Addiction, Author Interviews, Opiods / 21.08.2018

MedicalResearch.com Interview with: Bikram Subedi, PhD Assistant Professor of Analytical Chemistry Murray State University, Murray KYBikram Subedi, PhD Assistant Professor of Analytical Chemistry Murray State University, Murray KY MedicalResearch.com: What is the background for this study? What are the main findings? Response: The USA is one of the major consumers of diverse neuropsychiatric and illegal drugs, and recently declared a national public health emergency on opioid abuse. Law enforcement typically utilized conventional methods of determining drug consumption rate which are based on survey questionnaire, hospital admissions, drug-related crime statistics, and self-reported information. Conventional methods typically underestimate the actual consumption rate of drugs. Our new approach of determining consumption rates of drugs in community is time and cost effecting and comprehensive. Based on levels of drugs quantified from raw sewage, the per capita consumption rates of several illicit drugs including methamphetamine, amphetamine, cocaine, and THC in two communities of Western Kentucky (similar population and only ~50 miles apart) were significantly different. During special events such as July 4th and 2017 solar eclipse, the consumption rates were found even higher. The consumption rate of methamphetamine was among one of the highest ever reported in the country.