Author Interviews, Diabetes, JAMA, Pediatrics / 18.10.2017

MedicalResearch.com Interview with: Prof. Dr. med. Reinhard Holl Division of Endocrinology and Diabetes, Medical Faculty Aachen University, Aachen, Institute of Epidemiology and Medical Biometry University of Ulm, Ulm Germany  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Today there are two accepted strategies to treat type-1 diabetes: pump or multiple daily injections. In a large group of patients we compared both strategies, and our results indicate advantages for pump therapy with fewer severe hypos, fewer events of diabetic ketoacidosis, and better metabolic control. (more…)
Author Interviews, Gastrointestinal Disease, Global Health, Lancet / 18.10.2017

MedicalResearch.com Interview with: Gilaad Kaplan, MD, MPH, FRCPC Associate Professor CIHR New Investigator & AI-HS Population Health Investigator Co-Director, Environmental Health Research Group Snyder Institute for Chronic Diseases & Institute of Public Health Departments of Medicine & Community Health Sciences University of Calgary MedicalResearch.com: What is the background for this study? What are the main findings? Response: The aim of the study was to provide a global perspective on the epidemiology of the inflammatory bowel diseases in the 21st century. During the 20th century IBD was considered a disease of the Western world. At the turn of the 21st century, IBD has become a global disease with accelerating number of cases in the developing world as it transition towards a westernized society. (more…)
Anesthesiology, Author Interviews, Pediatrics, Surgical Research, Technology / 18.10.2017

MedicalResearch.com Interview with: Dr. Sunghee Han Professor Seoul National Unversity College of Medicine Seoul National University Hospital Department of Anesthesia and Pain Medicin What is the background for this new technology and study? What are the main findings? Response: The time from patient arrival in the operating theatre to induction of general anesthesia is one of the most stressful moments for children undergoing surgery. Various strategies such as 'pre-operative guided operating room tour' or 'therapeutic play intervention' have been developed in order to reduce children's pre-operative anxiety. Although these existing simulation-based approaches may be effective, they have not been widely used in real clinical settings with limited budget and resources such as manpower and space. Virtual Reality(VR), a relatively new technology in the field of healthcare, can allow the user to experience an immersive environment. In this study, using VR technology, we provided the children with a realistic trip to the operating theatre accompanied by ‘My best friend’ Pororo. “Pororo, The Little Penguin” is a very famous cartoon character in Korea and Asia. Most children in Korea watch Pororo in TV, play with Pororo toys since early yeas and perceive Pororo as a ‘close friend’. In the VR content used in this study, Pororo acts as a patient and is subjected to anesthesia and surgery himself. Pororo kindly brings his friend(the viewer; paediatric patient) to the theatre and shows all that is going on in there. Intervention with the VR content was able to reduce the level of anxiety in paediatric patients and promote collaborative behavior and acceptance of the invasive procedures, especially general anesthesia. Parental satisfaction level was also relatively higher in the VR group. (more…)
Author Interviews, Cancer Research / 18.10.2017

MedicalResearch.com Interview with: Craig Tendler, M.D. Vice President, Late-Stage Development and Global Medical Affairs for Oncology, Hematology and Supportive Care Janssen Research & Development, LLC.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Janssen announced the submission of a supplemental New Drug Application (sNDA) to the FDA seeking to expand the indication of ZYTIGA in combination with prednisone and androgen deprivation therapy (ADT) to include treatment of patients with high-risk metastatic hormone naïve prostate cancer (HNPC) or newly diagnosed, high-risk metastatic hormone sensitive prostate cancer (HSPC). This submission is based on the pivotal Phase 3 LATITUDE trial results presented earlier this year at the plenary session of the American Society of Clinical Oncology (ASCO) Annual Meeting, which found that in patients with newly diagnosed high-risk metastatic hormone-sensitive prostate cancer (mHNPC), abiraterone acetate with prednisone in combination with androgen deprivation therapy (ADT) demonstrated a significant improvement in median overall survival (OS) and in radiographic progression-free survival (rPFS). Additional data, which were presented at the 2017 European Society for Medical Oncology (ESMO) Annual Conference, demonstrated clinically meaningful and statistically significant improvements in patient reported outcomes (PRO) in patients with high-risk mHNPC who received ZYTIGA in combination with prednisone and ADT compared to placebo plus ADT alone. (more…)
Aging, Author Interviews, Gastrointestinal Disease, Microbiome / 18.10.2017

MedicalResearch.com Interview with: Greg Gloor, PhD Principal investigator Professor at Western's Schulich School of Medicine & Dentistry and Scientist at Lawson Health Research Institute. MedicalResearch.com: What is the background for this study? What are the main findings? Response: We sampled the bacteria in the gut (stool) in over 1000 members of a super healthy population in China across the age ranges of 3 to over 100. Exclusion criteria included a history of genetic or chronic disease (intergenerational in the case of people younger than 30), no smoking, drinking or drug use (including no prescription drugs). Our goal was to identify what, if any changes in the makeup of the gut microbiota occurred in this population so that we could define "what is associated with health". We found three things.
  • First, that the expected differences between the very young and everyone else were found in this population. This indicates that we could observe the standards signatures of a maturing gut microbiota.
  • Second, that the gut microbiota of very healthy very elderly group (over 95 yo) was very similar to that of any very healthy person over the age of 30.
  • Third, we found that the gut microbiota of 20yo people (in three distinct groups) was different from all other age groups. The reason for the differences observed in the 20 yo groups from all the others is unknown, but is not methodological in origin.
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AstraZeneca, Author Interviews, Boehringer Ingelheim, Diabetes, Eli Lilly, J&J-Janssen, Merck, Pharmacology / 18.10.2017

MedicalResearch.com Interview with: Melanie J Davies CBE MB ChB MD FRCP FRCGP Professor of Diabetes Medicine NIHR Senior Investigator Emeritus Diabetes Research Centre Leicester Diabetes Centre – Bloom University of Leicester MedicalResearch.com: What is the background for this study? What are the main findings? Response:  This was the first study to test the effectiveness of an oral GLP-1 in patients with type 2 diabetes. The main findings were that compared to both placebo and a GLP-1, Semaglutide, delivered by sub-cutaneous injection weekly, the oral therapy delivered once a day produced better results than placebo and similar results to injectable GLP-1 with regard to reductions in HbA1c and weight loss. (more…)
AHA Journals, Author Interviews, Heart Disease, Radiology / 17.10.2017

MedicalResearch.com Interview with: Dr. Maria Grazia Andreassi, PhD Director, Genetics Research Unit CNR Institute of Clinical Physiology, Pisa- Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: In recent years, there has been a growing concern about the health risks for contemporary interventional cardiologists who have a high and unprecedented levels of occupational ionizing radiation (IR) exposure. Because dysregulation of microRNAs (miRNAs) have been shown in many human diseases, we investigated the differential expression of miRNAs in the plasma of interventional cardiologists professionally exposed to IR and unexposed controls. In this study, our microarray analysis with 2,006 miRNAs and subsequent validation identified brain-specific miR-134 as one of the miRNAs that is highly dysregulated in the response to ionizing radiation exposure, supporting the notion that the brain damage is one of the main potential long-term risks of unprotected head irradiation in interventional cardiologists, with possible long-lasting cognitive consequences. Indeed, miR-134 was first identified as a brain-specific miRNA, which is involved in synapse development and directly implicated in learning and memory. (more…)
Author Interviews, CDC, JAMA, Neurological Disorders, Zika / 17.10.2017

MedicalResearch.com Interview with: Emilio Dirlikov, PhD Epidemic Intelligence Service Officer CDC  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In December 2015, Puerto Rico Department of Health (PRDH) reported its first confirmed locally acquired case of Zika virus disease. In February 2016, PRDH reported the first person diagnosed with Guillain-Barré syndrome (GBS) who also had evidence of Zika virus infection. At the time, scientific evidence of the potential association between Zika virus infection and GBS was lacking, and rigorous studies were needed. Through a collaboration between PRDH, CDC, and the University of Puerto Rico (UPR), we conducted a case-control study to determine risk factors for GBS during the 2016 Zika virus epidemic. By prospectively enrolling case-patients, we shortened the time to enrollment, increasing the likelihood of detecting Zika virus nucleic acids to confirm Zika virus infection. As a result, we found that an acute Zika virus infection confirmed by laboratory testing is a risk factor for developing Guillain-Barré syndrome. This is the first case-control study to find laboratory evidence showing this given the difficulty of confirming Zika virus infection among people diagnosed with GBS. (more…)
Author Interviews, Autism, Pediatrics, Race/Ethnic Diversity / 17.10.2017

MedicalResearch.com Interview with: Maureen Durkin, PhD, DrPH Professor and Interim Chair Department of Population Health Sciences University of Wisconsin School of Medicine and Public Health Madison, WI  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies of the prevalence of autism spectrum disorder (ASD) among children in the U.S. have found two consistent patterns.  One is a higher prevalence among white non-Hispanic children than among black non-Hispanic or Hispanic children.  The other is a positive socioeconomic gradient, meaning that ASD prevalence in the U.S. is found to increase with increasing income and other indicators of socioeconomic status. One of the findings of this new study is that the racial and ethnic differences in autism spectrum disorder prevalence are not explained by socioeconomic factors, because even after adjusting for socioeconomic factors, ASD prevalence was found to be significantly lower in black and Hispanic children than in white non-Hispanic children.  Another finding is that the gap in ASD prevalence between children of high and low socioeconomic status did not change over time between 2002 and 2010, though the overall prevalence of ASD more than doubled during this period. (more…)
Author Interviews, Psychological Science / 17.10.2017

MedicalResearch.com Interview with: Tamara Masters, PhD Marketing Marriott School of Management Brigham Young University MedicalResearch.com: What is the background for this study? What are the main findings? Response: As a marketing professor I have studied the disparity of what people are willing to sell items/products for and how much that differs from how much others are willing to pay. I do research in consumer decision making and find the neurophysiological aspects of consumers fascinating.  I read medical and neuroscience research for fun and see many ways individuals may be effected in the use of their limited resources.  We are all consumers – many make purchases of some type daily – even it if it is to play online games or where and how to get our next meal. The main findings relate to how a person is either attached to or feels an aversion to losing an object.  There has been debate as to which of these factors leads to a difference in buy and selling prices.  This research provides a new and unique look at how BOTH factors must be present for this disparity to emerge.  This research is unique because it uses combines the fields neuroscience, psychology and economics to explain something we all experience. (more…)
Author Interviews, Nature, Weight Research / 17.10.2017

MedicalResearch.com Interview with: Dr. Hoon-Ki Sung MD PhD Scientist at The Hospital for Sick Children (SickKids) and Assistant Professor in Laboratory Medicine & Pathobiology University of Toronto  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite extensive research and medical interventions, the prevalence of obesity and associated metabolic disease is increasing. More and more studies show that obesity and its associated metabolic problems are often associated with unhealthy lifestyles and eating habits, including frequent eating (non-stop) throughout the day, resulting in a shorter period of physiological fasting. As such, various dietary approaches, such as calorie restriction and intermittent fasting have gained popularity as therapeutic strategies for obesity treatment. Intermittent-fasting is when one temporarily stops eating for a period of time, returns to normal food consumption, and then temporarily stops again. In our study we examined the effect of an intermittent-fasting regimen, without restricting caloric intake, in mice. We found that an intermittent fasting regimen not only prevented obesity in mice, but also improved metabolism by changing the quality of fat in the body. Our findings show that the health of the mice is significantly influenced by daily eating patterns. The addition of a 'stop eating' period converted inflammatory fat to brown-like (or beige) fat by anti-inflammatory immune cells, meaning it changed bad fat into good fat. The results are exciting, because they show that weight loss is not the sole benefit of fasting. Fasting also restores the dual function of fat cells, which is to store energy and to release energy. (more…)
Author Interviews, Gender Differences, Hematology, JAMA / 17.10.2017

MedicalResearch.com Interview with: Rutger Middelburg, PhD Assistant Professor in clinical epidemiology Sanquin Research and LUMC  MedicalResearch.com: What is the background for this study? Response: Six years ago we found transfusions from female donor to be associated with increased mortality among male recipients, especially under 50 years of age. This was an unexpected observation and we considered the probability of a false positive finding (i.e. a chance association) to be relatively high. We therefore immediately started a follow-up study with two main objectives. First, we wanted to confirm our findings in an independent and much larger cohort. Second, since some complications of blood transfusion are known to be related to pregnancy history of the donor, we wanted to study a possible relationship with previous pregnancy of the blood donors. (more…)
Author Interviews, Dermatology / 17.10.2017

MedicalResearch.com Interview with: Neelam A. Vashi, MD Assistant Professor of Dermatology Director, Boston University Center for Ethnic Skin Director, Cosmetic and Laser Center Boston University School of Medicine Boston Medical Center   Mayra B. C. Maymone, MD, DSc. Department of Dermatology Boston University , Boston   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Societal interest with beauty dates back centuries; Plato described the 3 wishes of every man to include beauty, good health, and riches.  Given this fascination, there are many people who have dedicated their entire lives to studying the concept of beauty and the implications it presents to society.  The ability to set ‘beauty’ as a standard of comparison has shown us the advantages of being deemed beautiful – those who are more beautiful being able to get jobs easier and go out on more dates.  Beautiful people are even more often attributed qualities such as likeability, social competence, and intelligence. The study and concept of beauty are quite fascinating yet complicated.  We have found that there are both biological/innate indicators and also subjective aspects.  As discussed in my article, the classical conception of beauty is a matter of mathematical conceptions and instantiating definite proportions.  However, this inflexible treatment of the concept of beauty as objective denies paying tribute to its many different aspects and the contributions of individuality, culture, and history.  From our study, we can see that beauty standards are evolving and slowly drifting from the rigid standards once set. We found that compared to 1990, celebrities rated beautiful in 2017 were older, more often women, and had a higher rate of darker skin types and mixed race. The study of beauty is a quite lengthy topic - I wrote a book on it:  https://www.amazon.com/Beauty-Body-Dysmorphic-Disorder-Clinicians/dp/3319361988/ref=sr_1_2?ie=UTF8&qid=1508076953&sr=8-2&keywords=neelam+vashi. (more…)
Author Interviews, Dermatology, Melanoma, Transplantation, University of Pennsylvania / 17.10.2017

MedicalResearch.com Interview with: Thuzar M.Shin MD, PhD Assistant Professor of Dermatology Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Organ Procurement Transplant Network (OPTN) collects data on cancers that develop after organ transplantation. Previous studies have shown incomplete reporting to the OPTN for many cancers (including melanoma). Skin cancer is the most common malignancy in solid organ transplant recipients and the most common post-transplant skin cancer, cutaneous squamous cell carcinoma (cSCC), is not captured in standard cancer registries. We hypothesized that cSCC and melanoma are underreported to the OPTN. When compared to detailed medical record review obtained from the Transplant Skin Cancer Network database (JAMA Dermatol. 2017 Mar 1;153(3):296-303), we found that the sensitivity of reporting to the OPTN was only 41% for cSCC and 22% for melanoma. The specificity (99% for cSCC and 100% for melanoma) and negative predictive values (93% for cSCC and 99% for melanoma) were high. As a result, the OPTN database is unable to robustly and reliably distinguish between organ transplant recipients with and without these two skin malignancies. (more…)
Author Interviews, Depression, Diabetes, JAMA, Pediatrics, Pharmacology / 17.10.2017

MedicalResearch.com Interview with: Mehmet Burcu, PhD, MS Department of Pharmaceutical Health Services Research University of Maryland, Baltimore  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Antidepressants are one of the most commonly used psychotropic medication classes in U.S. youth, with serotonin reuptake inhibitors representing a large majority of total antidepressant use in youth. The most interesting finding was that the current use of serotonin reuptake inhibitors in youth was associated with an increased risk of type 2 diabetes mellitus, and this increased risk intensified further with the increasing duration of use and with the increasing dose. A secondary analysis also revealed that the risk of incident type 2 diabetes was most apparent in youth who used serotonin reuptake inhibitors for longer durations AND in greater daily doses. (more…)
Alzheimer's - Dementia, Author Interviews, Biomarkers, JAMA, Personalized Medicine / 17.10.2017

MedicalResearch.com Interview with: Ingrid S. van Maurik, MSc Department of Neurology and Alzheimer Center Department of Epidemiology and Biostatistics Amsterdam Neuroscience VU University Medical Center Amsterdam, the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: CSF and MRI biomarkers are increasingly used in clinical practice, but their diagnostic and prognostic value is not perfect. Furthermore, criteria do not specify how to deal with conflicting or borderline results, or how to take patient characteristics into account. Therefore, optimal use of these biomarkers in clinical practice remains challenging. As part of the ABIDE project, we constructed biomarker-based prognostic models (CSF, MRI and combined) that enable prediction of future Alzheimer’s disease, or any type of dementia, in individual patients with mild cognitive impairment. When using these models, any value can be entered for the variables, resulting in personalized probabilities with confidence intervals. (more…)
Author Interviews, Endocrinology, Epilepsy / 17.10.2017

MedicalResearch.com Interview with: Dr. Samba Reddy, Ph.D., R.Ph., FAAPS, FAAAS, FAES Professor Neuroscience and Experimental Therapeutics College of Medicine Texas A&M University Health Science Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: For the past two decades, D. Samba Reddy, PhD, RPh, professor of neuroscience and experimental therapeutics at the Texas A&M College of Medicine, has been searching for answers to catamenial epilepsy, a subset of chronic epilepsy that causes a dramatic increase in seizures during women’s menstrual periods. Although this condition has been documented for millennia, there is currently no effective treatment for catamenial seizures, leaving many women and their families desperate for answers. In this report, the researchers discovers the neuro-code for treating women with menstrual period-linked epilepsy. A unique platform has been created for clinical trials for catamenial seizures with synthetic neurosteroid agents. (more…)
Author Interviews, PTSD, Technology / 17.10.2017

MedicalResearch.com Interview with: Dr. Gale Lucas, PhD Director of Research USC Institute for Creative Technologies Playa Vista, CA   MedicalResearch.com: What is the background for this study? What are the main findings? Response: A common barrier to healthcare for psychiatric conditions is the stigma associated with these disorders. Perceived stigma prevents many from reporting their symptoms. Stigma is a particularly pervasive problem among military service members, preventing them from reporting symptoms of combat-related conditions like posttraumatic stress disorder (PTSD). This put them at risk for having their symptoms go untreated, with possible disastrous outcomes including suicide attempts. We envisioned a technology system – a virtual human interviewer – whereby military service members can get feedback about their risk for PTSD in a safe place without stigma. Indeed, our prior research has shown that, because its “just a computer” (therefore safe and anonymous), this virtual human interviewer helps people to feel safe discussing sensitive issues like mental health symptoms. In this follow-up research project (published in Frontiers), we sought to demonstrate the value of this kind of virtual human interviewer specifically for encouraging reporting of PTSD symptoms among service members. Specifically, we were interested in comparing the willingness of service members to report symptoms of PTSD to our virtual human interviewer, compared to the gold standard of the Post Deployment Health Assessment (PDHA). We wanted to isolate the effect of anonymity, separating it from “relational factors” that the virtual human interviewer uses to encourage service members to open up. Indeed, before asking these same questions as on the PDHA to capture PTSD symptoms, the system engages in social dialogue, which build rapport with users. The system asks “get to know you questions,” and throughout the interview, engage in active listening with responses such as nods, smiles, saying “uh huh,” and other encouraging phrases like “that’s great.” (more…)
Author Interviews, Diabetes, Heart Disease, JAMA, OBGYNE / 17.10.2017

MedicalResearch.com Interview with: Cuilin Zhang MD, PhD Senior Investigator Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health. Bethesda, MD 20817 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gestational diabetes (GDM) is a common pregnancy complication. The American Heart Association identifies gestational diabetes as a risk factor for cardiovascular disease (CVD) in women, based on consistent evidence for the relationships between gestational diabetes and subsequent hypertension, dyslipidemia, type 2 diabetes, vascular dysfunction and atherosclerosis. Also, previous studies identify GDM as a risk factor for intermediate markers of CVD risk; however, few are prospective, evaluate hard cardiovascular disease end points, or account for shared risk factors including body weight and lifestyle. (more…)
Asthma, Author Interviews, Technology / 16.10.2017

MedicalResearch.com Interview with: Frank Trudo, MD, MBA Brand Medical Lead US Respiratory AstraZeneca MedicalResearch.com: Would you tell us about Lungprint?  How will Lungprint help asthma patients take better control of their disease? Response: Lungprint is an interactive digital tool that creates a dynamic visual representation of a person’s lungs based on their unique experiences with asthma. It is meant to provide people with asthma a better understanding of the role of asthma in their life and motivate them to have a more personalized conversation with their healthcare provider about the severity of their symptoms, a more individualized treatment plan and a blood test that measures eosinophil levels. Each person’s Lungprint, which is generated as they respond to a digital questionnaire about their experience with asthma, will help reveal information about their individual experience with asthma. You can visit www.lungprint.com to learn more about the tool and create your own Lungprint.  (more…)
Author Interviews, Environmental Risks, Tobacco Research / 15.10.2017

MedicalResearch.com Interview with: Abbas Mohajerani BsEng, MsEng, PhD, FIEAust, MAGS. MACI Senior Lecturer School of Engineering, Civil and Infrastructure Engineering RMIT University Melbourne Victoria  Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: I knew about the harmful chemicals in cigarette butts and was not happy to see them everywhere in the environment, in our footpath, parks, and rivers. Cigarette butts (CBs) contain a large number of toxic to highly toxic chemicals and stay in the environment for a long time. Decomposition of CBs can take from a couple of months to many years depending on the environmental factors. Cigarette butts are one of the most common types of waste found around the world. Currently about 6 trillion cigarette butts per year are deposited somewhere in the environment. This is equivalent to an estimated mass of over 1.2 million tonnes of Cigarette butts each year. And this is expected to increase significantly by 2025, mainly due to an increase in the world population. In 2005, I started to think about different ways to recycle CBs in construction materials, and the first idea which struck me was to recycle them in fired clay bricks. After several years of research, we came up with a proposal, that if every brick manufacturer were to produce 2.5% of their bricks with 1% Cigarette butts incorporated, all CBs produced worldwide could be recycled. A 1% CB content would have very little effect on the physical and mechanical properties of the brick. And the estimated firing energy saved by incorporating 1% CBs into clay bricks is about 10%. That is a very significant reduction in the firing energy. This proposal was published in the journal of Waste Management in May 2016. (more…)
Author Interviews, Gastrointestinal Disease, Pharmacology / 15.10.2017

MedicalResearch.com Interview with: Brooks D. Cash, M.D., A.G.A.F., F.A.C.G., F.A.S.G.E. Professor of Medicine and Chief of the USA Gastroenterology Division Director, Motility and Physiology Service University of South Alabama Mobile, Alabama  MedicalResearch.com: What is the background for this study? Response: Irritable Bowel Syndrome (IBS) among patients with IBS-M (mixed diarrhea and constipation) is a challenging and difficult to diagnose and treat sub-type of IBS. Patients with IBS-M represent a dissatisfied group of IBS patients due to the lack of proven therapies. It is an area of high unmet medical need. Among adult patients with IBS, a sizeable proportion suffers from IBS-M with prevalence rates estimated to be between 44 to 66 percent of IBS sufferers[1],[2],[3]. IBS-M patients carry a heavy burden, characterized by bouts of constipation interrupted by diarrhea and vice versa. Physicians find IBS-M challenging to manage because of the difficulty in avoiding ‘overshoots’ when diarrhea management can turn into constipation and vice versa.[4]  (more…)
Author Interviews, Infections / 14.10.2017

MedicalResearch.com Interview with: Susan S. Huang, MD Professor, Infectious Disease School of Medicine Medical Director, Epidemiology and Infection Prevention UCI MedicalResearch.com: What is the background for this study? What are the main findings? Response:  The SHIELD Orange County Project is a CDC-initiated public health collaborative among nursing homes, long-term acute care (LTAC) facilities, and hospitals in the 6th largest U.S. County (Orange County, California). The 38 facilities (18 nursing homes, 3 LTACs, 17 hospitals) received targeted invitations based upon their high degree of shared patients with one another. The goal of the collaborative is to reduce multi-drug resistant organisms throughout the county using a decolonization strategy. As part of the baseline assessment, we swabbed 50 adult patients in each facility to assess the frequency that patients had multi-drug resistant organisms (MDRO) on their body. Nursing home and LTAC patients were sampled from the entire population while hospital sampling involved only adults in contact precautions. We found that an alarmingly high percent of patients had an MDRO, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), extended-spectrum beta-lactamase producers (ESBLs), and carbapenem-resistant enterobacteriaceae (CRE).
  • For nursing homes, 64% of residents have an antibiotic resistant bacteria on their body. Almost all of these are not known to the nursing home.
  • For LTACs, 80% of patients have an antibiotic resistant bacteria on their body. 7 in 10 patients have an MDRO that is not known to the LTAC.
  • For hospitalized patients on contact precautions, 64% have an antibiotic-resistant bacteria on their body. One third have an antibiotic-resistant bacteria that is not known to the hospital.
  • Having one MDRO is highly associated with having another one/
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Author Interviews, Autism, BMJ, Nutrition / 14.10.2017

MedicalResearch.com Interview with: Elizabeth DeVilbiss, PhD MPH Dornsife School of Public Health Drexel University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unfortunately, not much is known about how diet during pregnancy affects autism risk.  There have been studies in recent years about varied aspects of diet during pregnancy and autism risk involving multivitamins, iron, folic acid, vitamin D, and more, but the evidence is still inconclusive. After adjusting for several potentially influencing factors in both mothers and children, we found that multivitamin use, with or without additional iron and/or folic acid, was associated with a lower likelihood of child autism spectrum disorder with intellectual disability relative to mothers who did not use folic acid, iron, and multivitamins. (more…)
Author Interviews, ENT, JAMA, Stanford, Surgical Research / 12.10.2017

MedicalResearch.com Interview with: David Schoppy, MD PhD Resident, Division of Head and Neck Surgery Department of Otolaryngology Stanford University School of Medicine Stanford, Palo Alto, California MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a growing focus in healthcare on quality, and one component of this focus is the development of robust measures of quality. Currently, there are relatively few validated metrics of performance in oncologic surgery, and several of these indicators are relatively static metrics (such as hospital case volume and institution type). This study examined the relationship between overall survival (one surrogate of quality cancer surgery) and two modifiable variables in Head and Neck surgery - achieving negative surgical margins around a primary tumor and 18 or more lymph nodes from a concurrent neck dissection. After controlling for multiple other patient variables, data collected from the National Cancer Database (NCDB) showed that treatment at hospitals where a high percentage of patients had a surgery with negative margins and 18 or more lymph nodes removed from their neck was associated with improved survival. Importantly, this survival benefit was independent of the individual, patient-level survival benefit conferred by having either of these surgical process measures reached. This study therefore highlights two modifiable measures of institutional performance in Head and Neck surgery that may serve as targets for quality improvement programs. (more…)
Author Interviews, Cost of Health Care, Infections, Merck, Stem Cells, Transplantation / 12.10.2017

MedicalResearch.com Interview with: Dr. Jonathan Schelfhout, PhD Director, Outcomes Research Merck & Co. Inc. North Wales, PA MedicalResearch.com: What is the background for this study? What are the main findings? Response: The cost of hematopoietic stem cell transplantation has received increased attention after it was identified as a top 10 contributor to increasing healthcare costs in an AHRQ 2016 report. Many recent studies have explored the cost of HSCT but additional research is needed on the costly complications that can follow the transplant procedure. This research is particularly relevant for inpatient decision makers, as most transplant centers receive one bundled payment for the transplant and the treatment of any complications over the first 100 days. (more…)
Author Interviews, Education, Pediatrics, Sleep Disorders / 12.10.2017

MedicalResearch.com Interview with: Jack Peltz, Ph.D. Clinical assistant professor in Psychiatry Rochester Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Approximately 90% of high-school aged adolescents get either insufficient sleep during school nights or barely meet the required amount of sleep (ie, 8–10 hours) expected for healthy functioning.(1) In fact, sleep problems and insufficient sleep are so pervasive for adolescents that they could be considered an epidemic due to their adverse impact on adolescent mental and physical health.(2–5) As a result,addressing insufficient adolescent sleep represents a critical point of study and intervention. The growing body of evidence suggests that later school start times (SST), 8:30 AM or later as recommended by the American Academy of Pediatricians,6 convey multiple benefits on adolescents, including improved sleep, better mental and physical health, and improved academic outcomes.(7–10) This research, however, has focused on the direct effects of delaying school start times, or specifically how moving SST back directly predicts changes in an outcome (eg, mental health, academic achievement). This type of analysis precludes examining the important role that SST might play as a condition or context under which other sleeprelated processes take place. For instance, earlier school start times might exacerbate the impact of sleep-related processes on adolescent behavioral health outcomes. Thus, incorporating school start times as a larger contextual variable that might moderate models of sleep and adolescent functioning represents a gap in the literature and a unique opportunity to advance conceptual models. Accordingly, the current study examines the moderating role of school start times on the associations between sleep hygiene, sleep quality, and mental health. (more…)
Accidents & Violence, Author Interviews, Gender Differences, Psychological Science, Social Issues / 11.10.2017

MedicalResearch.com Interview with: Dr. Thekla Morgenroth Preferred pronouns: They/them/their Research Fellow in Social and Organisational Psychology Psychology University of Exeter Washington Singer Laboratories, Exeter UK  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Risk-taking is often seen as an important trait that leads to economic success - for example when it comes to investing money - and career success. For example, we often hear that leaders need to be willing to take risks. Risk-taking is also strongly associated with masculinity, which leads to the idea that maybe gender differences in economic and career success can be explained by the fact that women are just too risk averse. When you look at the risk-taking literature, it appears that there is support for this idea with many studies showing that men do indeed take more risks than men. Our research questions these ideas. We show that current measures of risk-taking are biased. They focus only on stereotypical "masculine" risk taking behaviors such as betting your money on the outcome of a sporting event or going whitewater rafting, and ignore the many risks that women take, such as going horseback riding or donating a kidney to a family member. When this bias is addressed, gender differences in risk-taking disappear or even reverse. (more…)
Author Interviews, Mental Health Research, Pharmacology, Psychological Science / 10.10.2017

MedicalResearch.com Interview with: Vanda Faria PhD Department of Psychology Uppsala, Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been debated whether selective serotonin reuptake inhibitors (SSRIs), which are commonly prescribed for depression and anxiety, are more effective than placebo. Concerns have been raised that the beneficial effects of SSRIs, as measured in double-blind clinical trials, may be explained by expectancies (a crucial placebo mechanism) rather than the biochemical compound. But no study has tested experimentally the extent to which the SSRI treatment effect can be influenced by expectancies induced by verbal suggestions. We compared the efficacy of overt vs. covert administration of an SSRI (escitalopram) in patients with social anxiety disorder. Rather than comparing the SSRI with placebo, we compared it with itself while manipulating the patients’ expectations of improvement. This was achieved by informing one group correctly about the SSRI and its effectiveness (overt group) whereas the comparison (covert) group received incorrect information. By use of a cover story, the covert group was led to believe they were treated with a so called “active placebo”, an ineffective neurokinin-1 antagonist yielding similar side effects as the SSRI but lacking anxiety-reducing properties. But the treatment, dosage and duration was in fact identical in both groups. Results showed that overt outperformed covert SSRI treatment, as the number of treatment responders was more than three times higher on the main clinical outcome measure when correct information was given. Using neuroimaging (fMRI) we also noted differences between the overt and covert SSRI groups on objective brain activity measures. There were differences between the groups e.g. with regard to activation of the posterior cingulate cortex with treatment, and the functional coupling between this region and the amygdala which is a brain region crucially involved in fear and anxiety. The fMRI  results may reflect the interaction between cognition and emotion as the brain changes differently with treatment pending on the expectations of improvement. (more…)
Author Interviews, Gender Differences, Social Issues / 09.10.2017

MedicalResearch.com Interview with: Rebecca Horne, MSc, PHEc MSc graduate in Family Sciences from the University of Alberta Professional human ecologist PhD student in Psychology at the University of Toronto Research area in intimate relationships MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although several studies have argued that time, money, and gender are important factors that shape the division of household labour, we know little about how these factors impact housework at different stages of the life course. Specifically, are time, money, and gender-related variables equally important for explaining housework involvement at different life stages? In our study, we compared men’s and women’s housework contributions at different life stages and explored how work hours, income (relative to one’s partner), marital status, raising children, and gender impacted housework at these distinct stages. We drew on data from the Edmonton Transitions Study, which has tracked the school-to-work and adolescence-to-adulthood transitions of nearly 1,000 Canadians for over three decades. We analyzed survey data from participants who had romantic partners during three developmental periods: the transition to adulthood (age 25; assessed in 1992), young adulthood (age 32; assessed in 1999), and midlife (age 43; assessed in 2010). We found that regardless of age or life stage, women performed more housework than men. In addition, lower housework involvement was most reliably predicted by earning a greater share of income and being male at age 25; working longer hours and raising children (for men only) at age 32; and earning a greater share of income, working longer hours, and being male at age 43. Importantly, gender was the strongest predictor of housework responsibility earlier and later in life. (more…)