Author Interviews, Boehringer Ingelheim, Dermatology, Immunotherapy / 29.03.2017

MedicalResearch.com Interview with: Eric Hughes, Global Head of Development, Immunology & Dermatology Novartis Pharma AG Basel, Switzerland MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well established that psoriasis negatively affects quality of life and work productivity. However, how the treatments affect psoriasis severity (based on skin clearance, itch, pain and scaling symptoms), health-related quality of life (HRQOL), work productivity, and daily activity directly or indirectly (via other factors) are still largely unknown. Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin-17A (IL-17A), exhibits significant efficacy in the treatment of moderate-to-severe psoriasis, ankylosing spondylitis, and psoriatic arthritis, demonstrating a rapid onset of action and a favorable safety profile. In CLEAR, a Phase 3b head-to-head study versus ustekinumab, secukinumab demonstrated sustained superior efficacy in clearing skin through Week 52, greater improvement in symptoms and HRQOL, greater relief of work and activity limitations, and a comparable safety profile. In this sub-analysis of the CLEAR study, Novartis was interested in examining the relationships among multiple variables that are thought to be important to patients with psoriasis. The direct and indirect (i.e. mediated) effects of treatment (secukinumab or ustekinumab) on psoriasis severity and patients’ HRQOL, work productivity, and daily activity were examined. The evaluation was conducted using structural equation modeling (or path analysis) and compared these relationships for secukinumab versus ustekinumab at 16 and 52 weeks. Structural equation modeling or path analysis is a statistical method that models the direct and indirect relationship between multiple patient-relevant outcomes simultaneously. Goodness-of-fit statistics for all models were excellent confirming the robustness of the results. Results at Week 16 and at Week 52 for different Psoriasis Area and Severity Index (PASI) response categories (e.g. PASI 75, PASI 90, PASI 100) indicated that psoriasis treatment indirectly affected HRQOL and work productivity and daily activity, measured with the Dermatology Life Quality Index (DLQI) and the Work Productivity and Activity Impairment (WPAI) questionnaires, respectively. Actually, greater effect of secukinumab over ustekinumab on DLQI was mediated by greater improvement of secukinumab in PASI response as well as by greater improvement in psoriasis-related symptoms (itch, pain and scaling). Greater effect of secukinumab over ustekinumab on work productivity and daily activity was mediated by greater improvement of secukinumab in psoriasis-related symptoms. (more…)
Author Interviews, Gastrointestinal Disease, Microbiome / 28.03.2017

MedicalResearch.com Interview with: Dr Pauline Scanlan Royal Society-Science Foundation Ireland University Research Fellow/APC Faculty, APC Microbiome Institute, Biosciences, University College Cork, Éire MedicalResearch.com: What is the background for this study? Response: The human gut is host to an incredible diversity of microbes collectively known as the gut microbiome. Each of us has a unique collection of bacterial strains that form part of the gut microbiome. This uniqueness is of potentially crucial importance with respect to host health as we know that differences in bacterial strain diversity within species could have a range of positive or negative consequences for the human host. For example, some strains of a given bacteria are harmless whilst another strain of the same bacterial species could kill you. A classic example of such a difference in strain functionality is exemplified by the gut bacterium Escherichia coli – one strain called E. coli Nissle 1917 is used as a probiotic and another, E. coli O157:H7, has been responsible for a number of deadly food-borne pathogen outbreaks. Therefore a better understanding of what drives bacterial strain diversity is not just fundamental to our understanding of the ecology and evolution of microbes but is also highly relevant for improvements in human health and disease prevention. (more…)
Author Interviews, Brigham & Women's - Harvard, HIV, Pediatrics / 28.03.2017

MedicalResearch.com Interview with: Anne M Neilan, MD,MPH Assistant in Medicine and Pediatrics Massachusetts General Hospital Instructor at Harvard Medical School Department: Medicine Service Division: Infectious Disease Department: Pediatric Service Massachusetts General Hospital Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Adolescents infected with HIV – either at birth or later in life – experience poorer health outcomes compared to adults with HIV in nearly every respect. This study found that U.S. youth infected with HIV around the time of their birth are at higher risk throughout their adolescence and young adulthood for experiencing serious health problems, poor control of the HIV virus (having high levels of HIV virus in their bodies and fewer CD4 immune cells which protect the body from infection), or death. The study also found that among those with good HIV control, serious health problems are rare. By combining data from two large, long-term U.S. studies – the Pediatric HIV/AIDS Cohort Study (PHACS, www.phacsstudy.org) and the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT, www.impaactnetwork.org) Network – we were able to study the health of more than 1,400 perinatally HIV-infected children, adolescents and young adults ages 7 to 30 years between 2007 and 2015. The study found that youth ages 13 to 30 were most likely to have poor HIV control AIDS-related illnesses, and death compared to younger participants. Among 18 – 30 year-olds, the study found that poor control of the HIV virus – meaning higher levels of HIV virus and lower levels of CD4 immune cells which protect the body from infection –35 percent of the time, increasing the risk that these youth would stop responding to certain HIV medications and could transmit HIV to others. These findings are consistent with other U.S. and European reports. Despite being engaged in health care, the number of deaths among youth born with HIV in the U.S. is 6 to12 times higher than for youth without HIV of the same age, sex and race. Along with HIV-related health problems, the most commonly reported health conditions concerned mental health and brain and nervous system development. Many women in the study also had sexually transmitted infections, which was found to be associated with lower CD4 immune cell counts. This may suggest a biological mechanism or may reflect that patients who have difficulty with their medications are also engaging in more frequent risky sexual behaviors. (more…)
Author Interviews, Cancer Research, JAMA, OBGYNE, Pediatrics / 27.03.2017

MedicalResearch.com Interview with: Hazel B. Nichols, PhD, UNC Assistant professor Lineberger Comprehensive Cancer Center member UNC Gillings School of Global Public Health. MedicalResearch.com: What is the background for this study? Response: Each year more than 45,000 adolescent and young adult women (AYA, ages 15-39 years) are diagnosed with cancer in the United States. While many of these women may wish to have children in the years following diagnosis, there is currently little information available to address their concerns about the impact of cancer diagnosis and treatment on future pregnancy. We identified >2,500 women who had a child after their cancer diagnosis using data from the North Carolina Central Cancer registry and statewide birth certificate files. We investigated whether adverse birth outcomes, such as preterm birth and low birth weight, were more common among AYA cancer survivors compared to women without cancer. We also looked at infant Apgar scores, which measure newborn health, and a calculation called small-for-gestational age, which can indicate restricted growth during pregnancy. (more…)
Author Interviews, Dermatology, Environmental Risks, Melanoma / 27.03.2017

MedicalResearch.com Interview with: Matthew Reynolds Acting Team Lead, Office of Communication Division of Cancer Prevention and Control (DCPC) Centers for Disease Control and Prevention (CDC) Chamblee GA MedicalResearch.com: What is the background for this study? Response: Indoor tanning and sunburns, particularly during adolescence and young adulthood, increases the risk of developing skin cancer. Researchers examined trends in the prevalence of indoor tanning and the relationship between indoor tanning and sunburn among US high school students. Pooled cross-sectional data from the 2009, 2011, 2013, and 2015 national Youth Risk Behavior Surveys. The study included nationally representative samples of U.S. high school students. (more…)
Author Interviews, Cancer Research, JAMA, Vitamin D / 27.03.2017

MedicalResearch.com Interview with: Joan M. Lappe, Ph.D., R.N., F.A.A.N. Associate Dean for Research, College of Nursing Criss/Beirne Professor of Nursing Professor of Medicine Creighton University Omaha NE 68131 MedicalResearch.com: What is the background for this study? What are the main findings?
  • Numerous observational studies show that higher vitamin D intake and serum 25, hydroxyvitamin D [25(OH)D], the functional indicator of vitamin D status, are associated with lower incidence of cancer.
  • However, the scientific fields consider randomized clinical trials (RCT) as a gold standard for testing new interventions for prevention and treatment of disease. In the only RCT of cancer and vitamin D to date with cancer as a primary outcome, the Women’s Health Initiative, postmenopausal women randomly assigned to vitamin D3400 IU/day and calcium 1000 mg/day showed no difference from those assigned to placebo in colorectal cancer incidence. One criticism of that study was that the vitamin D intervention was low, only 400 international units (IU) per day.
  • In our study we found that, in healthy women ages 55 and older with a mean baseline serum 25(OH)D of 33 ng/mL, supplementation with 2000 IU/day of vitamin D3and 1500 mg/day of calcium for four years, compared with placebo, decreased all-type cancer incidence by about 30%, but this did not reach statistical significance. (p value =0.057 and for statistical significance, the p value would need to be less than 0.05.)
  • In a secondary analysis, we re-analyzed the data excluding cancers that developed during the first year of study and were likely present but not diagnosed upon study enrollment. The findings here were that vitamin D and calcium did significantly decrease cancer risk by about 35%.
  • In another secondary analyses, we combined all of the serum 25(OH)D values to determine if higher levels were associated with lower cancer incidence. Here, higher serum 25(OH)D was significantly associated with lower cancer incidence. Persons with serum 25(OH)D of 55 ng/mL had a 35% lower risk of cancer than persons with serum 25(OH)D of 30 ng/mL.  This is especially interesting since current recommendations for sufficient serum 25(OH)D levels are 20 ng/mL (the National Academy of Medicine) and 30 ng/mL (the Endocrine Society).
  • Note that serum 25(OH)D is a better predictor of cancer development than assigning persons to supplement groups. Serum 25(OH)D takes into account poor compliance of the active supplement group with taking supplements, personal use of supplements by the placebo group, dietary vitamin D intake, sunlight exposure, and the variation among persons in absorption and metabolism of the vitamin D supplement.
(more…)
Author Interviews, Heart Disease, JAMA, Osteoporosis / 27.03.2017

MedicalResearch.com Interview with: Wallis CY Lau BSc Centre for Safe Medication Practice and Research Department of Pharmacology and Pharmacy Li Ka Shing Faculty of Medicine The University of Hong Kong MedicalResearch.com: What is the background for this study? What are the main findings? Response: Warfarin is a vitamin K antagonist (VKA) oral anticoagulant used for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), a common heart rhythm disorder. It works by interfering with vitamin K-dependent reactions in the process of blood clot formation. As these reactions also play a role in bone mineralization, there is concern that warfarin use may be linked with osteoporotic fracture. Despite the concerns for fracture risk, warfarin had been an inevitable treatment choice for over 50 years as there were no other alternatives available. Dabigatran is the first non-VKA oral anticoagulant (NOAC) approved for use in patients with NVAF. Recently, an animal study reported that use of dabigatran is associated with a better bone safety profile compared to warfarin in rats, suggesting a potential for a lower risk of osteoporotic fractures over warfarin. However, the actual risk of osteoporotic fractures with dabigatran use in human remains unclear. Therefore, we conducted a population-based cohort study to compare the risk of osteoporotic fractures in patients with NVAF treated with dabigatran and warfarin. (more…)
Author Interviews, Sexual Health, Sleep Disorders / 27.03.2017

MedicalResearch.com Interview with: Jen-Hao Chen PhD Assistant Professor Department of Health Sciences and School of Public Affairs University of Missouri - Columbia MedicalResearch.com: What is the background for this study? Response: It has been well known that sexual minority adults in the US have worse health as compared with heterosexual peers. Queer folks are found to have poorer physical, mental and behavioral health outcomes because of their marginalized status and social environments. But we know very little about prevalence of sleep problems in the population of sexual minorities compared to heterosexual people. Do sexual minorities lose sleep? Do they wake up more often during the night? Do they sleep less? This study aims to address this important gap in the LGBT health literature. Using recent nationally representative data, we exam whether sexual minority adults have greater odds of having short sleep duration and poor sleep quality. In addition, we also investigate sexual minorities’ sleep in the context of gender and race/ethnicity  (more…)
Author Interviews, Rheumatology, Weight Research / 27.03.2017

MedicalResearch.com Interview with: Elizabeth Badley PhD Professor Emeritus Dalla Lana School of Public Health, University of Toronto Director: The Arthritis Community Research and Evaluation Unit and Head, Division of Health Care and Outcomes Research Krembil Research Institute Toronto Western Hospital Toronto, Ontario  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The aging of the baby boomer population is focusing attention on the health experience of this sector of the population.  Arthritis is one of the most frequent chronic health problems in the population.  Our research question was to investigate whether the prevalence of arthritis differs between generations (also called birth cohorts) and what might be associated with any differences. Using data collected in a longitudinal Canadian population health survey between 1994 and 2011, we looked at 4 generations: the World War II generation born 1935-1944, older baby boomers born 1945-1954, younger baby boomers born 1955-64, and Generation X born 1965-1974. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Dermatology, Pediatrics / 26.03.2017

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois MedicalResearch.com: What is the background for this study? Response: Stevens-Johnson syndrome and Toxic Epidermal Necrolysis (SJS/TEN) are relatively rare and potentially life-threatening disorders. There have been some recent advances in our understanding of the epidemiology and risk factors of SJS/TEN in adults. However, little is known about the epidemiology of pediatric SJS/TEN. (more…)
Author Interviews, Dermatology, Orthopedics / 26.03.2017

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois Response: Psoriasis is associated with a number of potential risk factors for developing osteoporosis and pathological fractures, including including low vitamin D, chronic inflammation, higher rates of cigarette smoking and systemic corticosteroid usage. We hypothesized that adults with psoriasis have higher rates of osteoporosis and pathological fractures. We examined data from the 2002-2012 National Inpatient Sample, which contains a representative 20% sample of all hospitalizations in the United States. We found that psoriasis was associated with higher odds of osteopenia, osteoporosis, osteomalacia, ankylosing spondylitis, and pathological fractures. In particular, psoriasis was associated with vertebral, pelvic, femoral and tibial/fibular fractures. The associations between psoriasis and pathological fractures were more pronounced in women than men. (more…)
Author Interviews, Cost of Health Care, Dermatology / 26.03.2017

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atopic dermatitis (AD) is associated with considerable morbidity and quality of life impairment. AD patients may require hospitalization for acute treatment of serious flares and/or inadequately controlled chronic disease. We examined data from the 2002-2012 National Inpatient Sample, which contains a representative 20% sample of all hospitalizations in the United States. We found that there were substantial numbers of children and adults hospitalized in the United States for AD. Hospitalization rates for atopic dermatitis were highest in the northeast during the winter likely due to cold and dry weather and south during the summer likely due to heat and humidity. Further, hospitalization rates for AD significantly increased in adults between 2002 and 2012. The costs per individual hospitalization were lower in children and adults with AD compared to those without  atopic dermatitis. However, the high prevalence of hospitalization resulted in total inpatient costs of >$8 and >$3 million per-year for adults and children, respectively. (more…)
ALS, Author Interviews, Biomarkers, Neurology / 24.03.2017

MedicalResearch.com Interview with: Mary-Louise Rogers, PhD Senior Research Fellow, Lab Head, Motor Neurone Disease and Neurotrophic Research Laboratory, Department of Human Physiology, Centre for Neuroscience, Flinders University, School of Medicine, South Australia, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: ALS is a fatal neurodegenerative disease in which motor neurons, cells that control muscle activity such as walking, talking and breathing, gradually die off, resulting in paralysis. There is no cure for ALS. In a groundbreaking study published in the journal Neurology, and led by Mary-Louise Rogers, Ph.D., senior research fellow at Flinders University, Australia, and Michael Benatar, M.D., Ph.D, University of Miami, Miller School of Medicine,  have identified concentrations of p75ECD, the extracellular domain on the common neurotrophin receptor p75, as the first biological fluid-based biomarker for ALS progression. . Neurotrophin receptor p75 is a growth factor receptor for neurotrophins whom promote the survival of nerve cells. Under normal circumstances, it is highly expressed on motor neurons during development but decreases after birth. Following nerve injury, however, the expression of p75 is increased and the extracellular domain of p75 is detectable in urine. Dr Rogers and her Doctoral student Stephanie Shepheard hypothesized and then showed, that p75ECD is excreted into the urine of SOD1 mice, the most commonly used animal model of ALS. These findings empowered further investigation of p75ECD, showing raised levels in the urine of patients with ALS and that it might have potential as an ALS biomarker. (more…)
Author Interviews, Breast Cancer, Genetic Research, University Texas / 24.03.2017

MedicalResearch.com Interview with: Fangjian Guo, MD, PhD Department of Obstetrics and Gynecology Center for Interdisciplinary Research in Women’s Health University of Texas Medical Branch Galveston TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: BRCA testing in patients diagnosed with early-onset breast or ovarian cancer can identify women with high-risk mutations, which can guide treatment. Women who learn they have a high-risk mutation may also want to inform family members that they may also carry a high-risk mutation. Additionally, BRCA testing can be used to identify high-risk mutation carriers before they develop breast or ovarian cancer. Carriers can then manage their cancer risks with screening (MRI/mammogram), chemoprevention, or prophylactic surgery. Current guidelines recommend BRCA testing for individuals who are considered high-risk for breast or ovarian cancer based on personal or family history.  However, this practice fails to identify most BRCA mutation carriers. It is estimated that more than 90% of mutation carriers have not been identified. One of the issues is that many women who do get tested are actually low-risk and do not have any personal or family history of breast or ovarian cancer. This study assessed how BRCA testing was used in the US health care system during the past decade. We found that in 2004 most of the tests (75.7%) were performed in patients who had been diagnosed with breast or ovarian cancer. Only 24.3% of tests were performed in unaffected women. However, since 2006, the proportion of BRCA tests performed in unaffected women has increased sharply, with over 60% of the tests performed in unaffected women in 2014. (more…)
Author Interviews, Cancer Research, Genetic Research, JAMA / 24.03.2017

MedicalResearch.com Interview with: Heikki Joensuu, MD Department of Oncology Helsinki University Hospital University of Helsinki Helsinki, Finland  MedicalResearch.com: What is the background for this study? Response: The randomized Scandinavian Sarcoma Group (SSG) XVIII trial compared three years of adjuvant imatinib to one year of adjuvant imatinib as adjuvant treatments of patients who had undergone macroscopically complete surgery for a GIST with a high risk for tumor recurrence. In this trial, patients treated with 3 years of imatinib had improved overall survival as compared to those who were allocated to one year of adjuvant imatinib. In 2 other randomized trials that compared either 1 year of adjuvant imatinib to one year or placebo, or 2 years of adjuvant imatinib to observation, no improvement in overall survival was found, although in all three trials adjuvant imatinib improved recurrence-free survival (RFS). The reasons for the discrepant findings with respect of overall survival in the 3 trials have been unclear. (more…)
Author Interviews, Nutrition, Pediatrics, Pediatrics, Weight Research / 24.03.2017

MedicalResearch.com Interview with: Brandon Auerbach, MD, MPH Acting Instructor Division of General Internal Medicine University of Washington MedicalResearch.com: What is the background for this study? What are the main findings? Response: The question of whether 100% fruit juice causes poor health outcomes in children, such as weight gain, has been a subject of controversy. On one hand, 100% fruit juice contains vitamins and nutrients that many children lack, is often cheaper than whole fruit, and may help kids with limited access to healthy food meet their daily fruit requirements. On the other hand, leading nutrition experts have expressed concern that fruit juice contains amounts of sugar equal to or greater than those of sugary drinks like regular soda. Guidelines from the American Academy of Pediatrics warn that 100% juice can be a significant source of calories and contribute to obesity if consumed excessively. Our main finding was that consuming 1 serving/day of 100% fruit juice was not associated with weight gain in children. Children ages 1 to 6 years gained a small amount of weight, but not enough to negatively impact health. Children ages 7 and older gained no weight. We did not study amounts of 100% fruit juice higher than 1 serving/day. (more…)
Author Interviews, Heart Disease, JACC, Sleep Disorders / 24.03.2017

MedicalResearch.com Interview with: Christopher M. O’Connor, MD FACC  CEO and Executive Director, Inova Heart & Vascular Institute IHVI Administration Falls Church, Virginia 22042 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sleep apnea is a very common comorbidity of patients with heart failure (both reduced ejection fraction and preserved ejection fraction). Early evidence from observational and small studies suggested that treating sleep apnea with adaptive servo-ventilation (ASV) therapy may improve patient outcomes. There is minimal clinical evidence about identifying and treating sleep apnea in those who’ve been hospitalized with acute decompensated heart failure. The CAT-HF study was designed to help address this, with the primary endpoint being cardiovascular outcomes measured as a Global Rank Score that included survival free from cardiovascular hospitalization and change in functional capacity as measured by the six-minute walk distance. It was also planned to expand on the SERVE-HF study that was investigating the use of ASV therapy to treat central sleep apnea (CSA) in chronic stable heart failure patients with reduced ejection fraction patients (HFrEF). (more…)
Author Interviews, Clots - Coagulation, Electronic Records, JAMA, NYU, Surgical Research / 23.03.2017

MedicalResearch.com Interview with: Zachary Borabm, Research fellow Hansjörg Wyss Department of Plastic Surgery NYU Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent studies have shown that health care providers perform poorly in risk stratifying their patients for venous thromboembolism (VTE) which leads to inadequate VTE prophylaxis delivery, especially in surgical patients. Computerized Clinical Decision Support Systems (CCDSSs) are programs integrated into an electronic health record that have the power to aid health care providers. Using a meta-analysis study technique we were able to pool data from 11 studies, including 156,366 patients that either had CCDSSs intervention or routine care without CCDSSs. Our main outcome measures were the rate of prophylaxis for VTE and the rate of actual VTE events. We found that CCDSSs increased the rate of VTE prophylaxis (odds ratio 2.35, p<0.001) and decreased the risk of VTE events (risk ratio 0.78, p<0.001). (more…)
Author Interviews, Biomarkers, Exercise - Fitness, Osteoporosis / 23.03.2017

MedicalResearch.com Interview with: Pamela S. Hinton, Ph.D. Associate Professor & Director of Graduate Studies Department of Nutrition and Exercise Physiology Columbia MO 65211 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study builds on our previous work showing that weight-bearing, high-impact physical activity throughout the lifespan is associated with greater bone mass in men.  We previously conducted a 12-month randomized trial of the effectiveness of resistance training versus jump training to increase bone mass in men with low bone density of the hip or lumbar spine. The current study is a follow up study investigating how exercise might work to increase bone mass. The main findings are that exercise reduced circulating levels of a bone protein that inhibits bone formation (sclerostin) and increased levels of insulin-like growth factor-I (IGF-I), a hormone with osteogenic effects. (more…)
Accidents & Violence, Author Interviews, Cost of Health Care / 23.03.2017

MedicalResearch.com Interview with: Sarabeth Spitzer MD Candidate | MS2 Stanford University School of Medicine MedicalResearch.com: What is the background for this study? Response: While firearm homicides make headlines, they cause many more injuries than deaths.[1] No one had performed any recent analysis on the costs of hospitalizations for firearm-related injuries. Stanford is a Level One trauma center, and we care for patients injured by firearms. We wanted to know how much it costs the health system to treat these patients. (more…)
Author Interviews, Heart Disease / 23.03.2017

MedicalResearch.com Interview with: Christopher L.F. Sun MIE PhD candidate Department of Mechanical and Industrial Engineering University of Toronto, ON, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Strategic automated external defibrillator (AED) placement is critical for reducing the time to treatment and improving survival outcomes of public out-of-hospital cardiac arrest (OHCA). Many previous studies have focused on examining broad location categories without considering temporal availability (i.e. hours of operation). These broad location categories are often composed of many individual businesses, each with their own unique properties including varying accessibility. Examining specific businesses and locations while incorporating hours of operations and time of OHCA occurrence can improve AED placements in respect to where and when they are needed. Our goal was to examine individual businesses and municipal locations that maximize spatiotemporal OHCA coverage, the number of OHCAs that occurred within 100 m of each location when it was open. We identified a total of 41 businesses and municipal locations with 20 or more locations in Toronto to include the study. We proceeded to rank these businesses and municipal locations by spatiotemporal coverage. We found that coffee shops and bank automated teller machines (ATMs) were the best places to put public AEDs, corresponding to 8 of the "Top 10" ranking stop in Toronto. Specifically, the Canadian coffee shop chain Tim Hortons ranked first of all 41 businesses considered. (more…)
Author Interviews, Environmental Risks, Nature / 23.03.2017

MedicalResearch.com Interview with: Dr. Norbert Kamjunke Helmholtz-Centre for Environmental Research UFZ Department of River Ecology Magdeburg, Germany  MedicalResearch.com: What is the background for this study? Response: Aquacultures are of great importance worldwide but pollute pristine headwater streams, lakes, and estuaries. Chilean salmon production is economically important, contributing ~25% of the worldwide salmon yield (Chile ranks second of the world’s salmon-producing countries). Salmon farming has continuously increased in recent decades; the annual salmonid production in Chile was 820,000 tons in 2012, representing a value of 4.9 billion USD (32% of the total worldwide value of salmonid production). Small salmon are reared in land-based aquacultures supplied with stream water, whereas mid-sized fish are grown in cages in lakes and adult fish in cages along the coast. The effluents from land-based aquaculture pollute pristine streams with nutrients, antibiotics and organic carbon, resulting in oxygen depletion and negative consequences for the abundance and biodiversity of stream organisms. While aquacultures have recently started to remove suspended matter from waste water using sedimentation basins and rotating drum filters, dissolved components are still discharged untreated. Nutrients and dissolved organic matter (DOM) originating from the leaching of remaining food pellets, fish faeces and fish excretions are major components released by aquacultures. One aquaculture in northern Patagonia was estimated to release DOM amounting to 21% of the carbon applied as feed and 76% of the annual fish production. (more…)
Author Interviews, Lifestyle & Health, Weight Research / 23.03.2017

MedicalResearch.com Interview with: Jill Gonzalez WalletHub Analyst MedicalResearch.com: What is the background for this study? What are the main findings? Response: We based our research on recent findings that suggest that 70 percent of the adult U.S. population is overweight or obese. With that in mind, we wanted to find which metro areas offer the best environments for a healthy and active lifestyle. Based on the report's methodology, we concluded that areas in the south tend to have higher overweight and obese rates, as some fail to offer residents healthy environments and amenities that would facilitate a more active lifestyle. Please find the report's main findings here: https://wallethub.com/edu/fattest-cities-in-america/10532/#main-findings. (more…)
Author Interviews, CDC, HIV, Sexual Health / 23.03.2017

MedicalResearch.com Interview with: Qian An, PhD Epidemiologist/statistician Division of HIV/AIDS Prevention CDC MedicalResearch.com: What is the background for this study? Response: Since 2006, the Centers for Disease Control and Prevention (CDC) has recommended HIV testing for all persons aged 13-64 years old. Persons at high risk for HIV infection should be tested more frequently. Among sexually active men who have sex with men (MSM), repeat testing is recommended at least annually. An analysis in 2011 suggested that MSM might benefit from more frequent than annual testing.(1) Among non-MSM, repeat testing is recommended at least annually for persons at high risk, including persons who inject drugs (PWID) and their sex partners, those who have sex in exchange for money or drugs, heterosexuals who have had more than one sex partner since their most recent HIV test, and those whose partners are living with HIV.. Using statistical models based on renewal theory, we estimate the mean HIV inter-test interval (ITI) — meaning the average time period (in months) between two successive HIV tests — to describe temporal trends in HIV testing frequency among MSM, PWID and high-risk heterosexuals (HRH) and differences in testing frequency by age and race/ethnicity. A decrease in ITI means individuals are testing more frequently. (more…)
Author Interviews, Neurological Disorders / 23.03.2017

MedicalResearch.com Interview with: Joshua Kim, researcher RIKEN-MIT Center for Neural Circuit Genetics at The Picower Institute for Learning and Memory, Department of Biology and Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA Howard Hughes Medical Institute, Massachusetts Institute of Technology Cambridge, MA 02139 MedicalResearch.com: What is the background for this study? Response: We previously identified to populations of neurons in a structure known as the basolateral amygdala, one that is capable of mediated fear-related behaviors and the other reward-related behaviors. Both of these basolateral amygdala populations send projections to a structure known as the central amygdala. For this study, we wanted to examine the function of 7 different populations of central amygdala neurons in regard to fear-related and reward-related function and how each of these 7 populations are connected to the 2 basolateral amygdala populations. (more…)
Author Interviews, Heart Disease, JACC, Lifestyle & Health / 23.03.2017

MedicalResearch.com Interview with: Andrew T. Yan, MD Terrence Donnelly Heart Centre St Michael's Hospital University of Toronto Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: The pathogenesis of aortic stenosis is complex and incompletely understood. Previous experimental data and epidemiologic studies (mostly cross-sectional) have demonstrated an association between conventional cardiovascular risk factors such as hypertension, diabetes, and dyslipidemia, and aortic sclerosis or stenosis. However, there is a paucity of longitudinal data from large population studies. Therefore, we sought to examine the relationship between conventional cardiovascular risk factors and incident severe aortic stenosis during extended follow-up in a large unselected elderly population in Ontario, Canada. In over 1 million individuals older than 65 who were followed for a median of 13 years, hypertension, diabetes and dyslipidemia were all significantly and independently associated with development of severe aortic stenosis requiring hospitalization or intervention. Furthermore, we observed a positive dose-response relationship between the number and duration of cardiac risk factors, and the risk of aortic stenosis. Together, these risk factors accounted for approximately one third of the incidence of severe aortic stenosis at a population level. (more…)
Author Interviews, Dermatology / 23.03.2017

MedicalResearch.com Interview with: Usha Nagavarapu, PhD Senior director of preclinical drug development BioPharmX MedicalResearch.com: What is the background for this study? What are the main findings? Response: Acne vulgaris is a complex chronic inflammatory disease known to be linked with P. acnes and can have profound social and psychological effects. Though a number of treatments exist, there is promise of a long-term benefit for acne patients. BioPharmX’s in vitro and in vivo studies have revealed that a low-dose, topical 1% minocycline gel (BPX-01) provided a localized and targeted delivery of adequate minocycline to the epidermis and pilosebaceous units that can potentially limit systemic exposure and may reduce treatment related side effects. At the intended clinical dose, toxicity and safety animal studies found that BPX-01 was well tolerated with no significant local or systemic toxic effects. A comparative animal study with oral minocycline demonstrated that topical application of minocycline can limit systemic exposure while delivering sufficient minocycline to the skin to treat acne vulgaris. Along the same lines, a 4-week clinical study with extended release oral minocycline to assess the skin and plasma concentrations of minocycline was conducted. A marked reduction of mean acne lesion counts from baseline was seen with oral minocycline with presence in plasma. On the contrary no minocycline was identified in the skin from periauricular biopsies. Recently, BioPharmX completed a 4-week Phase 2 clinical repeat-dose study of BPX-01. The minocycline gel was well tolerated and over 90% of P. acnes were eliminated. A 12-week Phase 2 dose-finding clinical trial to further assess the efficacy and safety of BPX-01 for the treatment of moderate-to-severe, non-nodular inflammatory acne vulgaris has been initiated. The dose-finding study will provide additional support for the planned Phase 3 clinical trial program with BPX-01. (more…)