Complex Issues Drive Young Marital Age in Southeast Asia

MedicalResearch.com Interview with:
“Marriage” by sowrirajan s is licensed under CC BY 2.0Dr Akanksha Marphatia and

co-authors, Dr Alice Reid and Dr Gabriel Amable
Cambridge, UK

MedicalResearch.com: What is the background for this study?

Response: Although the total prevalence of girls marrying below the UN prescribed minimum age of 18 years has decreased over time, this is mostly due to a decrease in child marriages, <15 years. Marriages during adolescence, between 16-17 years, have increased. Women marring just after 18 years may also experience some of the consequences of those marrying under-age. These patterns are important to recognise because the predictors and consequences of marriage in these age groups are likely to differ.

The aim of our review was to summarise research evidence on why women’s marriage age, independent of early child-bearing, is a major public health issue. In the four South Asian countries of our review, Bangladesh, India, Nepal and Pakistan, marriage precedes reproduction.

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Trumenba Vaccine Helps Protect Against Meningococcal B Infections in Adolescents and Young Adults

MedicalResearch.com Interview with:

Judith Absalon, M.D., M.P.H Senior Director, Vaccines Clinical Research  Pfizer Pharmaceuticals

Dr. Judith Absalon

Judith Absalon, M.D., M.P.H
Senior Director, Vaccines Clinical Research
Pfizer Pharmaceuticals

MedicalResearch.com: What is the background for these two studies?

Response: Invasive serogroup B meningococcal disease (MenB) is uncommon, yet serious, is unpredictable and can strike at any age, including healthy teenagers and young adults, with potentially long-lasting and devastating consequences, including death. The data from these two Phase 3 studies, one in adolescents (Study 1009) and one young adults (Study 1016), highlight that Trumenba can help protect teens and young adults against meningococcal group B disease.

Additionally, these two large Phase 3 studies confirmed the results of earlier studies and supported the transition from Accelerated to Traditional Approval in the US; were pivotal for approvals in Europe, Australia, and Canada earlier this year; and add to the growing portfolio of research for TRUMENBA.

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Does the Working Class Handle Interpersonal Conflicts Better Than The Middle Class?

MedicalResearch.com Interview with:
“working class” by arileu is licensed under CC BY 2.0Igor Grossmann, Ph.D
.
Director, Wisdom and Culture Laboratory
Associate Professor of Psychology
University of Waterloo, Canada
Associate Editor, Emotion

MedicalResearch.com: What is the background for this study?

Response: Our Wisdom & Culture laboratory studies the concepts of wisdom and cultural factors. For wisdom, we specifically focus on pragmatic reasoning that can help people to better understand and navigate uncertain contexts – strategies that philosophers for millennia discussed as “epistemic virtues.” In our prior work, my colleagues and I have observed that wisdom tends to be lower in situations when self-interests are salient, and higher when one adopted an socially-sensitive interdependent mindset. In other work by myself and several other labs, consistent finding emerged showing that lower social class tends to be more socially interdependent, whereas middle class (both in the US, Russia, and even China) tends to be more self-focused.

This led to the present research, which combines prior insights to examine how wise reasoning varies across social classes. Because lower class situation involves more uncertainty and more resource-scare life circumstances, we questioned whether these situations would also evoke more wise reasoning from people who are in them. Higher class situations are assumed to provide conditions that benefit people in every way. But in so doing, they may also encourage entitlement, self-focus and thereby intellectual humility and open-mindedness – key features of a wise thought. As such, our studies show that it turns out that middle class conditions are not beneficial in at least one way – they may discourage reasoning wisely.

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GERD Associated With Increased Risk of Malignancy of the Upper Aerodigestive Tract

MedicalResearch.com Interview with:

Dr. Edward D. McCoul, MD, MPH Ochsner Medical Center

Dr. McCoul

Dr. Edward D. McCoul, MD, MPH
Ochsner Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Population-level data suggests a link between gastroesophageal reflux disease and cancer of the throat and sinuses in adults over 65 years of age.  T

he strength of association between reflux and cancer is strongest for anatomic sites closest to the esophagus, where acid and other stomach contents may have the greatest exposure.

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Phase 3 Darzalex Trial Demonstrated Meaningful Improvement in Patients with Newly Diagnosed Multiple Myeloma

MedicalResearch.com Interview with:
janseen-oncologyMaria-Victoria Mateos, MD, PhD

University Hospital of Salamanca/IBSAL
Salamanca, Spain

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Phase 3 ALCYONE study data showed DARZALEX (daratumumab) in combination with bortezomib, melphalan, and prednisone (VMP) significantly improved clinical outcomes, including reducing the risk of disease progression or death by 50 percent, in newly diagnosed patients with multiple myeloma who are ineligible for autologous stem cell transplantation (ASCT) at a median follow-up of 16.5 months (Hazard Ratio [HR] = 0.50; 95 percent CI [0.38-0.65], p<0.0001).

The median progression-free survival (PFS) for DARZALEX-VMP had not yet been reached, compared to an estimated median PFS of 18.1 months for patients who received VMP alone. In addition to reducing the risk of disease progression or death, DARZALEX significantly improved the overall response rate (ORR) as compared to VMP alone, including more than doubling rates of stringent complete response, significantly improved rates of very good partial response or better and complete response or better (CR).

The most common (≥10 percent) Grade 3/4 treatment-emergent adverse events (TEAEs) for DARZALEX-VMP vs. VMP were neutropenia (40 percent vs. 39 percent), thrombocytopenia (34 percent vs. 38 percent), anemia (16 percent vs. 20 percent) and pneumonia (11 percent vs. 4 percent). One patient in each arm discontinued treatment due to pneumonia, and 0.9 percent of patients discontinued DARZALEX due to an infection. Twenty-eight percent of patients experienced infusion reactions (IRs) due to DARZALEX.. In the DARZALEX-VMP arm, 42 percent of patients experienced a serious adverse event (SAE), compared to 33 percent in the VMP arm.

The study findings were as a late-breaking abstract (Abstract #LBA-4) at the 59th American Society of Hematology (ASH) Annual Meeting in Atlanta, and simultaneously published in the New England Journal of Medicine (NEJM).

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Cotton Tip Applicators Single Biggest Cause of Eardrum Ruptures

“Qtip” by Rafael Castillo is licensed under CC BY 2.0MedicalResearch.com Interview with:
Eric T. Carniol, MD, MBA
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Toronto
Toronto, Ontario, Canada

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Tympanic membrane perforations (aka “popped” or “burst” ear drum) is a common complaint of patients presenting to the emergency room, primary care offices, and otolaryngologist (ENT doctors) offices. These may be caused by trauma, infections, or other causes. As well, many patients will use qtips (cotton-tipped applicators) to clean ears and remove ear wax and are unaware of the potential harms of doing so.

This study was designed to examine the cause of ear drum perforations as diagnosed in emergency departments in the United States.

Foreign body instrumentation of the ear (qtips, hair combs, hair pins, needles, etc) were the cause of 61.2% of perforations. Cotton tip applicators are the single leading cause of traumatic tympanic membrane perforation in all age groups except young adults (13-18) and 19-36 year olds, in which it is the second largest cause (behind water trauma).

Children less than 18 years old constitute nearly 2/3 of all ear drum perforations in the emergency department.

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Premature Babies Less Likely To Have Siblings

MedicalResearch.com Interview with:
“Premature baby” by Elin B is licensed under CC BY 2.0
Suvi Alenius, MD
National Institute for Health and Welfare
Helsinki and Oulu, Finland

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Parents of very or extremely low birth weight infants are less likely to have subsequent children after preterm birth. We assessed whether this phenomenon extends over the whole range of prematurity.

We now show that parents of preterm-born infants (gestational age less than 37 completed weeks of gestation) have fewer subsequent children than do parents of term born infants. This is not limited to the extreme group of parents of children born very preterm, but is even seen within the large groups of parents of infants born less preterm.

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Not Clear That Physical Activity Programs Reduce Cognitive Decline

MedicalResearch.com Interview with:
“Exercise” by Diabetes Education Events is licensed under CC BY 2.0
Michelle Brasure, MSPH, PhD, MLIS
Evidence-based Practice Center
School of Public Health
University of Minnesota 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We conducted a large systematic review to assess the evidence relating to interventions to prevent cognitive decline and dementia. We included experimental studies with follow up times of at least six months. This paper analyzes the physical activity interventions; other papers in this issue address other types of interventions.

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Positive Topline Results from Phase 3 Study of Cariprazine for the Treatment of Bipolar I Depression

MedicalResearch.com Interview with:
allergan
Gary Sachs, MD
Associate Clinical Professor of Psychiatry
Harvard Medical School 

MedicalResearch.com: What is the background for this data milestone?

Response: Bipolar disorder affects about 5.7 million adults in the United States.  It is a common, often disabling condition in which abnormal mood states impair a person’s ability to carry out everyday tasks. Bipolar disorder touches nearly every family and community in America, because periods of illness, a patient’s symptoms often impact their family, their friends, and their community.

There are a limited number of products approved to treat bipolar depression and even fewer products that have been studied and approved to treat the full spectrum of bipolar disorder, from mania through depression. Having another product proven to treat the full range of bipolar disorder would be a welcome addition to the treatment options currently available to the psychiatry community and patients.

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Could Trace Levels of Lithium Protect Against Alzheimer’s Disease?

MedicalResearch.com Interview with:
Val Andrew Fajardo, PhD.

NSERC Postdoctoral Fellow | Centre for Bone and Muscle Health
Brock University | Department of Health Sciences
St. Catharines, ON, Canada 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Lithium is best known for its role as a mood stabilizer, and several ecological studies across a number of different regions have shown that trace levels of lithium in tap water can exert its mood stabilizing effect and reduce rates of suicide, crime, and homicide.

The results from our study show that these trace levels of lithium could also potentially protect against Alzheimer’s disease.  These findings are actually supported by several years of research using pre-clinical and clinical models to demonstrate low-dose lithium’s neuroprotective effect against Alzheimer’s disease. In addition, we also found that trace lithium in tap water may potentially protect against obesity and diabetes – an effect that is also supported with previous literature.  In fact, some of the earlier reports of lithium’s effect of increasing insulin sensitivity and improving glucose metabolism were first published in the 1920s.  Finally, we found that trace lithium’s effect on Alzheimer’s disease may be partly mediated by its effect on obesity and diabetes.

My collaborator Dr. Rebecca MacPherson who is an expert on Alzheimer’s disease as a metabolic disorder explains that this effect is in support of recent research demonstrating that obesity and diabetes are important risk factors in the development of Alzheimer’s disease.  So interventions aiming to reduce obesity and diabetes such as physical activity can go a long way in lowering risk for Alzheimer’s disease, which is also something we present in our study.

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Elevated of Biomarker NT-proBNP Liked To Cardiac Fibrosis

MedicalResearch.com Interview with:

David A. Bluemke, MD PhD, MsB Professor, Radiology Editor in Chief (2018), Radiology University of Wisconsin-Madison, School of Medicine and Public Health Madison WI 53792

Dr. Bluemke

David A. Bluemke, MD PhD, MsB
Professor, Radiology
Editor in Chief (2018), Radiology
University of Wisconsin-Madison,
School of Medicine and Public Health
Madison WI 53792 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Heart failure is expected to markedly increase in the United States, because of the aging population (https://www.ncbi.nlm.nih.gov/pubmed/23616602. For patients with congestive heart failure, NT-proBNP is an excellent marker of disease severity. The presence of elevated levels of NT-proBNP also predicts future cardiac events.

For individuals who do not have clinically diagnosed heart failure, the significance of small elevations in NT-proBNP is not known. We hypothesized that these small elevations were related to subclinical elevations in myocardial wall stress. However, in patients with advanced heart disease, we do know that greater myocardial wall stress is associated with histological evidence of fibrosis — i.e., replacement of myocardial muscle by greater fibrotic tissue.

New techniques using MRI can find evidence of expansion of the space between myocytes (the extracellular volume). The most common cause of this expansion is diffuse myocardial fibrosis/ collagen deposition. Using MRI to detect myocardial fibrosis is an advance because MRI is non-invasive (we would not otherwise perform myocardial biopsy for patients without clinically evident disease). Thus we can use MRI to probe the actual composition of myocardial tissue.

Using MRI, we found evidence that individuals in the community (in the MESA study) who had small elevations of NT-proBNP also have evidence of myocardial fibrosis.   The mean NT-proBNP levels in the MESA study (1,334 study subjects) was 65 pg/ml. That level is considered to be normal; levels of NT-proBNP of 1200 pg/ ml or greater are found in patients with congestive heart failure.

Of note, the relationship between elevations of NT-proBNP and myocardial fibrosis were independent of multiple risk factors such as age, gender, smoking status, blood pressure, cholesterol levels and diabetes. That is, if the NT-proBNP level was slightly higher (for example, due to increased wall stress), then MRI found an association with greater myocardial fibrosis.

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Deep Brain Stimulation Helpful For Some Visual Hallucinations

MedicalResearch.com Interview with:

Dr. Foltynie

Dr. Foltynie

Thomas Foltynie MD PhD
Senior Lecturer and Honorary Consultant Neurologist
Unit of Functional Neurosurgery Institute of Neurology and
National Hospital for Neurology and Neurosurgery
University College London

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Stimulation of the Nucleus Basalis of Meynert can enhance cholinergic innervation of the cortex in animal models and has been previously reported to have beneficial cognitive effects in a single patient with Parkinson’s Disease dementia.

In this double blind crossover trial, six patients with Parkinson’s Disease underwent low frequency stimulation to the NBM bilaterally.  While there were no consistent objective improvements in cognitive performance, there was a marked reduction in visual hallucinations in two of the participants. .

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Older, Frail and Physically Inactive Adults At Risk of Multivitamin Deficiency

MedicalResearch.com Interview with:
“vitamins” by Colin Mutchler is licensed under CC BY 2.0
Priv.-Doz. Dr. Barbara Thorand 
Helmholtz Zentrum München
German Research Center for Environmental Health
Institute of Epidemiology II
Neuherberg, Germany 

MedicalResearch.com: What is the background for this study?

Response: Micronutrients, which include vitamins, minerals (e.g. calcium) and trace elements (e.g. iron), are essential nutrients that are required in minute amounts by the organism for proper growth and good health. Results from the last German National Nutrition Survey (NVS II)* uncovered a high prevalence of insufficient dietary intake of micronutrients in older adults aged 65 years and over in Germany. By means of blood analyses, our study has confirmed these critical results. This is a highly relevant issue, particularly in light of our growing aging population and the high societal relevance of successful healthy aging.

*Max Rubner-Institut: Nationale Verzehrsstudie II, Ergebnisbericht Teil 2 (2008). Die Bundesweite Befragung zur Ernährung von Jugendlichen und Erwachsenen.

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Our Memory System Is Adapted To Helping Us Raise Children

MedicalResearch.com Interview with:
“Cute babies” by daily sunny is licensed under CC BY 2.0Benjamin M. Seitz
Doctoral Student
Department of Psychology, Learning & Behavior
University of California, Los Angeles

MedicalResearch.com: What is the background for this study? What are the main findings?

 

Response: The adaptive memory literature is based on two crucial theories.

The first is that we process information on different ‘levels’ and these different levels of processing information strongly influence our ability to later remember that information.

The second is that our evolutionary history has shaped our cognitive abilities and that these abilities therefore perform optimally when performing tasks related to evolutionary fitness. It has been established that processing words based on their relevancy to an imagined ancestral survival scenario yields incredible memory performance far superior than processing those same words based on their relevancy to similar imagined scenarios that do not involve the survival element or ancestral environment.

Our study demonstrates that thinking about raising offspring in an ancestral environment while processing words leads to a similar benefit to recall of those words as when thinking about survival, suggesting the human memory system while also useful in helping our species survive may have also been particularly useful in helping us raise our offspring.

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Why Doesn’t That Medicine Work For Me? Genetic Mutations Affect Drugs’ Efficacy

MedicalResearch.com Interview with:

Alexander S Hauser, PhD student MRC Laboratory of Molecular Biology Cambridge UK Department of Drug Design and Pharmacology, University of Copenhagen Copenhagen, Denmark

Alexander Hauser

Alexander S Hauser, PhD student
MRC Laboratory of Molecular Biology
Cambridge UK
Department of Drug Design and Pharmacology, University of Copenhagen
Copenhagen, Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The prevalence and impact of genetic variation among all human G protein coupled receptors (GPCRs) that are targeted by FDA-approved drugs remain unknown. In this study, we present a comprehensive analysis and map of the pharmacogenomics
landscape of GPCR drug targets. The key highlights are:

– GPCRs targeted by drugs show extensive genetic variation in the human population

– Variation occurs in functional sites and may result in altered drug response

– Understanding GPCR genetic variation may help reduce global healthcare expenses

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Fewer Cigarettes But More Vaping Among Today’s Adolescents

MedicalResearch.com Interview with:
“Checking your phone and vaping as you do” by Alper Çuğun is licensed under CC BY 2.0
Richard Allen Miech, PhD
Research Professor, Survey Research Center
Institute for Social Research
University of Michigan 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Monitoring the Future conducts annual, nationally-representative surveys of ~45,000 adolescents every year to assess trends in substance use.  We track which drugs are gaining traction among adolescents and which are falling out of favor.  The survey draws separate, nationally-representative samples of 8th, 10th, and 12th grade students from about 400 total schools every year.  Once a recruited school agrees to participate, a field interviewer travels to the school to administer the paper-and-pencil survey, typically in classrooms.  The project is funded by the National Institute of Drug Abuse and is carried out by the University of Michigan.  More details on the project’s survey design and survey procedures can be found in chapter 3 here: http://monitoringthefutu re.org/pubs/monographs/mtf- vol1_2016.pdf

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Local Politics Determine How Cannabis Is Distributed and Marketed By Dispensaries

MedicalResearch.com Interview with:

MedicalResearch.com Interview with: Greta Hsu PhD Graduate School of Business Stanford University, Graduate School of Business   MedicalResearch.com: What is the background for this study? What are the main findings?  Response:  My co-authors, Ozgecan Kocak at Emory University and Balazs Kovacs at Yale University, and I became interested in the cannabis industry in early 2014, when Colorado and Washington states were in the early stages of licensing recreational cannabis operations.  As organizational researchers, we were interested in how the emergence of the new legalized recreational-use dispensary stores would impact existing medical cannabis dispensaries that had already been in existence for years in both states.  For decades, activists and many dispensaries had framed cannabis as medicine that relieves pain for patients suffering from a wide variety of illnesses.  As recreational-use legalization took hold, would medical dispensaries emphasize their identities as medical providers or downplay their medical orientation to compete directly for potential customers?  We found that some clusters of dispensaries were more conservative in their marketing, continuing and even accentuating an organizational identity focused on therapy and patients.  This was reflected in statements like: “We aim to educate our patients about cannabis treatments and other alternative health approaches to supplement their medicine.”  Counties where the majority of voters voted against legalizing recreational marijuana tended to encourage this increasing focus on therapy.  Dispensaries that embraced the new recreational market took more risk by advertising to a broader, emerging consumer class, which has been bolstered by a growing tourism industry.  These dispensaries de-emphasized their medical orientation and focused more on themes such as product variety and prices.  Dispensaries with this more recreational-oriented marketing tended to be in counties that voted in favor of legalizing recreational use.  Overall, our research suggests local communities hold a great deal of power in affecting how dispensaries present themselves both to consumers and the broader population.  MedicalResearch.com: What should clinicians and patients take away from your report? Response:  In states that have legalized cannabis for adult recreational-use and sales, the law often gives local municipalities flexibility in deciding how easily dispensaries can operate within their boundaries. Many counties have chosen to ban cannabis-related businesses. Others are carefully regulating sales and businesses through zoning and taxes.  Our research suggests that dispensaries are responsive to the level of concern raised by local community members about recreational-use cannabis.  How dispensaries choose to market and present themselves will be shaped by their need to project a positive organizational identity and be accepted as legitimate members of the local community.   MedicalResearch.com: What recommendations do you have for future research as a result of this study?  Response: Many national polls indicate strong support for legalizing the use of cannabis for medical and, to a somewhat lesser degree, recreational uses.  The progression of state-level legalization has been fast and is likely to continue in the coming years.  The overall landscape in the United States is incredibly complex.  Different states has enacted different types of state-level regulations, and different localities within each of these states also differ widely in the types of regulations enacted.  Future research studying dynamics in different states is needed to better understand how this fast-growing industry will continue to evolve.   MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.  Citation: Co-opt or co-exist? A study of medical cannabis dispensaries’ identity-based responses to recreational-use legalization in Colorado and Washington Greta Hsu* University of California, Davis Özgecan Koçak Emory University Balázs Kovács Yale University https://gsm.ucdavis.edu/sites/main/files/file-attachments/cannabis_os_final.pdf  Note:  Content is Not intended as medical advice.  Please consult your health care provider regarding your specific medical condition and questions.

Dr. Hsu

Greta Hsu PhD
Graduate School of Business
Stanford University, Graduate School of Business

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: My co-authors, Ozgecan Kocak at Emory University and Balazs Kovacs at Yale University, and I became interested in the cannabis industry in early 2014, when Colorado and Washington states were in the early stages of licensing recreational cannabis operations.  As organizational researchers, we were interested in how the emergence of the new legalized recreational-use dispensary stores would impact existing medical cannabis dispensaries that had already been in existence for years in both states.

For decades, activists and many dispensaries had framed cannabis as medicine that relieves pain for patients suffering from a wide variety of illnesses.  As recreational-use legalization took hold, would medical dispensaries emphasize their identities as medical providers or downplay their medical orientation to compete directly for potential customers?

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Liquid Biopsies Sent To Different Labs May Yield Different Results

MedicalResearch.com Interview with:
Gonzalo Torga, MD
Urology Department
Johns Hopkins Hospital
Baltimore, MD 21287

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Liquid biopsy is a new and noninvasive alternative to tumor tissue sequencing, and it is intended to specifically detect and sequence tumor DNA circulating in patients’ blood. The results are used to help guide oncologists to tailor the best treatment for patients at each point of their disease. Our research was initially aimed at finding the best commercial lab to test samples from metastatic prostate cancer patients. We wanted to make the best choice for our patients, so we started submitting the samples to both places at the same time to compare results. However, we found significant disparities in the results from identical patient samples submitted to two different commercial liquid biopsy providers, and we believed it would be important to share them with the oncology community.

The two liquid biopsy panels compared were the Guardant360, from Guardant Health, Inc., which sequenced at least part of the coding sequences of 73 genes; and the PlasmaSELECT panel from Personal Genome Diagnostics, which sequenced coding segments of 64 genes.  Both laboratories were licensed by Clinical Laboratory Improvement Amendments (CLIA) and accredited by the College of American Pathologists (CAP), and report having high sensitivity (in this case, the ability to correctly identify mutations when they occur) and high specificity (the ability to correctly report as negative when those mutations are not present). The two companies differ in which genes, and regions within each gene, are covered. Just 25 of the 40 patients in the study had at least one genetic mutation reported within the overlapping genetic sequences covered by both companies.

Even when the companies were analyzing DNA from the same blood drawn, their results rarely matched each other. When comparing results within the overlapping genetic sequences, the results from both companies completely matched for all the mutations reported in only 7.5 percent (3 of 40 patients) of cases. In 15 percent of the patients (6 of 40), both companies’ results matched for at least one of the reported mutations. In 40 percent (16 of 40) of the patients, no mutations reported that were potentially covered by both panels were detected by both companies.

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Patronizing Hair and Nail Salons Linked To Increased Risk of Skin and Fungal Infections

MedicalResearch.com Interview with:
Lindsey Milich Rutgers School of Public Health studiesLindsey Milich

Rutgers School of Public Health studies
 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Much of the spotlight has been focused on hair and nail technicians, with the focus now shifting towards the health and safety of hair and nail salon clients. We wanted to assess perceived safety and health risks and prevalence of respiratory and dermal symptoms among hair and nail salon clients in New Jersey.

Main findings include dermal/fungal symptoms being more prevalent among clients who visited salons three or more times within the past year, compared with those with fewer reported visits. Respiratory symptom prevalence was higher among clients with fewer salon visits, indicating a “healthy client effect”; clients with these symptoms may be less likely to return.

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Breakthrough Treatment With Prometic’s IV Plasminogen Treats Rare Disabling Disorder

MedicalResearch.com Interview with:
Dr. Charles T. Nakar, MD

Indiana Hemophilia and Thrombosis Center Pediatrics
Indianapolis, IN  

MedicalResearch.com: What is the background for this study?

Response: Congenital plasminogen deficiency is a rare genetic disorder that is caused by mutations in the PLG gene. Mutations in this gene lead to clinical manifestations such as fibrinous deposits on mucous membranes leading to disruption of tissue or organ function. These symptoms, when untreated, lead to significant morbidity and decreased quality of life. Life-threatening episodes may occur especially when the respiratory system is affected. There is currently no established approach to treatment of type 1 plasminogen deficiency and the available topical and systemic therapies (e.g. FFP, corticosteroids, immunomodulatory drugs, anticoagulants, amongst others) lack consistent efficacy. Patients may undergo multiple surgeries to remove lesions, but this approach typically leads to regrowth of lesions. Prometic’s intravenous plasminogen replacement therapy represents the first direct treatment for this serious disorder.

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Multiple Myeloma: Phase 3 Study of DARZALEX + VMP Reduced Risk of Disease Progression and Mortality

MedicalResearch.com Interview with:

Dr. Meletios A. Dimopoulos MD Professor and Chairman Department of Clinical Therapeutics University Athens School of Medicine Athens, Greece

Dr. Dimopoulos

DrMeletios A. Dimopoulos MD
Professor and Chairman
Department of Clinical Therapeutics
University Athens School of Medicine
Athens, Greece

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Updated data from the Phase 3 POLLUX trials showed DARZALEX, in combination with lenalidomide and dexamethasone, reduced the risk of disease progression or death by 56 percent, compared to lenalidomide and dexamethasone alone (Hazard Ratio [HR]=0.44; 95 percent CI [0.34-0.55], p<0.0001). After a median follow-up of 32.9 months, the median progression-free survival (PFS) in the DARZALEX arm has not been reached, compared with a median PFS of 17.5 months for patients who received lenalidomide and dexamethasone alone.

DARZALEX in combination with lenalidomide and dexamethasone also significantly increased the overall response rate (ORR) compared to lenalidomide and dexamethasone alone (93 percent vs. 76 percent, p<0.0001), including rates of complete response (CR) or better (55 percent vs. 23 percent, p<0.0001). DARZALEX also showed significantly higher (>3-fold) MRD-negative rates compared to lenalidomide and dexamethasone alone. These data were featured as an oral presentation (Abstract #739) at the 59th American Society of Hematology (ASH) Annual Meeting in early December.

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UK Study Finds Pulmonary Rehab for COPD Underutilized

MedicalResearch.com Interview with:

Dr Jennifer K Quint MSc PhD FHEA FRCP Clinical Senior Lecturer Respiratory Epidemiology Respiratory Epidemiology, Occupational Medicine and Public Health National Heart and Lung Institute Imperial College London

Dr. Quint

Dr Jennifer K Quint MSc PhD FHEA FRCP
Clinical Senior Lecturer Respiratory Epidemiology
Respiratory Epidemiology, Occupational Medicine and Public Health
National Heart and Lung Institute
Imperial College
London 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We were commissioned by the Chartered Society of Physiotherapy in the UK to undertake a piece of work to show the value of pulmonary rehabilitation in reducing exacerbations in COPD patients so that they could create a web based tool that would show cost savings if GPs actually referred people for pulmonary rehabilitation.

Previous systematic reviews have found that pulmonary rehab can reduce hospital admissions but those groups are often small and not very generalizable so we decided to look at what happens in a primary care COPD population. Our main finding is that people who are eligible for referral are not being referred  – less than 10% eligible were actually referred.

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Most Laboratory Testing For Cancer-Causing Gene Mutations Found Reliable

MedicalResearch.com Interview with:

Annette S. Kim, MD, PhD Associate Professor, Harvard Medical School Brigham & Women's Hospital Boston MA 02115

Dr. Kim

Annette S. Kim, MD, PhD
Associate Professor, Harvard Medical School
Brigham & Women’s Hospital
Boston MA 02115 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The recent debate on laboratory developed tests (LDTs) and FDA-approved companion diagnostics (FDA-CDs) has centered upon both the regulatory and performance aspects of LDTs and we, at the College of American Pathologists (CAP), had the data through our proficiency testing (PT) programs to address the latter point, performance that we wanted to share with the community.  We analyzed almost 7000 PT responses on three molecular oncology tests, those for BRAF, EGFR, and KRAS mutations, and found that both LDTs and FDA-CDs demonstrated excellent performance, with both test types exceeding 97% accuracy overall.

The second key finding of the study was that more than 60% of all laboratories in our study that were using an FDA-CD kit report using it with modifications from the FDA-approved protocol.  These modifications in fact render these test LDTs.  These modifications appear to be driven by the exigencies of real day-to-day clinical practice that requires adapting the assays to meet the needs of a variety of clinical situations that may not be accommodated by the FDA-approved protocol.  These modifications include, for example, the testing of other tumor types that may carry targetable variants, different types of input specimen preparations available in pathology such as cytology smears or other fresh specimens rather than paraffin blocks, and availability of different methods of DNA quantification that those mandated by the FDA approval based upon pre-existing technologies in the laboratories.  In the clinical laboratory, we are always acutely aware that there is a patient awaiting this result.

Therefore, we validate our assays to ensure that we can provide reliable and accurate results from our laboratory under as many varied clinical situations as possible. These data support that practice.

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C-Section and Formula-Fed Babies Have Different Microbiome From Breastfed or Vaginal Births

MedicalResearch.com Interview with:

Anita Kozyrskyj, PhD, Professor Dept Pediatrics Faculty of Medicine & Dentistry, University of Alberta Edmonton, AB   

Dr. Kozyrskyj

Anita Kozyrskyj, PhD, Professor
Dept Pediatrics
Faculty of Medicine & Dentistry, University of Alberta
Edmonton, AB   

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The first year of an infant’s life is a critical time for the development of his or her gut microbiome. Gut microbes not only help infants digest food, but they also “train” their developing immune system. An infant’s environment, from the type of birth and infant diet to use of antibiotics, has a large impact in determining which microbes are present. Frequently these early life exposures occur together. Using data from AllerGen’s CHILD birth cohort and a new analytical approach —called Significance Analysis of Microarrays—we quantified changes to gut microbiota throughout the first year of life according to common combinations of early life exposures.

We found that, compared to vaginally-born and breastfed infants, formula-fed or cesarean-delivered infants had different trajectories of microbial colonization in later infancy, which could have implications for their future health.

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Intestinal Microbiome Linked To Pediatric Asthma

MedicalResearch.com Interview with:

Anita Kozyrskyj, PhD, Professor, Dept Pediatrics Faculty of Medicine & Dentistry, University of Alberta Edmonton, AB 

Dr. Kozyrskyj

Anita Kozyrskyj, PhD, Professor, Dept Pediatrics
Faculty of Medicine & Dentistry, University of Alberta
Edmonton, AB  

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: I was motivated to study the maternal asthma-infant microbiome link by the well-established fact that maternal asthma affects infant birth weight in a sex-specific manner. Based on data from AllerGen’s CHILD birth cohort, Caucasian baby boys born to pregnant moms with asthma—putting them at the highest risk for developing asthma in early childhood—were one-third as likely to have high levels of the microbe, Lactobacillus, in their gut microbiome at 3-4 months after birth.

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Frequent Take-Out Food Linked To Increased Cholesterol and Obesity in Children

MedicalResearch.com Interview with:

Dr. Angela S Donin Population Health Research Institute, St George’s University of London, London, UK

Dr. Donin

Dr. Angela S Donin
Population Health Research InstituteSt George’s
University of London
London, UK 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are increasing numbers of takeaway outlets, particularly in deprived neighbourhoods. This is driving an increase in consumption of takeaway meals, which previous evidence has shown is linked to higher risks of heart disease, type 2 diabetes and obesity. Little is known about the dietary and health impact of high consumption of takeaway foods in children.

This research found children who regularly ate takeaway meals had higher body fat and cholesterol compared to children who rarely ate take away meals, they also had overall poorer diet quality.

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Familial Members Without Genetic Mutation Can Still Have Increased Risk of Melanoma

MedicalResearch.com Interview with:

Hildur Helgadottir, M.D., Ph.D. Department of Oncology Karolinska University Hospit

Dr. Helgadottir

Hildur Helgadottir, M.D., Ph.D.
Department of Oncology
Karolinska University Hospital

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Malignant melanoma of the skin is one of the fastest increasing cancer types in the West.

The main risk factors for melanoma are UV light exposure and hereditary factors. It is therefore relatively common for the afflicted to have family members with the disease. Inherited mutations of the tumour suppressor gene CDKN2A are the strongest known risk factors for familial melanoma and mutations in this gene also increase the risk of other cancers. Children, siblings or parents of mutation carriers have a 50-50 chance of also having the mutation, which can be identified with a gene test.

The present study included Swedish and American families with inherited CDKN2A mutations. The researchers studied whether family members who have not inherited the mutation have any higher than normal risk of developing melanoma or other cancers.

Melanoma, but no other cancers, was more common in the non-carriers in these families compared to the normal population. The phenomenon whereby non-carriers of a specific mutation copy the phenotype (in this case melanoma) from their mutation-carrying relatives is known as phenocopy.

Phenocopy can be caused by other risk-modifying genes or exposure patterns that increase the probability of the specific phenotype manifesting itself. Previous studies have shown that people with the mutation who also have certain pigmentation variants run an even higher risk of melanoma.

Even though the CDKN2A mutation should be present in all populations, it has almost exclusively been identified in families with a Caucasian heritage.This suggests that dark-skinned people with this mutation probably don’t develop melanoma as often and are therefore not tested for this specific mutation, presumably because they lack the risk-modifying pigmentation variants that increase the risk of melanoma. The researchers believe that such pigmentation variants also contribute to a higher melanoma risk in the family members who do not carry the mutation.

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Antibiotic Resistance Common In Infections After Ocular Surgery

MedicalResearch.com Interview with:

Dr-Penny Asbell

Dr. Asbell

Penny Asbell, MD
Icahn School of Medicine
Mt. Sinai, New York City.

MedicalResearch.com: What is the background for this study?

─     Bacterial endophthalmitis is a serious, although infrequent, complication of ocular surgery, typically caused by perioperative introduction of bacterial flora from the patient’s own conjunctiva and skin.

─     Prophylactic measures such as perioperative antibiotic treatment may minimize the risk for endophthalmitis, but can be complicated by antibiotic resistant bacteria.

─     The ongoing Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) study is the only nationwide antibiotic resistance surveillance program specific to ocular pathogens.

─     The purpose of this presentation is to report on the antibiotic susceptibility profiles of bacterial isolates from the vitreous and aqueous humor collected in the ARMOR study expanding upon earlier findings.

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How Do Stem Cells Respond To Diagnostic Radiation Studies?

MedicalResearch.com Interview with:
http://www.insilico.com/
Andreyan Osipov PhD
Insilico Medicine and
Dmitry Klokov PhD
Canadian Nuclear Laboratories, Chalk River, Ontario, Canada 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Cells and tissues can be damaged when exposed to ionizing radiation. In case of radiotherapy, it is a desirable effect in tumor cells. In case of occupational, medical and accidental exposures, typically to low-dose radiation, this may pose health risk to normal cells and tissues.

In both cases, short-term assays that quantify damage to DNA and help evaluate long-term outcome are key to treatment/risk management. One such short-term assay is based on quantification of a modified histone protein called gH2AX in exposed cells up to 24 hrs after exposure. This protein marks sites in DNA that have both strands of the DNA helix broken or damaged. This assay is also widely used for various applications, including determination of individual radiosensitivity, tumor response to radiotherapy and biological dosimetry. With the advent of regenerative medicine that is based on stem cell transplantation, the medical and research communities realized that there is a need to understand how stem cells respond to low-dose diagnostic radiation exposures, such as CT scans. Stem cell therapies may have to be combined with diagnostic imaging in recipient patients. The gH2AX assay comes in very handy here, or at least it seemed this way.

We exposed mesenchymal stem cells isolated from human patients to low or intermediate doses of X-rays (80 and 1000 mGy) and followed formation of gH2AX in their nuclei. First we found that residual gH2AX signal in cells exposed to a low dose was higher than in control non-irradiated cells. If the conventional assumptions about this assay that it is a surrogate for long-term detrimental effects was followed it would mean that the low-dose exposed cells were at a high risk of losing their functional properties. So we continued growing these cells for several weeks and assayed gH2AX levels, ability to proliferate and the level of cellular aging. Surprisingly, we found that low-dose irradiated cells did not differ from non-irradiated cells in any of the measured functional end-points. This was in contrast to 1000 mGy irradiated cells that did much worse at those long-term end points.

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Adolescent Violent Offenders With Childhood Adversity Have Increased Risk of Suicide

MedicalResearch.com Interview with:
Emma Björkenstam PhD
Department of Public Health Sciences
Karolinska Institutet

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: My research team and I have previously shown that childhood adversity is associated with an elevated suicide risk in young adults, and this increased risk may be explained by maladaptive trajectories during adolescence. We also know that adolescent violent offending is linked with suicide, but up until now, less was known about the role of violent offending in the association between childhood adversity and later suicide.

Our main finding in the current study, based on almost half a million Swedes, is that individuals with a history of childhood adversity who also engage in violent offending in late adolescence, have a substantial increased risk of suicide.

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Small Increased Risk of Cardiac Birth Defects With ADHD Drug During Pregnancy

MedicalResearch.com Interview with:

Krista F. Huybrechts, M.S., Ph.D. Assistant Professor of Medicine at Harvard Medical School Epidemiologist in the Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital. Boston, MA 02120

Dr. Krista Huybrechts

Krista F. Huybrechts, MS PhD
Assistant Professor of Medicine
Division of Pharmacoepidemiology and Pharmacoeconomics
Brigham and Women’s Hospital
Harvard Medical School
Boston, MA 02120  

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In recent years, use of stimulant medications in adults, including women of reproductive age, has increased substantially.

However, data regarding the safety of stimulant medications in early pregnancy are sparse and conflicting.  For example, two recent cohort studies failed to detect an association between use of methylphenidate in early pregnancy and overall or cardiac malformations, while another found an 81% increased risk of cardiac malformations, although the estimate was imprecise.

Given the rapidly increasing use of stimulant medications during pregnancy and among women of reproductive age who may become pregnant inadvertently, there is an urgent need to better understand their safety.

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Tapeworm Drug May Be Repurposed To Fight Parkinson’s Disease

MedicalResearch.com Interview with:

Dr. Youcef Mehellou PhD Lecturer in Medicinal Chemistry Cardiff School of Pharmacy and Pharmaceutical Sciences Cardiff University

Dr. Mehellou

Dr. Youcef Mehellou PhD
Lecturer in Medicinal Chemistry
Cardiff School of Pharmacy and Pharmaceutical Sciences
Cardiff University

MedicalResearch.com: What is the background for this study?

Response: Over the last decade or two, there has been many reports linking genetic mutations to the pathogenesis of Parkinson’s disease (PD). Among the proteins that have been found to be mutated in PD is a protein called PINK1. Indeed, PINK1 mutations that disturb its function in cells were found to be causal of PD in humans. Subsequent studies showed that PINK1 is a major player in maintaining healthy neurons. This is because it is one of the components involved in controlling the quality of the mitochondria, an organelle within the cell, and it does this by triggering the disposal of unhealthy mitochondria. Overall, studies into PINK1 indicated that the activation of PINK1 as a plausible strategy for maintaining health neurons and hence slowing down the development and progress of Parkinson’s disease.

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Deep Learning System Can Screen For Diabetic Retinopathy, Glaucoma and Macular Degeneration

MedicalResearch.com Interview with:

Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. Illustration depicting diabetic retinopathy

Illustration depicting diabetic retinopathy

Dr. Tien Yin Wong MD PhD
Singapore Eye Research Institute, Singapore National Eye Center,
Duke-NUS Medical School, National University of Singapore
Singapore

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Currently, annual screening for diabetic retinopathy (DR) is a universally accepted practice and recommended by American Diabetes Association and the International Council of Ophthalmology (ICO) to prevent vision loss. However, implementation of diabetic retinopathy screening programs across the world require human assessors (ophthalmologists, optometrists or professional technicians trained to read retinal photographs). Such screening programs are thus challenged by issues related to a need for significant human resources and long-term financial sustainability.

To address these challenges, we developed an AI-based software using a deep learning, a new machine learning technology. This deep learning system (DLS) utilizes representation-learning methods to process large data and extract meaningful patterns. In our study, we developed and validated this using about 500,000 retinal images in a “real world screening program” and 10 external datasets from global populations. The results suggest excellent accuracy of the deep learning system with sensitivity of 90.5% and specificity of 91.6%, for detecting referable levels of DR and 100% sensitivity and 91.1% specificity for vision-threatening levels of DR (which require urgent referral and should not be missed). In addition, the performance of the deep learning system was also high for detecting referable glaucoma suspects and referable age-related macular degeneration (which also require referral if detected).

The deep learning system was tested in 10 external datasets comprising different ethnic groups: Caucasian whites, African-Americans, Hispanics, Chinese, Indians and Malaysians

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Menopausal Hormone Replacement Should Not Be Used For Disease Prevention

MedicalResearch.com Interview with:

Dr-Suzanne Fenske.jpg

Dr. Fenske

Dr. Suzanne Fenske, MD
Assistant Professor of Obstetrics, Gynecology and Reproductive Science
Icahn School of Medicine at Mount Sinai

 MedicalResearch.com: What is the background for this study? What are the main findings?

Response: USPSTF recommendations are based off several studies, but is mainly based off of the Women’s Health Initiative.

The Women’s Health Initiative was a 15 year prevention study with a focus on death, disability and impaired quality of life in postmenopausal women. This study was originally performed in 1991.

The USPSTF reevaluated the data along with several other studies to assess the role of hormone replacement therapy in prevention of chronic diseases such as heart disease, stroke, blood clot, gallbladder disease, dementia.  The USPSTF has found that hormone replacement therapy has some benefit in reducing the risk of fractures, and, potentially, diabetes.  The USPSTF has found that hormone replacement therapy can increase the risk of coronary artery disease, stroke, blood clot, gall bladder disease, urinary incontinence and dementia.

With these risks, the USPSTF states that hormone replacement therapy should not be used as a preventative medicine, but, rather, used for treatment of symptomatic menopause and not prevention of osteoporosis or heart disease.

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Deep Learning Algorithms Can Detect Spread of Breast Cancer To Lymph Nodes As Well or Better Than Pathologists

MedicalResearch.com Interview with:
Babak Ehteshami Bejnordi Department of Radiology and Nuclear Medicine Radboud University medical center, NijmegenBabak Ehteshami Bejnordi

Department of Radiology and Nuclear Medicine
Radboud University medical center, Nijmegen

MedicalResearch.com: What is the background for this study?

Response: Artificial intelligence (AI) will play a crucial role in health care. Advances in a family of AI popularly known as deep learning have ignited a new wave of algorithms and tools that read medical images for diagnosis. Analysis of digital pathology images is an important application of deep learning but requires evaluation for diagnostic performance.

Accurate breast cancer staging is an essential task performed by the pathologists worldwide to inform clinical management. Assessing the extent of cancer spread by histopathological analysis of sentinel lymph nodes (SLN) is an important part of breast cancer staging. Traditionally, pathologists endure time and labor-intensive processes to assess tissues by reviewing thousands to millions of cells under a microscope. Using computer algorithms to analyze digital pathology images could potentially improve the accuracy and efficiency of pathologists.

In our study, we evaluated the performance of deep learning algorithms at detecting metastases in lymph nodes of patients with breast cancer and compared it to pathologist’s diagnoses in a diagnostic setting.

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Babies’ Brain Responses Predict Dyslexic Reading Skills in School

MedicalResearch.com Interview with:

Kaisa Lohvansuu, PhD
Postdoctoral Researcher
Jyväskylä Centre for Interdisciplinary Brain Research
Department of Psychology
University of Jyväskylä 

MedicalResearch.com: What is the background for this study?
Response: Developmental dyslexia, a specific reading disability, has a strong genetic basis: The risk of having developmental dyslexia at school age is eight times higher than usual if either of the parents has reading difficulty. It has been known that dyslexia and also family risk for dyslexia are strongly associated with a speech perception deficit, but the underlying mechanism of how the impaired speech processing leads to reading difficulties has been unclear.

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Daratumumab Monotherapy for Patients with Intermediate or High-Risk Smoldering Multiple Myeloma

MedicalResearch.com Interview with:

Craig C. Hofmeister, MD, MPH The Ohio State University 

Dr. Hofmeister

Craig CHofmeisterMD, MPH
The Ohio State University 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Preliminary data presented from the randomized, open-label, Phase 2 CENTAURUS (SMM2001) study evaluated three dosing schedules for DARZALEX monotherapy in patients with intermediate or high-risk smoldering multiple myeloma. A total of 123 patients were enrolled, with a median time since initial smoldering multiple myeloma diagnosis of 6.83 months (0.4-56). Patients were randomized to one of three treatment arms receiving DARZALEX 16 mg/kg intravenously in 8-week cycles: 1.) a long-intense dosing schedule (LONG) where DARZALEX was administered weekly in Cycle 1, every other week in Cycle 2-3, every 4 weeks in Cycle 4-7, and every 8 weeks up to Cycle 20; 2.) an intermediate dosing schedule (INT), where DARZALEX was given weekly for 1 cycle, and every 8 weeks up to Cycle 20 and; 3.) a short intense dosing schedule (SHORT), where DARZALEX was given weekly for 1 cycle. Results from the study showed DARZALEX monotherapy had a tolerable safety profile in patients with intermediate or high-risk smoldering multiple myeloma, with the most common treatment-emergent adverse events (TEAEs) being fatigue, cough, headache and insomnia. The efficacy endpoints included overall response rate, progression free survival, time to next treatment, and overall survival rate at 4 years. These study results serve as the basis for a Phase 3 study for DARZALEX in smoldering multiple myeloma, which is actively enrolling. These findings demonstrated DARZALEX had a manageable safety profile in patients with intermediate or high-risk smoldering multiple myeloma.

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Thyroid Treatment Did Not Improve IVF Miscarriage Rate in Women With Thyroid Antibodies But Normal Thyroid Function

MedicalResearch.com Interview with:
Professor Tianpei Hong, MD, PhD
Of behalf of Prof. Jie Qiao and all the coauthors,
Director, Department of Endocrinology & Metabolism
Director, Department of Laboratory Medicine
Peking University Third Hospital
Beijing, China

MedicalResearch.com: What is the background for this study?

  • Ÿ           Women who test positive for thyroid autoantibodies have been reported to be at 2- to 3-fold higher risk of spontaneous miscarriage than those who test negative. However, the effect of levothyroxine on miscarriage among women with positive thyroid autoantibodies and normal thyroid function has been documented in limited studies with conflicting results.
  • Ÿ           Given the substantial difficulty achieving successful pregnancy among infertile women, identifying optimal treatment for infertile women who test positive for thyroid autoantibodies is particularly important. There are a few randomized clinical trials showing a beneficial effect of levothyroxine treatment on pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer (IVF-ET). However, the sample size of those trials was rather small which may weaken the quality of the evidence.
  • Ÿ           Therefore, the Pregnancy Outcomes Study in euthyroid women with Thyroid Autoimmunity after Levothyroxine (POSTAL) study was conducted in Peking University Third Hospital to evaluate whether levothyroxine treatment initiated before IVF-ET could decrease the miscarriage rate and improve the live birth rate in infertile women who tested positive for antithyroperoxidase antibody but had normal thyroid function.

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Parents Encouraged To Keep Screen Devices Out Of Kids’ Bedrooms At Night

MedicalResearch.com Interview with:
“Video Game Addicts” by Michael Bentley is licensed under CC BY 2.0Dr. Marsha Novick, MD

Associate professor of pediatrics and family and community medicine,
Penn State College of Medicine 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The results of this study solidify some well-established data concerning childhood obesity – namely that children who watch more television and have a more sedentary lifestyle are more likely to have an overweight or obese BMI compared with those who are more active. The survey results highlight some associations between increased technology use and difficulty with sleep quantity in children and adolescents.

The data suggest:

  • ​​Increased technology use at bedtime, namely television, cell phones, video games and computers, is associated with a decrease in the amount of sleep children are getting. These children were more likely to be tired in the morning and less likely to eat breakfast.
  • Specifically, children who reported watching TV or playing video games before bed got an average of 30 minutes less sleep than those who did not, while kids who used their phone or a computer before bed averaged an hour less of sleep than those who did not.
  • The data also suggests that children with overweight or obesity were more likely to have trouble falling asleep and trouble staying asleep than their normal BMI counterparts
  • When children were reported by their parents to use one form of technology at bedtime, they were more likely to use another form of technology as well.

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Letermovir (Prevymis) Prevents CMV Infection in Stem Cell Transplant

MedicalResearch.com Interview with:

Francisco M. Marty, M.D Associate Professor, Harvard Medical School Dana–Farber Cancer Institute and Brigham and Women’s Hospital

Dr. Marty

Francisco M. Marty, M.D
Associate Professor, Harvard Medical School
Dana–Farber Cancer Institute and
Brigham and Women’s Hospital

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Cytomegalovirus (CMV) is the most common infection in patients who undergo allogeneic hematopoietic-cell transplantation (bone marrow transplantation with cells from donors different than the patient). Up until now, we had no antiviral agent that could be used for prophylaxis (prevention) of CMV post-transplant because of the side effects of drugs available to date (ganciclovir, valganciclovir, foscarnet, cidofovir).

This trial confirmed that letermovir was highly effective in preventing CMV infection when used in the first 100 days after allogeneic HCT, was associated with minimal side effects of concern and was also associated with lower all-cause mortality by Week 24 post-HCT.

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Post Exposure Doxycycline in PReP Users May Reduce Risk of Syphilis and Chlamydiae

MedicalResearch.com Interview with:

Professor Jean-Michel Molina MD Head of Department of Infectious Diseases, Hôpital Saint-Louis Paris France 

Prof. Molina

Professor Jean-Michel Molina MD
Head of Department of Infectious Diseases, Hôpital Saint-Louis
Paris France 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There is a high rate of sexually transmitted infections (STIs) among Pre-exposure prophylaxis users and we wished to assess whether post-exposure prophylaxis (PEP) with doxycycline could reduce the incidence of sexually transmitted infections in this population.

We have found indeed a high rate of STIs most of them (71%) being asymptomatic and warranting therefore systematic testing. Also PEP reduced the incidence of syphilis and chlamydiae infection by 70%, not for gonorrhea due to the high rate of detection in throat swabs without any impact of PEP.

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Medicaid Work Requirements May Have Unintended Consequences on Costs and Enrollees

MedicalResearch.com Interview with:

Renuka Tipirneni, MD, MSc Clinical Lecturer in Internal Medicine University of Michigan Department of Internal Medicine, Division of General Medicine, and Institute for Healthcare Policy & Innovation Ann Arbor, MI

Dr. Tipirneni

Renuka Tipirneni, MD, MSc
Clinical Lecturer in Internal Medicine
University of Michigan Department of Internal Medicine, Division of General Medicine, and
Institute for Healthcare Policy & Innovation
Ann Arbor, MI

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Several states have submitted proposals to require Medicaid expansion enrollees to work, actively seek work or volunteer, or risk losing Medicaid coverage. The current federal administration has signaled a willingness to approve the waivers states need to enact such requirements.

In our survey of over 4000 Medicaid expansion enrollees in Michigan, we found that nearly half of enrollees have jobs, another 11 percent can’t work, likely due to serious physical or mental health conditions, and another 27% are out of work but also are much more likely to be in poor health.

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Personalized Medicine Tool Helps Direct Cardiac Care in Elderly Patients

MedicalResearch.com Interview with:

Joseph A. Ladapo, MD, PhD Principal Substudy Investigator, PRESET Registry Subgroup Analysis, Elderly Patients Associate Professor, Division of General Internal Medicine and Health Services Research David Geffen School of Medicine University of California, Los Angeles

Dr. Ladapo

Joseph A. Ladapo, MD, PhD
Principal Substudy Investigator, PRESET Registry
Subgroup Analysis, Elderly Patients
Associate Professor, Division of General Internal Medicine and Health Services Research
David Geffen School of Medicine
University of California, Los Angeles

MedicalResearch.com: What is the background for this study? 

Response: The mapping of the Human Genome 14 years ago ushered in a new era of precision medicine. Many people are familiar with advances in oncology using precision medicine, but recently, new developments in precision medicine in cardiology have allowed us to develop a tool to differentiate patients likely to have obstructive coronary artery (CAD) from those who have non-cardiac causes of their symptoms.

Diagnosing CAD in the elderly is challenging. Aging individuals often present with atypical symptoms of CAD which can complicate the evaluation process. The typical diagnostic pathway for possible CAD often starts with less invasive testing and progresses to invasive testing, especially in older patients. Invasive procedures pose greater risk in the elderly population than they do in younger patients because of the higher risk of side effects, including bleeding, vascular complications and kidney injury.

Elderly adults evaluated for CAD have a higher pretest probability of CAD and are also at higher risk of experiencing procedure-related complications during their evaluation.[i],[ii] It is also important to note that elderly patients are often underrepresented in clinical trials and other types of comparative effectiveness research.[iii],[iv] For example, the 2013 American College of Cardiology/American Heart Association Atherosclerotic Cardiovascular Disease Risk Algorithm is only formally approved to be used in individuals up to the age of 75, despite the fact that individuals exceeding this threshold in age experience higher rates of adverse cardiovascular events.[v]

All of this means that the elderly population may have the most to gain from timely and accurate determination of their currently likelihood of obstructive CAD.
This precision medicine tool, the age, sex and gene expression score (ASGES), and its clinical utility in the elderly population is the focus of this study. It was based on patient data from the PRESET Registry, a prospective, multicenter, observational study enrolling stable, symptomatic outpatients from 21 U.S. primary care practices from August 2012 to August 2014.

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Family Members of Patients Prescribed Opioids More Likely To Fill Opioid Prescriptions Themselves

MedicalResearch.com Interview with:
“Pills” by Victor is licensed under CC BY 2.0Marissa J. Seamans, Ph.D

Postdoctoral Fellow
Department of Mental Health
Johns Hopkins School of Public Health
Baltimore, MD 21205 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Many patients report sharing their prescriptions for opioids with family members. What we didn’t know is whether family members of opioid users are more likely to fill opioid prescriptions themselves than family members of non-opioid users. Our study found that the 1-year risk of prescription opioid initiation among family members of prescription opioid users was an absolute 0.71% higher than among family members of non-opioid users. The risks were particularly higher for initial prescriptions with refills or longer days supply.

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A Computer Can Predict Health From A Photograph Of A Face

MedicalResearch.com Interview with:

Credit: Stephen et al. 2017

Credit: Stephen et al. 2017

Dr Ian Stephen PhD
Senior Lecturer
Department of Psychology
ARC Centre of Excellence in Cognition and its Disorders,
Perception in Action Research Centre
Macquarie University, Sydney
NSW, Australia

 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Since the 1990s, the dominant view of attraction in the scientific community has been that it is an evolved mechanism for identifying appropriate, healthy, fertile mates. People who are attracted to appropriate, healthy, fertile people are more likely to have more, healthy offspring and therefore any genes for having these preferences will become more common. On the other hand people who are attracted to inappropriate, unhealthy, infertile people will be less likely to pass on their genes to the next generation, so genes for this attraction pattern will become less common. However, for this model to be correct, two things have to be true. First, we should be able to identify cues in the face and body that people find attractive/healthy looking. And second, these cues must be related to some aspect of actual physiological health. The first part of this is well established – cues like symmetry, skin color, body shape are all related to looking healthy and attractive. But there is much less research on the second part.

The computer modeling techniques that we use allowed us to build a model based on 272 African, Asian and Caucasian face photographs that identifies three aspects of physiological health – body fat, BMI (a measure of body size) and blood pressure – by analysing facial shape. We then used the model to create an app that predicts what different faces would look like if those individuals increased or decreased their fatness, BMI or blood pressure. We gave this app to some more participants and asked them to make the faces look as healthy as possible. We found that, to make the faces look healthy, the participants reduced their fatness, BMI and (to a lesser extent) blood pressure.

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Hearing Loss Associated With Higher Risk of Cognitive Decline and Dementia

MedicalResearch.com Interview with:
“Hear” by Jaya Ramchandani is licensed under CC BY 2.0David G. Loughrey, BA(Hons)

NEIL (Neuro Enhancement for Independent Lives) Programme
Trinity College Institute of Neuroscience, School of Medicine
Trinity College Dublin, Dublin, Ireland

MedicalResearch.com: What is the background for this study?

Response: Age-related hearing loss, a common chronic condition among older adults, has emerged in the literature as a potential modifiable risk factor for dementia. This is of interest as current pharmacological therapies for dementias such as Alzheimer’s disease only offer symptom-modifying effects. Treatment of risk factors such as hearing loss may help delay the onset of dementia and may provide an alternate therapeutic strategy. However, there is variance in the research on hearing loss and cognition with some studies reporting a small or non-significant association. In this meta-analysis, we investigated this association and we only included observational studies that used standard assessments of cognitive function and pure-tone audiometry (the clinical standard).

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Anesthesia, Sterility Measures Contribute To Large Carbon Footprint of Health Care Systems

MedicalResearch.com Interview with:
 <a href="https://www.flickr.com/photos/armymedicine/6127836005">“surgery”</a> by <i> <a href="https://www.flickr.com/people/armymedicine/">Army Medicine</a> </i> is licensed under <a href="https://creativecommons.org/licenses/by/2.0"> CC BY 2.0</a>Andrea MacNeill MD MSc FRCSC

Surgical Oncologist & General Surgeon
University of British Columbia
Vancouver General Hospital
BC Cancer Agency

MedicalResearch.com: What is the background for this study?

Response: Climate change is one of the most pressing public health issues of the present era, responsible for 140,000 deaths annually.  Somewhat paradoxically, the health sector itself has a considerable carbon footprint, as well as other detrimental environmental impacts.  Within the health sector, operating rooms are known to be one of the most resource-intensive areas and have thus been identified as a strategic target for emissions reductions.

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No Convincing Evidence of Memory Dysfunction Due To Statins

MedicalResearch.com Interview with:

Dr-Beth-Taylor

Dr. Taylor

Beth A. Taylor, PhD
Director of Exercise Physiology Research, Hartford Hospital Associate Professor, Kinesiology
University of Connecticut

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Hydroxy-methyl-glutaryl (HMG) CoA reductase inhibitors (statins) are the most effective medications for managing elevated concentrations of low-density lipoprotein cholesterol (LDL-C).  Although statins are generally well-tolerated, they are not without side effects, and mild central nervous system (CNS) complaints such as memory loss and attention decrements are the second most commonly reported adverse effect of these drugs.

Studies assessing cognitive effects of statins vary widely and have produced inconclusive findings. Despite the equivocal data on adverse cognitive side effects with statin therapy, in 2012 the FDA announced a safety label change for statins, based on published case reports of memory loss and confusion and data from the Adverse Events Reporting System. One possibility for these equivocal findings is that studies involving the effects of statins on cognition typically have assessed cognitive function using traditional cognitive tests, which may yield small effect sizes and demonstrate high intra-participant variability. This may explain the discrepancy between clinical trials and patient self-reports, and could be addressed by utilizing CNS tests that directly assess brain parameters.

To the best of our knowledge and literature review, this study is the first to investigate the effects of statins on the central nervous system by utilizing fMRI to assess brain neural activation in healthy adults treated with 80 mg atorvastatin or placebo.

We detected few changes attributable to statin therapy with standardized neuropsychological tests, a finding similar to that from previous clinical trials. However, participants on atorvastatin demonstrated altered patterns of neural activation on vs. off statin compared to participants treated with placebo. Unexpectedly, the treatment groups differed at both timepoints. The clinical implications of these findings are unclear and warrant additional clinical trials.

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More Evidence That Higher Education May Lower Risk of Alzheimer’s Disease

MedicalResearch.com Interview with:

Susanna C. Larsson, PhD Associate Professor, Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden

Dr. Larsson

Susanna C. Larsson, PhD
Associate Professor, Karolinska Institutet,
Institute of Environmental Medicine,
Stockholm, Sweden

MedicalResearch.com: What is the background for this study?

Response: The causes of Alzheimer’s disease are largely unknown and there are currently no medical treatments that can halt or reverse its effects. This has led to growing interest in identifying risk factors for Alzheimer’s that are amenable to modification. Several observational studies have found that education and various lifestyle and vascular risk factors are associated with the risk of Alzheimer’s disease, but whether these factors actually cause Alzheimer’s is unclear.

We used a genetic epidemiologic method known as ‘Mendelian randomization’. This method involves the use of genes with an impact on the modifiable risk factor – for example, genes linked to education or intelligence – and assessing whether these genes are also associated with the disease. If a gene with an impact on the modifiable risk factor is also associated with the disease, then this provides strong evidence that the risk factor is a cause of the disease.

MedicalResearch.com:  What are the main findings?

Response: Our results, based on aggregated genetic data from 17 000 Alzheimer’s disease patients and 37 000 healthy controls, revealed that genetic variants that predict higher education were clearly associated with a reduced risk of Alzheimer’s disease. A possible explanation for this link is ‘cognitive reserve’, which refers to the ability to recruit and use alternative brain networks or structures not normally used to compensate for brain ageing. Previous research has shown that high education increases this reserve.

We found suggestive evidence for possible associations of intelligence, circulating vitamin D, coffee consumption, and smoking with risk of Alzheimer’s disease. There was no evidence for a causal link with other modifiable factors, such as vascular risk factors.

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Maternal Ingestion of Placenta Has No Proven Therapeutic Benefit

MedicalResearch.com Interview with:

Placenta – Wikipedia Image

Daniel C Benyshek, PhD
Professor, Department of Anthropology
Adjunct Professor, UNLV School of Medicine
Co-Director, Metabolism, Anthropometry and Nutrition Lab
UNLV
Sharon M. Young, PhD (first author)

MedicalResearch.com: What is the background for this study?

Response: Over the last several decades, human maternal placentophagy (postpartum ingestion of the placenta by the mother) has emerged as a rare but increasingly popular practice among women in industrialized countries seeking its many purported health benefits. Human placentophagy advocates, including many midwives, placenta encapsulation specialists, lactation consultants, and mothers who have experienced positive results previously from the practice, regularly claim improved lactation, energy levels, and postpartum mood, among other benefits, as a result of placentophagy. These advocates regularly speculate that these self-reported effects are likely due to (beneficial) changes to postpartum maternal hormone profiles as a result of the practice. While maternal placentophagy is ubiquitous among land mammals, including our closest primate relatives, recent research has shown that human maternal placentophagy is unknown as a traditional cultural practice. The conspicuous cross-cultural absence of maternal placentophagy among humans (as a long-standing traditional practice) thus remains a mystery. Our study is an important first step in the scientific (evolutionary and clinical) investigation of this rare but increasingly popular maternal practice.

Our study was a double-blind, and placebo controlled trial, meaning that there was a placenta group and a placebo group, and the participants and researchers didn’t know which supplement a participant had until the end of the study. We included 27 healthy women, recruited during pregnancy, who met with the researchers 4 times across pregnancy and early postpartum. At each meeting, they answered questionnaires on topics of interest (e.g., mood, energy, bonding, social support etc.), and we collected blood and saliva samples. At the first two meetings, they were not yet taking a placenta or placebo supplement, so we could collect baseline measures for their hormones and questionnaire data. After the second meeting, they were instructed to take either placenta or placebo supplements. Once the study had ended, we compared data between the two groups to identify any differences.

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