Author Interviews
09 May Randomized Controlled Trial of a Ragweed Allergy Immunotherapy Tablet in North American and European Adults
MedicalResearch.com eInterview with Author Peter S. Creticos, M.D. (corresponding author) Dr. Creticos' Comments: This paper reports the first successful randomized, double-blind, pivotal trial of sublingual immunotherapy with a ragweed tablet. The relevance of this lies in the recognition that ragweed is the dominant seasonal allergen in North America (~26% of US population is allergic to this noxious weed which pollinates from early August to early October). An alternate (sublingual) approach to immunotherapy for allergic respiratory disease would be a welcome addition to our armamentarium, as the current mode of treatment in the U.S., that of subcutaneous injection immunotherapy, is saddled with a burdensome injection regimen that requires frequent office visits over a 4-5 year course of treatment.08 May Diabetes Mellitus: A Risk Factor for Ischemic Stroke in a Large Bi-Racial Population
MedicalResearch.com eInterview with Jane C Khoury, PhD
Associate Professor Division of Biostatistics and Epidemiology Cincinnati Children’s Hospital Medical Center MLC 5041, 3333 Burnet Avenue Cincinnati, Ohio 45229-3039 MedicalResearch.com: What are the main findings of the study? Dr. Khoury: Over all age groups, those with diagnosed diabetes have at least 3-fold increased risk of incident ischemic stroke compared to those without diabetes. This is even more pronounced in those less than 65 years of age, with 5-fold and 12-fold increase for those of black and white race respectively. All rates are adjusted to the 2000 population.08 May Single, high-dose erythropoietin given 2 days pre-op reduces need for transfused blood
MedicalResearch.com eInterview with Luca Weltert, MD Cardiac Surgery Department of the European Hospital in Rome, Presentation during the Plenary Scientific Session of the 93rd AATS Annual Meeting in Minneapolis. MedicalResearch.com: What are the main findings of the study? Dr. Luca Weltert: This study illustrates the efficacy of Human Recombinant Erythropoietin (HRE) in avoiding blood transfusions in the heart surgery setting. And aside from complicated number, tables and statistics tells that HRE can reduce Blood Transfusions as much as 65%, while at the same time not exposing patients to any substantial added risk.08 May Incidence of multiple sclerosis in multiple racial and ethnic groups
MedicalResearch.com eInterview with Annette Langer-Gould, MD, PhD From the Department of Research and Evaluation Kaiser Permanente, Southern California, Pasadena; and Neurology Department Kaiser Permanente, Southern California Los Angeles Medical Center, CA. MedicalResearch.com: What are the main findings of the study? Dr. Langer-Gould: The main findings of the study were that multiple sclerosis is more common in black women than in white women, which run contrary to the widely accepted belief that blacks are less susceptible to MS. In particular, we found that black patients had a 47 percent higher risk of MS than white patients, while Hispanic and Asian patients had a 50 percent and 80 percent lower risk compared to white patients, respectively. We also found that 70 percent of MS cases occurred in females, but this preponderance of females diagnosed was more pronounced among black patients than white patients. In addition, black women had a higher incidence of MS than white patients of both genders, while black men had a similar risk of being diagnosed with MS compared to white men. The lower risk among Hispanic and Asian patients was true for both sexes.07 May Minimal dose CT superior to chest X-ray for detection of recurrent lung cancer
MedicalResearch.com eInterview with Dr. Waël C. Hanna University of Toronto departments of Thoracic Surgery and Diagnostic Radiology, MedicalResearch.com: What are the main findings of the study? Dr. Hanna: By using Minimal Dose CT Scan (MnDCT) for surveillance of patients after lung cancer resection, we can detect 94.2% of recurrent or new lung cancer in this patient population. When we use chest x-ray (CXR) to conduct surveillance on the same cohort of patients, we can only detect 21.1% of new or recurrent lung cancer cases. Therefore, while MnDCT scan subjects the patient to a similar effective dose of radiation as CXR (0.2 mSV vs. 0.16 mSv), it is a vastly superior test for follow-up of this high risk population. More importantly, when we use MnDCT for surveillance, we can detect new or recurrent lung cancer at the asymptomatic locoregional stage in 78% of patients, and there quarters of those patients are candidates for further treatment in the form of surgery or radiation. In the patients who were treated, median survival was 69 months after initial operation, versus 25 months in those who received no treatment.03 May Patterns of Emergency Medical Services Use and Its Association With Timely Stroke Treatment: Findings From Get With the Guidelines-Stroke
MedicalResearch.com eInterview with with Dr. O. James Ekundayo, MD, DrPH Assistant Professor Department of Family & Community Medicine Meharry Medical College 1005 Dr. D.B. Todd Jr. Blvd. Nashville, TN 37208 Written Interview conducted with author by Editor Marie Benz, MD MedicalResearch.com What are the main findings of the study? Answer: The key findings are: · One third of stroke patients did not activate Emergency Medical Services (EMS). · Subgroups of patients who were less likely to use EMS include younger patients, patients of minority race or ethnicity, and those living in rural communities. · Prior history of stroke /TIA does not confer greater likelihood of EMS activation during subsequent stroke. · Patients who used EMS had shorter pre-hospital and in-hospital delay. They arrived early, had prompter evaluation, and received more rapid treatment. · More patients, who were eligible for clot-busting drug, received them. These happened because EMS gives the receiving hospital pre-notification about the arrival of the patient and the ER staff is ready to act as soon as the patient arrives.02 May Structural basis for substrate transport in the GLUT-homology family of monosaccharide transporters.
MedicalResearch.com eInterview with Christian Löw, Ph.D. Department of Medical Biochemistry and Biophysics Karolinska Institutet SE-171 77 Stockholm Sweden MedicalResearch.com: What are the main findings of the study? Dr. Löw: In order to grow, cells need fuels such as sugars. Specialized proteins that reside in the cell envelope transport these nutrients into the cell; XylE is a bacterial transport protein that is highly similar to members of the human GLUT transporters. Our study describes for the first time the mechanistic details of how cells import sugars by resolving the different steps of the transport cycle at almost atomic resolution. Tumors are especially dependent on the uptake of sugars and other nutrients via these transporter systems in order to be able to grow rapidly. A possible strategy for cancer treatment therefore would be to block these transporters in the cell membrane, thus starving out and killing the cancer cells. Our structures can be used for initial structure based drug design studies to develop efficient and specific inhibitors against members of the GLUT family. We believe that our detailed mechanistic insights could become the basis for new strategies to fight cancer cells.
02 May Effects of obesity on patient experience in the emergency department
MedicalResearch.com eInterview with Professor David McDonald Taylor Emergency Department, Austin Health PO Box 5555, Heidelberg, Vic. 3084, Australia MedicalResearch.com: What are the main findings of the study? Answer: Overall, obese and non-obese patients have similar experiences during their ED stay. However, while obese patients tend to be younger and less sick, their more frequent presentation with potentially cardiac-related disease is reflected in their management. The excess of liver function tests and abdominal xrays performed on obese patients is likely to reflect examination difficulties and over investigation. Obese patients do experience more attempts at IV cannulation.02 May Serum C-peptide levels and risk of death among adults without diabetes mellitus
MedicalResearch.com: Dr. Kyoung-bok Min Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, Republic of Korea MedicalResearch.com: What are the main findings of the study? Answer: The aim of this study was to investigate the prospective association of serum C-peptide with all-cause, cardiovascular disease, and coronary heart disease mortality in a non-diabetic population. We also estimated the observed mortality as C-peptide increased across the strata of glycated hemoglobin and fasting blood glucose. We found a linear association between serum C-peptide levels and death from all-cause and cause-specific mortality among adults without non-diabetes mellitus at baseline. Our finding suggests that elevated C-peptide levels may be a marker of subsequent mortality in non-diabetic subjects.01 May Predictors of Survival from Perioperative Cardiopulmonary Arrests: A Retrospective Analysis of 2,524 Events from the Get With The Guidelines-Resuscitation Registry
MedicalResearch.com eInterview with Satya Krishna Ramachandran MD FRCA Director, Quality Assurance Department of Anesthesiology University of Michigan MedicalResearch.com: What are the main findings of the study? Answer: Background: A cardiac arrest is a life-threatening condition where the heart has stopped beating. This remains one of the biggest fears of patients undergoing anesthesia and surgery. This is a...
30 Apr Will green tea help you lose weight?
This interview content is written by Dr Dae-Kyu Song, the corresponding and responsible author of the manuscript shown at “Park, Jae-Hyung et al. (2013). Green tea extract with polyethylene glycol-3350 reduces body weight and improves glucose tolerance in db/db and high-fat diet mice. Naunyn-Schmiedeberg’s Archives of Pharmacology. DOI 10.1007/s00210-013-0869-9“. Dr Jae-Hyung Park is the first author of the manuscript and a graduate student of Dr. Dae-Kyu Song MedicalResearch.com: What are the main findings of the study? Answer: At doses which could be achieved by drinking green tea on a daily basis, it has been known that green tea extract (GTE) inhibits intestinal glucose and lipid absorption when it is present in the intestinal tract. It is a reason why green tea consumption has been known to be beneficial for controlling obesity and type 2 diabetes. However, we have found that, after the intestinal absorption of GTE itself, the circulating GTE can elevate blood glucose levels by blocking cellular glucose uptake in most tissues, thereby limiting glucose utilization of the tissues. Therefore, we have tried to prolong the residence time of GTE in the intestine and block the intestinal absorption of GTE, by adding non-toxic polymer polyethylene glycol (PEG) to GTE. As a result, in 4 week treatment, the GTE+PEG regimen dramatically helps obesity-induced diabetic mice lose body weight and ameliorate glucose intolerance. Interestingly, GTE alone is without any effect.27 Apr HIV and human herpesviruses in the semen of effectively treated HIV-1 infected men who have sex with men
MedicalResearch.com eInterview with Dr. Sara Gianella Weibel, M.D. Center For Aids Research (CFAR) University of California San Diego La Jolla CA, 92093-0679 Email: gianella@ucsd.edu MedicalResearch.com: What are the main findings of the study? Answer: In this study we evaluated a large number of seminal samples from HIV-infected sexually active gay men treated with antiretroviral therapy (ART) using an extensive battery of tests for viral and bacterial co-infections. Around 10% of enrolled subjects presented detectable levels of HIV RNA in semen despite being on suppressive ART.26 Apr Brain Response to Empathy-Eliciting Scenarios Involving Pain in Incarcerated Individuals With Psychopathy
Medical Research.com eInterview with: Prof. Jean Decety PhD Irving B. Harris Professor of Psychology and Psychiatry The University of Chicago 5848 S. University Ave. Chicago, IL 60637 - USA SCNL Web page: www.scnl.org Child NeuroSuite: www.childneurosuite.org MedicalResearch.com: What are the main findings of the study? Dr. Decety: In our study, psychopaths exhibited significantly less activation in the ventromedial prefrontal cortex, lateral orbitofrontal cortex, and brainstem relative to controls, but surprisingly showed greater activation in the insula. The major difference in brain response between psychopaths compared to controls during the perception of others in pain was the lack of engagement of regions in the brainstem, orbitofrontal cortex (OFC) and ventromedial prefrontal cortex (vmPFC).26 Apr A risk for hepatocellular carcinoma still persists long-term after sustained virological response in patients with hepatitis C associated liver cirrhosis
MedicalResearch.com: eInterview with:
Soo Aleman
Department of Gastroenterology and Hepatology, and Infectious Diseases
Karolinska University Hospital, at Karolinska Institute
171 76 Stockholm, Sweden,
MedicalResearch.com: What are the main findings of the study?
Answer: In this long-term, prospective study of 351 hepatitis C infected patients with liver cirrhosis, we found a reduced but persistent risk for hepatocellular cancer after successful treatment with eradication of the virus. This risk for hepatocellular cancer remained at a level of 1% per year for those with sustained virological response, and could persist as long as 8 years after eradication.
26 Apr Progranulin Mutations as Risk Factors for Alzheimer Disease
MedicalResearch.com eInterview with Dr. David Perry UCSF School of Medicine Clinical Fellow in Neurology 675 Nelson Rising Lane San Francisco CA 94158 MedicalResearch.com: What are the main findings of the study? Dr. Perry: We described two patients with clinical syndromes and brain imaging patterns that are consistent with Alzheimer’s disease. Both were found to have mutations in GRN, which are typically associated with inherited frontotemporal dementia. They both showed evidence of underlying Alzheimer’s pathology, in one case through autopsy confirmation (demonstrating Alzheimer’s disease in addition to TDP-43 pathology), and in the other case from a positive amyloid PET scan.25 Apr Analyzing excess mortality from cancer among individuals with mental illness
Posted at 01:29h
in Author Interviews, Cancer Research, Case Western, Cleveland Clinic, Mental Health Research
MedicalResearch.com: eInterview with Siran M. Koroukian, Ph.D.
Population Health and Outcomes Research Core,
Clinical & Translational Science Collaborative
Associate Professor Department of Epidemiology and Biostatistics
School of Medicine Case Western Reserve University
Cleveland, OH 44106-7281
MedicalResearch.com: What are the main findings of the study?
Dr. Koroukian: Among individuals who died of cancer, those with mental illness (MI) died an average of 10 years earlier than those without MI.
Overall, there was excess mortality from cancer associated with having mental illness in all the race/sex strata: SMR, 2.16 (95% CI, 1.85-2.50) for black men; 2.63 (2.31-2.98) for black women; 3.89 (3.61-4.19) for nonblack men; and 3.34 (3.13-3.57) for nonblack women.
We note statistically significant higher SMRs for every anatomic cancer site in nonblack men and women and for most cancer sites in black men and women.
23 Apr Symptomatic reduction in free testosterone levels secondary to crizotinib use in male cancer patients.
MedicalResearch.com eInterview with Andrew Weickhardt, MBBS, DMedSc, FRACP MedicalResearch.com: What are the main findings of the study? Dr. Weickhardt: The study was hoping to confirm our earlier published observation that crizotinib use led to low testosterone in male patients. The earlier study was based on our observation of symptoms of low testosterone in some patients treated with the drug, and had suggested strongly that crizotinib led to rapid decrease in testosterone levels, however this was based only on a single center's patients, and only 19 patients. We hoped to do this by surveying a larger population of crizotinib treated patients across multiple institutions. We serially measured several relevant hormones.22 Apr Trends in mammography screening rates after publication of the 2009 US Preventive Services Task Force recommendations
MedicalResearch.com eInterview with
Nancy L. Keating MD, MPH
Harvard Medical School
Department of Health Care Policy
180 Longwood Avenue
Boston, MA 02115-5899
MedicalResearch.com: What are the main findings of the study?
Dr. Keating: We examined data from the 2005, 2008 and 2011 waves of the National Health Interview Survey (NHIS) a national population-based in person survey to assess whether mammography rates changed following the Nov 2009 USPSTF recommendations. Prior to 2009 the USPSTF recommended routine screening every 1-2 years for all women older than 40 years old. In 2009, the USPSTF advised against routine mammography screening in women under 50, and recommended biennial screening for women 50-74.
17 Apr Dual energy CT accurately identifies ACL tears in emergency department
MedicalResearch.com: Katrina N. Glazebrook, MB, ChB Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 MedicalResearch.com: Why did you do the study? Dr. Glazebrook: We felt CT was being underutilized for evaluation of knee injuries. The utility of CT has been well documented in the assessment of fractures, but little attention has been made on soft tissue evaluation. CT now has high spatial resolution with very thin reconstructions in any desirable plane, and we have previously noted that this allowed injured soft tissue structures such as cruciate ligaments to be well visualized [presented at Society of Skeletal Radiology meeting March 2013]. We had determined in that prior study that the best reconstruction plane to evaluate both normal and torn anterior cruciate ligaments was the oblique sagittal plane parallel to the lateral femoral condyle as routinely used in MRI imaging of the knee The soft tissue window, single energy bone removal and Dual energy bone removal were the best reconstructions to determine the presence or absence of ACL disruption The bone removal techniques removed the distracting bone so the soft tissue structures were more apparent.16 Apr Prevalence of a Healthy Lifestyle Among Individuals With Cardiovascular Disease in High-, Middle- and Low-Income CountriesThe Prospective Urban Rural Epidemiology (PURE) Study
Posted at 22:00h
in Author Interviews, Exercise - Fitness, Heart Disease, JAMA, Smoking, Tobacco Research
MedicalResearch.com Author Interview with Dr. Koon Teo, MB, PhD
Population Health Research Institute, Hamilton Health Sciences,
McMaster University, Hamilton, Ontario, Canada
MedicalResearch.com: What are the main findings of the study?
Dr. Teo: In this study we examined the prevalence of smoking cessation or avoidance, eating a healthy diet and undertaking regular physical activities in nearly 8000 individuals who had previously experienced a coronary heart disease event or stroke, on average 5 years after their events. The individuals were recruited from over 600 communities in 17 countries with varying incomes and economic development. We found that although these healthy lifestyle activities could reduce the risk of further heart or stroke events, about one fifth of individuals continued to smoke, only one third undertook regular leisure or work related physical activities and about two fifths ate a healthy diet.
12 Apr Food Choice and Overconsumption: Effect of a Premium Sports Celebrity Endorser
MedicalResearch.com eInterview with Dr Emma Boyland Biopsychology Research Group. Liverpool Obesity Research Network. University of Liverpool. MedicalResearch.com: What are the main findings of the study? Dr. Boyland: Children who were exposed to a TV commercial for Walker’s potato chips featuring a celebrity endorser showed a greater brand preference for Walker’s and consumed more Walker’s chips than a purported ‘supermarket brand’. Exposure to the celebrity endorser in a different, non-promotional context (presenting a soccer highlights TV program) also had a similar impact on brand choice and intake. This effect was not seen in response to another snack food commercial or a non-food commercial. Importantly, children did not reduce their consumption of the perceived ‘supermarket brand’ to compensate, they simply consumed more Walker’s crisps so this effect could contribute to overconsumption.12 Apr Elder Abuse as a Risk Factor for Hospitalization in Older Persons
MedicalResearch.com eInterview with XinQi Dong, MD MPH APSA Congressional Policy Fellow/Health and Aging Policy Fellow Chair, IOM Global Violence Prevention Forum on Elder Abuse Senior Policy and Research Advisor, Administration on Aging Senior Policy Advisor (OCSQ), Center for Medicare and Medicaid Services Director, Chinese Health, Aging and Policy Program Associate Director, Rush Institute for Healthy Aging Associate Professor of Medicine, Nursing and Behavioral Science Rush University Medical Center Chicago, IL 60612 www.chinesehealthyaging.org MedicalResearch.com: What are the main findings of the study? Answer: Dong and Simon investigated the prospective association between elder abuse and rate of hospitalization in a Chicago community population. From the Chicago Health and Aging Project, the study surveyed 6,674 older adults. After consideration of potential confounding factors, elder abuse victims compared to those without elder abuse had 2.7 times more frequent rate of hospitalizations in this Medicare population. Older adults who suffered psychological abuse, financial exploitation and caregiver neglect also had more frequent rate of hospitalization. Health care professionals should consider screening for elder abuse in hospital settings. Future research is needed to quantify impact of elder abuse and broader health service utilization in community-dwelling older persons. Elder abuse and neglect is something hundreds of thousands of senior citizens suffer from. It is advised to act if you suspect elder abuse is occurring by contacting the police. People may also see it fit to enlist the services of an elder neglect attorney to fight for the rights of the elderly (siegel-law-elder-abuse-neglect-attorney).12 Apr Degenerative Disease Research: Structural basis of kynurenine 3-monooxygenase inhibition
MedicalResearch.com eInterview: Professor Nigel S. Scrutton ScD FRSC FSB Director Manchester Institute of Biotechnology EPSRC Established Career Fellow |Faculty of Life Sciences | Manchester Institute of Biotechnology | University of Manchester | Manchester | M1 7DN | UK | MedicalResearch.com: What are the main findings of your study? Dr. Scrutton: A major breakthrough has been made by our team of researchers seeking treatments for degenerative illnesses such as Parkinson's Disease. We have detailed how an enzyme in the brain interacts with a drug-like lead compound directed against Huntington's Disease (but also with major implications for Alzheimer’s and Parkinson’s diseases) to inhibit its activity. The work – which solved the molecular structure of a crucial brain enzyme called kynurenine 3-monooxygenase – opens the door to effective treatment for neurodegenerative diseases such as Huntington's, Alzheimer's and Parkinson's. The main findings not only describe the molecular details of the enzyme, but also how it interacts with a lead drug compound that inhibits the natural activity of the enzyme.12 Apr Amiodarone and the Risk of Cancer – A Nationwide Population-Based Study
MedicalResearch.com eInterview with Vincent Yi-Fong Su MD Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan MedicalResearch.com: What are the main findings of the study? Answer: Amiodarone, one of the most widely used medications to treat arrhythmias may increase the risk of developing cancer, especially in men and people exposed to high amounts of the drug. That is the conclusion of a new retrospective study published early online in CANCER, a peer-reviewed journal of the American Cancer Society. Patients who were male or who received high cumulative daily doses of amiodarone within the first year had an increased risk of developing cancer. Those with both factors were 46 percent more likely to develop cancer than those with neither factor.10 Apr Psychosocial Impact of Adolescent Gynecomastia: A Prospective Case-Control Study
MedicalResearch.com eInterview with Dr. Brian I. Labow MD
Boston Children’s Hospital
Dr. Labow received his MD from Harvard Medical School. He completed his postgraduate training at Massachusetts General Hospital, Harvard Plastic Surgery Training Program, Children's Hospital Boston, and Beth Israel Deaconess Medical Center.
MedicalResearch.com: What are the main findings of the study?
Dr. Labow: The main finding of the study is that gynecomastia, the enlargement of breast tissue in men, can have a significant impact on the psychosocial wellbeing of adolescent patients. Noted deficits were found in patients’ social functioning, mental health, and self-esteem when compared to healthy boys of the same age. Validated surveys were given to both groups to assess a wide array of different health domains. Interestingly there was no difference in the physical health of boys with gynecomastia and unaffected boys when differences in BMI were taken into consideration.
10 Apr Population-wide weight loss and regain in relation to diabetes burden and cardiovascular mortality in Cuba 1980-2010: repeated cross sectional surveys and ecological comparison of secular trends
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in Author Interviews, BMJ, Diabetes, Exercise - Fitness, Nutrition, Weight Research
MedicalResearch.com eInterview with
Manuel Franco MD, PhD Associate Professor Department of Health Sciences, Public Health Unit Universidad de Alcalá Johns Hopkins Bloomberg School of Public Health Adjunct Associate Professor Dept. of Epidemiology mfranco@jhsph.edu
MedicalResearch.com: What are the main findings of the study? Dr. Franco: Population wide weight loss of about 5 kg was related with large decreases in diabetes and cardiovascular mortality. On the contrary, Body weight regain was related with an increase in diabetes prevalence, incidence, and mortality, as well as a deceleration in the previously declining rates of cardiovascular death.09 Apr Calcium-deficiency assessment and biomarker identification by an integrated urinary metabonomics analysis
MedicalResearch.com eInterview with Maoquing Wang Department of Nutrition and Food Hygiene, School of Public Health, Harbin MedicalUniversity, 157 Baojian Road, Nangang District, Harbin, 150081, P. R. China MedicalResearch.com: What are the main findings of the study? Dr. Wang: Our group first reported that the 2-week low-calcium diet could result in metabolic changes and 27 reliable biomarkers of calcium deficiency were identified. The correlations between calcium intake and two of the biomarkers indicated that these biomarkers could be used alone or in combination as a non-invasive screening method with greater sensitivity and specificity for the diagnosis of calcium deficiency in humans in future. The identified biomarkers give new insights into the pathophysiological changes and molecular mechanisms of calcium deficiency.04 Apr Melatonin Secretion and the Incidence of Type 2 Diabetes
Posted at 03:02h
in Author Interviews, Brigham & Women's - Harvard, Diabetes, JAMA, Medical Research Centers, Melatonin, Sleep Disorders
MedicalResearch.com Interview with Dr. Ciaran McMullan MD
from Channing Division of Network Medicine in Boston, a research division within the Department of Medicine at Brigham and Women’s Hospital, Boston Mass
MedicalResearch.com: What are the main findings of the study?
Dr. McMullan: In this observational study performed in non-diabetic women we found that lower nocturnal melatonin secretion predicted future risk of developing type 2 diabetes. When we categorized the individuals by category of nocturnal melatonin secretion we found that those in the lowest category had twice the risk as those in the highest category of nocturnal melatonin secretion. This association remained even after adjusting for other well established risk factors for development of diabetes including body mass index, physical activity, dietary factors, family history of diabetes, smoking and hypertension. This increased risk translates into the lower melatonin secretion group having an additional 5 cases of incident diabetes per 1000 person years than the high melatonin secretion group.