Author Interviews, Cancer Research, Cleveland Clinic, Weight Research / 15.08.2019

MedicalResearch.com Interview with: Siran M. Koroukian, PhD Director, Population Cancer Analytics Shared Resource Case Comprehensive Cancer Center Director, Population Health and Outcomes Research Core Associate Professor Department of Population and Quantitative Health Sciences School of Medicine Case Western Reserve University Cleveland, OH MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown that obesity-associated cancers (OACs) have been increasing in younger people. Using data from over 6 million cancer cases from 2000-2016, we identified the specific age/sex/race-ethnicity groups that were most affected by increases in OACs. We found a substantial shift of obesity-associated cancers to younger age groups, with the most notable increases occurring to the 50-64 age group. In addition, we observed the greatest percentage increase in the number of OAC cases during the study period in Hispanic men and women, as well as for cancers of the thyroid, gallbladder, liver and intrabiliary duct. (more…)
Author Interviews, Cancer Research, FDA, Vaccine Studies / 14.08.2019

MedicalResearch.com Interview with: Dr. Graca Dores MD MPH US Food and Drug Administration Center for Biologics Evaluation and Research Office of Biostatistics and Epidemiology Division of Epidemiology Silver Spring, Maryland Oklahoma City, OK MedicalResearch.com: What is the background for this study? Would you briefly explain what Sipuleucel-T is used for?  Response: Sipuleucel-T was the first therapeutic vaccine approved by the U.S. Food and Drug Administration (FDA) in 2010.  It is indicated for the treatment of asymptomatic or minimally symptomatic, metastatic, castration-resistant prostate cancer (CRPC; prostate cancer that spreads while an individual is on hormone-blocking therapy).  During the preparation of this product, the patient’s cells are collected (leukapheresis), sent for processing to generate a dose of patient-specific vaccine, and then administered intravenously back to the patient.  This process is repeated approximately every two weeks for a total of three doses. Except for the pre-marketing clinical trials that were reviewed during the sipuleucel-T approval process, post-marketing studies that have evaluated the safety profile of sipuleucel-T are scarce. Therefore, we used the FDA’s Adverse Event Reporting System (FAERS) database to summarize the adverse events reported to FDA by industry, medical professionals, and consumers.  We also assessed whether sipuleucel-T and specific adverse events (product-event pairs) were reported more than expected compared to all other drug/biologic-adverse event pairs in the FAERS database. (more…)
Author Interviews, Dermatology, Microbiome, Pediatrics / 14.08.2019

MedicalResearch.com Interview with: Zhe-Xue Quan, PhD Ministry of Education Key Laboratory for Biodiversity Science and Ecological Engineering Institute of Biodiversity Science School of Life Sciences, Fudan University Shanghai, China  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The maturation of skin microbial communities during childhood is important for the skin health of children and development of the immune system into adulthood. This necessitates a better characterization of the environmental and genetic factors influencing these microbiome dynamics. We investigated the skin microbiota of children (158 subjects between 1 and 10 years old) and their mothers using 16S rRNA gene amplicon sequencing. Sample location and age were the primary factors determining a child’s skin bacterial composition. Relative abundances of Streptococcus and Granulicatella were negatively correlated with age, and the alpha diversity at all body sites examined increased during the first 10 years of life, especially on the face. The facial bacterial composition of 10-year-old children was strongly associated with delivery mode at birth.  (more…)
Author Interviews, Cancer Research, Dermatology / 14.08.2019

MedicalResearch.com Interview with: Dr Alessia Visconti, PhD Department of Twin Research King's College London, London MedicalResearch.com: What is the background for this study? Response: We know from previous studies that the body site where melanoma skin cancer develops varies according to sex, with men having melanoma more often on the head, neck, and trunk, and women on the legs. The body site where moles, a major risk factor for melanoma development, are more abundant also varies according to sex, at least in childhood, with boys having more moles on the head, neck, and trunk, and girls on the legs. (more…)
Author Interviews, JAMA, Mayo Clinic, Pancreatic, USPSTF / 14.08.2019

MedicalResearch.com Interview with: Dr. Chyke A. Doubeni, M.D., M.P.H. Dr. Doubeni is a family physician and The inaugural director of the Mayo Clinic Center for Health Equity and Community Engagement Research MedicalResearch.com: What is the background for this study? Response: The U.S. Preventive Services Task Force uses systematic review of existing research to make recommendations on clinical preventive services that are delivered in primary care, with the goal to promote and improve health for all Americans. Although pancreatic cancer is an uncommon condition in the general population, it is often deadly. Pancreatic cancer is now the third most common cause of cancer death in the United States, and could become the second leading cause if current trends continue. The vast majority of people with pancreatic cancer are diagnosed at a late stage and, unfortunately, even when caught early enough when surgery could be most effective, only a little over one-third of patients survive beyond five years. (more…)
Author Interviews, Blood Pressure - Hypertension, Duke, Heart Disease, JAMA, Race/Ethnic Diversity / 14.08.2019

MedicalResearch.com Interview with: Yuichiro Yano MD Assistant Professor in Family Medicine and Community Health Duke University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: African Americans are disproportionally affected by hypertension-related cardiovascular disease compared with other racial/ethnic groups in the United States and have higher blood pressure levels inside and outside the clinic than whites and Asians. However, little is known, among African Americans, regarding whether higher mean blood pressure measured outside of the clinic setting on 24-hour ambulatory blood pressure monitoring is associated with an increased risk for cardiovascular disease events, independent of blood pressure measured in the clinic setting. (more…)
Author Interviews, Heart Disease, JAMA, Pediatrics / 14.08.2019

MedicalResearch.com Interview with: Dr Juan Pablo Kaski MD(Res) FRCP FESC Director of the GOSH Centre for Inherited Cardiovascular Diseases Great Ormond Street Hospital, University College London Institute of Cardiovascular Science, London, UK  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Hypertrophic Cardiomyopathy?  Response: Hypertrophic cardiomyopathy (HCM) is a genetic condition characterised by abnormal thickening of the muscle of the heart and can affect people of all ages. It is associated with an increased risk of sudden cardiac death (SCD) and, in the last few years, a clinical risk tool that estimates the 5-year risk of SCD in adults with HCM has been developed. However, there are no similar risk models in children, where risk stratification has traditionally been based on clinical risk factors extrapolated from the adult population. We have recently shown that this approach does not discriminate risk well in children, and so the aim of this study was to develop a new risk tool to provide an individualised risk of SCD in children with HCM.  (more…)
Author Interviews, Cost of Health Care, Medicare / 14.08.2019

MedicalResearch.com Interview with: ABT-AssociatesMatthew Trombley, Ph.D. Associate/Scientist Abt Associates  MedicalResearch.com: What is the background for this study?   Response: CMS developed the Accountable Care Organization (ACO) Investment Model (AIM) as part of the Medicare Shared Savings Program (MSSP) to encourage the growth of ACOs in rural and underserved areas.  The goal of our study was to see if AIM ACOs could successfully decrease Medicare spending in these areas. (more…)
Accidents & Violence, Author Interviews, Geriatrics / 13.08.2019

MedicalResearch.com Interview with: XinQi Dong MD, MPH Henry Rutgers Distinguished Professor of Population Health Sciences Director of the Director of Institute for Health, Health Care Policy and Aging Research Rutgers University New Brunswick, NJ 08901XinQi Dong MD, MPH Henry Rutgers Distinguished Professor of Population Health Sciences Director of the Director of Institute for Health, Health Care Policy and Aging Research Rutgers University New Brunswick, NJ 08901  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study was done among community-dwelling US Chinese older adults aged 60 and above living in the greater Chicago area. The baseline cohort consisted of 3,157 participants, and we followed up with them from 2011 to 2017. There were heterogeneities in the associations between the strictness of definitions and subtypes of elder mistreatment (EM) and yearly mortality.   (more…)
Author Interviews, Environmental Risks, JAMA, NIH, Pulmonary Disease / 13.08.2019

MedicalResearch.com Interview with: Joel Kaufman, MD, MPH, Professor   Environmental & Occupational Health Sciences, Medicine, and Epidemiology University of Washington  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Increasingly, it is recognized that chronic lung diseases like emphysema occur in nonsmokers and rates of these diseases are continuing to increase.  We really need to understand what’s causing chronic lung disease. Air pollutants are known to make disease worse in people with prior lung disease, but little is known about whether long-term exposure to air pollutants can cause chronic lung disease. We found that higher residential concentrations of air pollutants—especially ozone and traffic-related air pollutants—are associated with changes in the lung—emphysema-like changes in the lung.  The associations were strong and suggest that air pollution may be an important contributor to chronic lung disease.  (more…)
Author Interviews, Heart Disease, Nature, Nutrition / 13.08.2019

MedicalResearch.com Interview with: apple-flavenoidsNicola Bondonno PhD National Health and Medical Research Council Early Career Research Fellow School of Medical and Health Sciences Edith Cowan University Joondalup  Perth WA   MedicalResearch.com: What is the background for this study? Response: In an aging society, there could be a huge importance in appropriate evidence-based diets to reduce mortality risk. Therefore, our main question was ‘do diets high in flavonoids reduce the risk of all-cause and cause-specific mortality and is this relationship affected by lifestyle risk factors for early mortality’? In brief, this is the largest study of flavonoid intake and mortality outcomes to date. This population based cohort study was conducted in 56,048 men and women of the Danish Diet, Cancer, and Health Cohort, followed for 23 years, with estimated intakes of 219 individual flavonoid compounds. The results provide a clarity not seen in previous smaller, often underpowered studies.  (more…)
Annals Internal Medicine, Author Interviews, Race/Ethnic Diversity, Weight Research / 13.08.2019

MedicalResearch.com Interview with: Jonathan Emberson, PhD Associate Professor (Medical Statistics and Epidemiology) Deputy Director of Graduate Studies Medical Research Council Population Health Research Unit Clinical Trial Service Unit & Epidemiological Studies Unit Nuffield Department Population Health University of Oxford    MedicalResearch.com: What is the background for this study? Response: Some previous studies had claimed that being overweight is not strongly associated with mortality in Hispanic populations (the ‘Hispanic paradox’). However, these studies had not accounted for the fact that while obesity makes diabetes and several other chronic diseases more common, these diseases may then result in substantial weight loss, thereby hiding the reason why those diseases arose in the first place.  (more…)
Author Interviews, Breast Cancer, JAMA, UCLA / 12.08.2019

MedicalResearch.com Interview with: Joann G. Elmore, MD, MPH Professor of Medicine, Director of the UCLA National Clinician Scholars Program David Geffen School of Medicine at UCLA  MedicalResearch.com: What is the background for this study? What are the main findings?
  • A pathologist makes the diagnosis of breast cancer versus non-cancer after reviewing the biopsy specimen. Breast biopsies are performed on millions of women each year and It is critical to get a correct diagnosis so that we can guide patients to the most effective treatments.
  • Our prior work (Elmore et al. 2015 JAMA) found significant levels of disagreement among pathologists when they interpreted the same breast biopsy specimen. We also found that pathologists would disagree with their own interpretations of breast biopsies when they where shown the same biopsy specimen a year later.
  • In this study, 240 breast biopsy images were fed into a computer, training it to recognize patterns associated with several types of breast lesions, ranging from benign (noncancerous) to invasive breast cancer. We compared the computer readings to independent diagnoses made by 87 practicing U.S. pathologists and found that while our artificial intelligence program came close to performing as well as human doctors in differentiating cancer from non-cancer, the AI program outperformed doctors when differentiating ductal carcinoma in situ (DCIS) from atypia, which is considered the greatest diagnostic challenge.
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Author Interviews, Cost of Health Care / 12.08.2019

MedicalResearch.com Interview with: Erin L. Duffy, PhD, MPH Adjunct Policy Researcher RAND  MedicalResearch.com: What is the background for this study?   Response: A patient treated at a hospital in his or her insurer’s network may be involuntarily treated by out-of-network (OON) physicians. In these cases, the OON physician can seek to collect full billed charges from the patient’s insurer and, if the insurer does not pay the full amount, the physician can bill the patient for the remaining balance. These unexpected bills from out-of-network physicians are known as “surprise medical bills” and most result from anesthesiology, radiology, and pathology services. California implemented a comprehensive policy (AB-72) addressing surprise medical billing for out-of-network nonemergency physician services at in-network hospitals in 2017 for patients in fully-insured health plans. AB-72 limits patients’ cost sharing to in-network levels, unless patients provide written consent to billing 24 hours in advance of services. Insurers and health plans pay out-of-network physicians at in-network hospitals the greater of the payer’s local average contracted rate or 125% of Medicare’s fee-for-service reimbursement rate.  (more…)
Author Interviews, Race/Ethnic Diversity, Sleep Disorders, Tobacco / 12.08.2019

MedicalResearch.com Interview with: Christine Spadola, M.S., LMHC, Ph.D. Assistant Professor Florida Atlantic University Phyllis and Harvey Sandler School of Social Work Boca Raton, FL 33431-0991 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Short sleep duration and sleep fragmentation are associated with adverse health outcomes including cardiovascular disease, diabetes, hypertension, certain cancers, and mental health challenges such as depression and anxiety. Avoiding the use of alcohol, caffeine, and nicotine close to bedtime represent modifiable behaviors that can improve sleep. Nonetheless, among community dwelling adults (e.g., adults in their natural bedroom environment as opposed to research laboratories) and specifically African Americans, there is a lack of longitudinal research investigating the use of these substances and the associations with objective measures of sleep.. (more…)
Author Interviews, Diabetes, JAMA / 12.08.2019

MedicalResearch.com Interview with: Pooyan Kazemian, Ph.D. Instructor in Medicine Massachusetts General Hospital  MedicalResearch.com: What is the background for this study? Response: Advances in diabetes care can meaningfully improve outcomes only if they effectively reach the populations at risk. However, it is not known if recent innovations in diabetes treatment and care models have reached the United States population at risk. (more…)
Author Interviews, Heart Disease, Pharmaceutical Companies, Stem Cells, Technology / 12.08.2019

MedicalResearch.com Interview with: Misti Ushio, Ph.D. Chief Executive Officer Michael Graziano, PhD Chief Scientific Officer TARA Biosystem MedicalResearch.com: What is the background for this study? Response: Almost half of all drug recalls are due to cardiac toxicity that was not picked up during early screens. These human cardiac liabilities can go undetected because historically it has been challenging to predict how human hearts will respond to potentially cardiotoxic drugs despite rigorous testing in both animals and in vitro systems throughout drug development. Traditional in vitro systems and animal models do not translate well to humans, and human donor tissue availability is limited for in vitro testing. There is great potential for human-induced pluripotent stem cell cardiomyocytes (iPSC-CMs) to bridge this human translation gap, but it’s been a challenge to train these cells to recapitulate pharmacology seen in mature human heart cells. This stems from the fact that existing experimental models utilize immature human iPSC-CMs which lack relevant physiological hallmarks of adult human cardiac muscle and therefore fail to predict drug responses seen in the clinic. (more…)
Author Interviews, Orthopedics, PLoS / 12.08.2019

MedicalResearch.com Interview with: Prof. Inger Mechlenburg, PhD, DMSc Orthopaedic Department, Aarhus University Hospital Department of Clinical Medicine Aarhus University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Traditionally, displaced 2-part humerus fractures have been operatively treated using a metal plate and screws. However, there are no studies showing a benefit of operation of those fractures. Therefore, we were interested in investigating, in a direct comparison between operation and non-operative treatment, whether there was a difference in patient-reported function, pain and health-related quality of life two years after the fracture. In this Nordic research collaboration http://nitep.eu/en/ between Finland, Sweden, Estonia and Denmark we showed that there is no difference in functional results between operative and non-operative treatment in persons aged 60 or more with displaced proximal humerus fractures. In the study, only fractures with a significant displacement between bone fragments were included. In the non-operative treatment group, patients used a collar and cuff sling for three weeks and underwent instructed physiotherapy. (more…)
Author Interviews, Dermatology, Weight Research / 12.08.2019

MedicalResearch.com Interview with: Prof Ching-Chi Chi, MD, MMS, DPhil (Oxford) Department of Dermatology Chang Gung Memorial Hospital, Linkou Taiwan MedicalResearch.com: What is the background for this study?   Response: Psoriasis has been associated various inflammatory comorbidities including diabetes mellitus, coronary artery disease, etc. Moreover, obesity is prevalent among psoriasis patients and has been considered as an independent risk factor for occurrence and worsening of psoriasis by promoting systemic inflammation. Notably, body weight (BW) gain of psoriasis patients after biologics use has been observed. However, there are inconsistent reports on whether biological therapy relates to BW gain.  (more…)
Author Interviews, Genetic Research, Heart Disease / 11.08.2019

MedicalResearch.com Interview with: Ambry GeneticsNancy Niguidula, MS, DPH Doctorate in Public Health in Toxicology Ambry Genetics   MedicalResearch.com: What is the background for this study? Response: The clinical presentations of many inherited cardiovascular conditions overlap; thus, genetic testing may clarify diagnoses, help with risk stratification, facilitate appropriate clinical management decisions, and aid in identifying asymptomatic, at-risk relatives. A large number of professional societies have developed practice guidelines and recommendations for genetic testing of cardiovascular diseases. These include international and collaborative expert panels that establish genetic screening and treatment recommendations by drawing on evidence-based medicine. To further strengthen the clinical utility of cardiovascular genetic testing, the American College of Medical Genetics and Genomics (ACMG) published a guideline for 59 genes with clinical actionability that should be reported if found on whole exome sequencing, even when unrelated to the testing indication. (more…)
Author Interviews, Melanoma, Vaccine Studies / 11.08.2019

MedicalResearch.com Interview with: Prof. Ronit Satchi-Fainaro, PhD Head, Cancer Research and Nanomedicine Laboratory Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv 69978, Israel Prof. Helena Florindo, PhD Head, BioNanoSciences – iMed.ULisboa Faculty of Pharmacy, University of Lisbon Lisbon, Portugal    MedicalResearch.com: What are the main findings? Response: The war against cancer in general, and melanoma in particular, has advanced over the years through a variety of treatment modalities, such as surgery, chemotherapy, radiation therapy and immunotherapy. The immune checkpoint inhibitors brought a breakthrough solution for advanced melanoma patients, but only a low percentage of those respond to this therapy, developing resistance and being affected by severe side effects. Despite the success of several vaccines against viral diseases, this success has not been materialized yet against cancer. This study led by my lab at Tel Aviv University, and Helena Florindo’s lab at the University of Lisbon, describes the development of an effective nano-vaccine against melanoma, that also sensitizes the immune system to immunotherapies. This nano-vaccine prevented melanoma, and also led to remarkable tumor inhibition and prolonged survival in mice already affected by this disease.  (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Nature, Science / 11.08.2019

MedicalResearch.com Interview with: Adnan Hirad, PhD MD Candidate, Medical Scientist Training Program University of Rochester School of Medicine and Dentistry  MedicalResearch.com: What is the background for this study? Response: Concussion is defined based on the manifestation of observable signs and symptoms (e.g., dizziness, difficulty with concentration, loss of consciousness, inter alia). A non-concussive head injury is when someone hits their head but does not exhibit the signs and symptoms of concussion -- IE concussion is defined by observable signs, and sub-concussive is defined as sustaining  head impacts similar (in magnitude and mechanism) to those sustained with concussion without observable signs and/or symptoms. These hits are a problem not only in football, but also with IED/bomb blasts experienced during war and potentially rugby.  (more…)
Author Interviews, Circadian Rhythm, Heart Disease, JACC / 11.08.2019

MedicalResearch.com Interview with: Dr. Alan Cheng, MD MBA Vice President at Medtronic Clinical Research and Therapy Development, Cardiac Rhythm Management Medtronic, Minnesota 55112  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ventricular arrhythmias can be life threatening among patients with certain types of heart disease. While implantable cardioverter defibrillators (ICDs) have become the primary means in managing these events, we still don’t fully understand when ventricular arrhythmias occur and whether they are just random events that occur at any time of the day. We pooled patient-level data from 6 prospective studies of ICD recipients and leveraged the continuous monitoring features of the ICD to understand when ventricular arrhythmias occur. Across almost 4000 patients with almost 2 years average follow up from the time of implant, we saw that ventricular arrhythmias aren’t randomly distributed throughout the day. In fact, there is a predilection for these events to occur during normal waking hours as compared to the times of the day when most patients are asleep. Additionally, we found that across the year, the spring season had higher rates of arrhythmia occurrence when compared to summer. We didn’t observe any differences in arrhythmia occurrence by the days of the week or months of the year. This analysis is not the first to explore this question but it is the largest to date.  (more…)
Author Interviews, Dermatology / 11.08.2019

MedicalResearch.com Interview with: Hong Liang Tey MBBS, FRCP Head of Research Division and Senior Consultant, National Skin Centre, Singapore Adj Assoc Prof., Yong Loo Ling School of Medicine, National University of Singapore Asst Prof., Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore  MedicalResearch.com: What is the background for this study? We developed dissolving microneedles embedded with a medication, triamcinolone, as a novel treatment option for patients with keloids and evaluated its efficacy and safety in a clinical trial.  Background: Keloids are a common skin disorder and itch and pain afflicts up to 80% of patients. The first-line and typically the only treatment option is multiple repeated intra-lesional corticosteroid injections by dermatologists or specially-trained nurses. However, many patients are unable to undergo this treatment. Typically, such patients
  • Are unable to tolerate the pain of conventional intra-lesional injection, as keloids are inherently hypersensitive. The problem is exacerbated by the fact that repeated monthly injections are required to achieve a response. In addition, children cannot tolerate pain and cannot undergo such injections.
  • Have keloids on the mid facial region, where injection carries a risk of causing blindness.
  • Are unable to afford the time and cost of repeated travelling to see a dermatology doctor or nurse for the injections. These include patients residing or working overseas.
  • Have mid-sternum protrusive scars after cardiac arterial bypass surgery, and painful injections may trigger another heart attack.
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Author Interviews, Opiods, Pediatrics, Surgical Research / 09.08.2019

MedicalResearch.com Interview with: Kao-Ping Chua, M.D., Ph.D. Assistant Professor, Department of Pediatrics and Communicable Diseases Susan B. Meister Child Health Evaluation and Research Center University of Michigan Ann Arbor, Michigan MedicalResearch.com: What is the background for this study?   Response: Tonsillectomy is one of the most common surgeries performed in children. It is also one of the most common reasons children are prescribed opioids, even though randomized trials suggest that non-opioids like ibuprofen are equally effective for pain control. We were interested in understanding whether it is possible to safely reduce opioid exposure after tonsillectomy in children without increasing the risk of complications such as emergency department visits for uncontrolled throat pain, which could lead to dehydration. (more…)
Author Interviews, JAMA, Orthopedics, Pediatrics / 09.08.2019

MedicalResearch.com Interview with: Dr Ahmed Elhakeem PhD Senior Research Associate in Epidemiology University of Bristol MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that the denser (stronger) your bones are, the less likely they are to break (fracture). We also have reliable evidence that later maturing adolescents tend on average to have lower bone density than their earlier maturing peers. We wanted to find out how the timing of puberty might influence the development of bone density throughout adolescence and into early adult life. We did this by following up a large group of young people born in the early 90s around Bristol, UK that took part in a unique study (the Children of the 90s study) that included repeated density scans over a 15-year period from age ten to 25. We found that those later maturing adolescents that got their growth spurt at an older age tended to catch-up to some degree to their earlier maturing peers during puberty however, they continued on average to have lower bone density than average for several years into adulthood. (more…)
Author Interviews, CDC, Opiods / 09.08.2019

MedicalResearch.com Interview with: Gery P. Guy Jr., PhD, MPH Senior Health Economist Division of Unintentional Injury Prevention CDC  MedicalResearch.com: What is the background for this study? Response: In 2017, among the 70,237 drug overdose deaths in the United States, 47,600 (67.8%) involved prescription or illicit opioids. Distribution of the opioid receptor antagonist naloxone to reverse overdose is a key part of the public health response to the opioid overdose epidemic. The 2016 CDC Guideline for Prescribing Opioids for Chronic Pain recommended clinicians consider offering naloxone when overdose risk factors, such as history of overdose or opioid use disorder, higher opioid dosages, or concurrent benzodiazepine use, are present. However, recent analyses examining pharmacy-based naloxone dispensing are lacking. To address this gap and to inform future overdose prevention and response efforts, CDC examined trends and characteristics of naloxone dispensed from retail pharmacies at the national and county level in the United States. (more…)
Author Interviews, Macular Degeneration, Ophthalmology / 08.08.2019

MedicalResearch.com Interview with: Matthew Campbell, PhD Smurfit Institute of Genetics Trinity College Dublin Dublin MedicalResearch.com: What is the background for this study? What are the main findings? Response: Age related macular degeneration (AMD) is the most common form of central retinal blindness in the world. However the underlying causes and initiating factors for disease progression are still not clear. It is classically a disease of the outer retina, where cells called retinal pigment epithelial (RPE) cells degenerate. However, our findings suggest that some of the early initiating events that promote AMD progression are actually coming from the inner retina and more specifically the microvasculature of the inner retina. We discovered that a gene called claudin-5 appears to be regulated by a circadian rhythm that in turn can regulate what gets into and out of the retina on a daily basis. Dysregulating the levels of this component made the inner retinal blood vessels marginally leaky and promoted a pathology that was AMD-like in animal models.  We also showed that the blood vessels of the retina appear to be highly dynamic in human subjects and can appear leakier at different times of the day, likely a mechanism that allows for clearance and replenishment of material into and out of the retina.  It is this process we believe breaks down in early AMD.  (more…)
Author Interviews, Cost of Health Care, Medicare, UCLA / 08.08.2019

MedicalResearch.com Interview with: Auyon Siddiq PhD Assistant Professor/INFORMS Member Decisions, Operations & Technology Management UCLA Anderson School of Management MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Medicare Shared Savings Program (MSSP) was created under the Patient Protection and Affordable Care Act to control escalating Medicare spending by incentivizing providers to deliver healthcare more efficiently. Medicare providers that enroll in the MSSP earn bonus payments for reducing spending to below a risk-adjusted financial benchmark that depends on the provider's historical spending. To generate savings, a provider must invest to improve efficiency, which is a cost that is absorbed entirely by the provider under the current contract. This has proven to be challenging for the MSSP, with a majority of participating providers unable to generate savings due to the associated costs. This study presents a predictive analytics approach to redesigning the MSSP contract, with the goal of better aligning incentives and improving financial outcomes from the MSSP. We build our model from data containing the financial performance of providers enrolled in the MSSP, which together accounted for 7 million beneficiaries and over $70 billion in Medicare spending. (more…)