Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Gender Differences, JAMA, Menopause / 03.04.2023

MedicalResearch.com Interview with: Rachel Buckley, PhD Assistant Professor Department of Neurology Massachusetts General Hospital/Harvard Medical School MedicalResearch.com: What is the background for this study? Response: While a fair amount of studies have focused on the effects of menopause and hormone therapy on risk of dementia, far fewer studies have tested their association with the biology of Alzheimer’s disease, namely amyloid and tau. This is critical to know given that it still remains unclear what might be the driving mechanism of the menopause transition on risk for dementia. This is what our study set out to investigate. This study is one of the first to report a link between women’s age at menopause and tau in the brain, which we measured with positron emission tomography neuroimaging. We found that in multiple areas of the brain that tend to be most likely to show higher tau in women than men, women with earlier age at menopause and elevated levels of amyloid showed higher levels of tau than those who reported an average age at menopause (~50 years in the United States). Women who reported premature menopause (<40 years at menopause onset) exhibited a much higher risk of tau in the brain. This supports the notion that longer exposure to estrogen throughout life might be protective against Alzheimer’s disease. (more…)
Accidents & Violence, Aging, Author Interviews, BMJ, Brain Injury, Brigham & Women's - Harvard, Exercise - Fitness / 15.12.2022

MedicalResearch.com Interview with: Rachel Grashow PhD Research Scientist Department of Environmental Health Football Players Health Study at Harvard University Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Anecdotally, we heard from former NFL players that they felt older than their chronological age. At the same time, doctors and medical care providers treating former players also observed that players appeared clinically older in some health domains. These observations motivated us to ask:  despite superior fitness and success as young men, are football players experiencing early aging and living with illness and disability for more years than their non-football peers? (more…)
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, Emory, JAMA, Race/Ethnic Diversity / 29.11.2022

MedicalResearch.com Interview with: Chris A. Rees, MD, MPH Assistant Professor of Pediatrics and Emergency Medicine Research Director, Pediatric Emergency Medicine Fellowship Emory University School of Medicine Attending Physician, Children's Healthcare of Atlanta Pediatric Research Scientist, CHAMPS, U.S. Program Office  and Eric W. Fleegler, MD, MPH, FAAP Associate in Pediatrics, Division of Emergency Medicine Director Sedation Service Boston Children’s Hospital Assistant Professor of Pediatrics and Emergency Medicine Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Rates of firearm fatalities in the United States have reached a 28-year high. Yet, an understanding of the specific demographic groups who have been most affected, and where in the United States these fatalities have occurred, has not been clearly described in the past. (more…)
Aging, Author Interviews, Brigham & Women's - Harvard, Dermatology, Heart Disease, Herpes Viruses, Stroke / 23.11.2022

MedicalResearch.com Interview with:| Sharon G. Curhan, MD, ScM| Director, CHEARS: The Conservation of Hearing Study Channing Division of Network Medicine Department of Medicine Brigham and Women’s Hospital Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response:       Herpes zoster, commonly known as “shingles,” is a viral infection that often causes a painful rash. Shingles can occur anywhere on the head or body. Shingles is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox. After a person has chickenpox, the virus stays in their body for the rest of their life. Years and even decades later, the virus may reactivate as shingles. Almost all individuals age 50 years and older in the US have been infected with the varicella zoster virus and therefore they are at risk for shingles. About 1 in 3 people will develop shingles during their lifetime, and since age is a risk factor for shingles, this number may increase as the population ages. The risk is also higher among individuals of any age who are immunocompromised due to disease or treatment. A number of serious complications can occur when a person develops shingles, such as post-herpetic neuralgia (long-lasting pain), but there was limited information on whether there are other adverse long-term health implications of developing shingles. There is a growing body of evidence that links VZV, the virus that causes shingles, to vascular disease. VZV vasculopathy may cause damage to blood vessels and increase the risk of stroke or coronary heart disease. Although some previous studies showed a higher risk of stroke or heart attack around the time of the shingles infection, it was not known whether this higher risk persisted in the long term. Therefore, the question we aimed to address in this study was to investigate whether shingles is associated with higher long-term risk of stroke or coronary heart disease. To address this question, we conducted a prospective longitudinal study in 3 large US cohorts of >200,000 women and men, the Nurses’ Health Study (>79,000 women), the Nurses’ Health Study II (almost 94,000 women) and the Health Professionals Follow-Up Study (>31,000 men), without a prior history of stroke or coronary heart disease. We collected information on shingles, stroke and coronary heart disease on biennial questionnaires and confirmed the diagnoses with medical record review. We followed the participants for up to 16 years and evaluated whether those who had developed shingles were at higher risk for stroke or coronary heart disease years after the shingles episode. The outcomes we measured were incident stroke, incident coronary heart disease [defined as having a non-fatal or fatal myocardial infarction (heart attack) or a coronary revascularization procedure (CABG, coronary artery bypass graft or percutaneous transluminal coronary angioplasty)]. We also evaluated a combined outcome of cardiovascular disease, which included either stroke or coronary heart disease, whichever came first. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Nutrition, Occupational Health, Sleep Disorders / 09.11.2022

MedicalResearch.com Interview with: Zhilei Shan, MD, PhD Postdoctoral fellow on Nutritional Epidemiology Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Unhealthy sleep behaviors and sleep disturbances are associated with higher risk of multiple diseases and mortality. The current profiles of sleep habits and disturbances, particularly the differences between workdays and free days, are unknown in the contemporary US. MedicalResearch.com: What are the main findings? Response: In this nationally representative cross-sectional analysis with 9004 adults aged 20 years or older, differences in sleep patterns between workdays and free days were observed. The mean sleep duration was 7.59 hours on workdays and 8.24 hours on free days (difference, 0.65 hour). The mean sleep and wake times were at 11:02 PM and 6:41 AM, respectively, on workdays and 11:25 PM and 7:41 AM, respectively, on free days (differences, 0.23 hour for sleep time and 1.00 hour for wake time). With regard to sleep disturbances, 30.5% of adults experienced 1 hour or more of sleep debt,46.5% experienced 1 hour or more of social jet lag, 29.8% had trouble sleeping, and 27.2% experienced daytime sleepiness. (more…)
Author Interviews, Brigham & Women's - Harvard, Schizophrenia, Sleep Disorders / 18.10.2022

MedicalResearch.com Interview with: Michael J. Prerau, Ph.D. Assistant Professor of Medicine, Faculty, Division of Sleep Medicine Harvard Medical School Associate Neuroscientist and Director of the Neurophysiological Signal Processing Core Division of Sleep and Circadian Disorders Department of Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: The brain is highly active during sleep, which makes it an important, natural way to study neurological health and disease. Scientists typically study brain activity during sleep using the electroencephalogram, or EEG, which measures brainwaves at the scalp. Starting in the mid 1930s, the sleep EEG was first studied by looking at the traces of brainwaves drawn on a paper tape by a machine. Many important features of sleep are still based on what people almost a century ago could most easily observe in the complex waveform traces. Even the latest machine learning and signal processing algorithms for detecting sleep waveforms are judged against their ability to recreate human observation. In this study, the researchers asked: What can we learn if we expand our notion of sleep brainwaves beyond what was historically easy to identify by eye? (more…)
Author Interviews, Brigham & Women's - Harvard, Melatonin, Pediatrics, Sleep Disorders / 28.09.2022

MedicalResearch.com Interview with: Rebecca Robbins, Ph.D. Instructor in Medicine Associate Scientist, Division of Sleep and Circadian Disorders Investigator, Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Teens face myriad challenges to sleep, ranging from biological factors, including a preference for later bedtimes and increased need for sleep, to social factors, including social pressures and increased academic workloads, all limiting teenagers in their ability to keep a healthy sleep schedule. In a nationally representative sample, we explored the prevalence of another potential barrier to sleep among teens, which are a set of beliefs that are held in the population, yet are actual counter to scientific principles regarding sleep and circadian rhythms. (more…)
Aging, Author Interviews, Brigham & Women's - Harvard, Frailty, Geriatrics, JAMA / 22.09.2022

MedicalResearch.com Interview with: Ariela Orkaby, MD, MPH Geriatrics & Preventive Cardiology Associate Epidemiologist Division of Aging, Brigham and Women's Hospital Assistant Professor of Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? Response: As the population is living longer, there is increased risk of frailty and vulnerability. Frailty is defined as reduced physiological reserve and decreased ability to cope with even an acute stress. Up to half of adults over the age of 85 are living with frailty and preventative measures are greatly needed. We tested the effect of vitamin D and marine omega-3 fatty acid supplementation on the risk of developing frailty in healthy older adults in the US enrolled in the VITamin D and OmegA-3 TriaL (VITAL) trial. (more…)
Aging, Author Interviews, Brigham & Women's - Harvard, Frailty, Geriatrics, JAMA, Medical Research Centers, Supplements / 15.09.2022

MedicalResearch.com Interview with: Ariela Orkaby, MD, MPH Geriatrics & Preventive Cardiology Associate Epidemiologist Division of Aging, Brigham and Women's Hospital Assistant Professor of Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? Response: As the population is living longer, there is increased risk of frailty and vulnerability. Frailty is defined as reduced physiological reserve and decreased ability to cope with even an acute stress. Up to half of adults over the age of 85 are living with frailty and preventative measures are greatly needed. We tested the effect of vitamin D and marine omega-3 fatty acid supplementation on the risk of developing frailty in healthy older adults in the US enrolled in the VITamin D and OmegA-3 TriaL (VITAL) trial. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, JAMA, Lancet, Lung Cancer, Medical Imaging, Technology / 07.09.2022

MedicalResearch.com Interview with: Raymond H. Mak, MD Radiation Oncology Disease Center Leader for Thoracic Oncology Director of Patient Safety and QualityDirector of Clinical Innovation Associate Professor, Harvard Medical School Cancer - Radiation OncologyRadiation Oncology Department of Radiation Oncology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What is the algorithm detecting? Response: Lung cancer, the most common cancer worldwide is highly lethal, but can be treated and cured in some cases with radiation therapy.  Nearly half of lung cancer patients will eventually require some form of radiation therapy, but the planning for a course of radiation therapy currently entails manual, time-consuming, and resource-intensive work by highly trained physicians to segment (target) the cancerous tumors in the lungs and adjacent lymph nodes on three-dimensional images (CT scans). Prior studies have shown substantial variation in how expert clinicians delineate these targets, which can negatively impact outcomes and there is a projected shortage of skilled medical staff to perform these tasks worldwide as cancer rates increase. To address this critical gap, our team developed deep learning algorithms that can automatically target lung cancer in the lungs and adjacent lymph nodes from CT scans that are used for radiation therapy planning, and can be deployed in seconds. We trained these artificial intelligence (AI) algorithms using expert-segmented targets from over 700 cases and validated the performance in over 1300 patients in external datasets (including publicly available data from a national trial), benchmarked its performance against expert clinicians, and then further validated the clinical usefulness of the algorithm in human-AI collaboration experiments that measured accuracy, task speed, and end-user satisfaction. (more…)
Author Interviews, Brigham & Women's - Harvard, Endocrinology, Hip Fractures, NEJM, Osteoporosis, Vitamin D / 27.07.2022

MedicalResearch.com Interview with: Meryl S. LeBoff, MD Chief, Calcium and Bone SectionDirector of the Skeletal Health and Osteoporosis CenterDirector, Bone Density UnitDistinguished Chair in Skeletal Health and Osteoporosis Professor of Medicine, Harvard Medical School Endocrinology, Diabetes and HypertensionWomen's Health Brigham And Women's Hospital JoAnn E. Manson, MD, DrPH Professor, Epidemiology, Harvard T.H. Chan School Of Public Health Michael and Lee Bell Professor of Women's Health, Medicine, Harvard Medical School Chief, Preventive Medicine, Brigham And Women's Hospital Co-Director, Womens Health, Brigham And Women's Hospital   MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Osteoporosis is a major public health problem. Although supplemental vitamin D has been widely used to reduce the risk of fractures in the general population, studies of the effects of vitamin D on fractures, the most important bone health outcome, have been conflicting. Randomized controlled trials, the highest quality studies, from around the world have shown benefit, no effect, or even harm of supplemental vitamin D on risk of fractures. Some of the trials used bolus dosing, had small samples sizes or short study duration, and co-administered calcium. No large RCTS of this scale tested whether daily supplemental vitamin D (without co-administration with calcium) prevented fractures in the US population. To fill these knowledge gaps, we tested the hypothesis in this ancillary study to VITAL, whether daily supplemental vitamin D3 reduced the risk of incident total, non-spine and hip fractures in women and men in the US. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lung Cancer, Supplements, USPSTF / 30.06.2022

MedicalResearch.com Interview with: Michael J. Barry, M.D Director of the Informed Medical Decisions Program Health Decision Sciences Center Massachusetts General Hospital. Professor of medicine at Harvard Medical School Dr. Barry was appointed as Vice Chair of USPSTF in March 2021. He previously served as a member from January 2017 through December 2020.   MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: The Task Force looked at the use of vitamin and mineral supplementation specifically for the prevention of heart disease, stroke, and cancer. We found that there is not enough evidence to recommend for or against taking multivitamin supplements, nor the use of single or paired nutrient supplements, to prevent these conditions. However, we do know that you should not take vitamin E or beta-carotene for this purpose. (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus / 23.06.2022

MedicalResearch.com Interview with: SCOTT DRYDEN-PETERSON, MD Assistant Professor, Medicine, Harvard Medical School Research Affiliate, Immunology and Infectious Diseases Harvard T.H. Chan School Of Public Health Associate Physician, Medicine, Infectious Diseases Brigham And Women's Hospital Research Associate, Botswana Harvard AIDS Institute MedicalResearch.com:  What is the background for this study?  Response: The combination of the antiviral medicine nirmatrelvir and ritonavir (Paxlovid) which boosts antiviral levels was found to reduce the need for hospitalization by nearly 90% among unvaccinated people. Whether nirmatrelvir plus ritonavir can also help vaccinated people was uncertain. (more…)
Author Interviews, Brigham & Women's - Harvard, Neurology, Parkinson's / 21.06.2022

MedicalResearch.com Interview with: Vikram Khurana, MD, PhD Chief of the Division of Movement Disorders Department of Neurology Brigham and Harvard Medical School Principal investigator, Ann Romney Center for Neurologic Diseases at the Brigham MedicalResearch.com:  What is the background for this study?   Response: Proteins abnormally accumulate in brain cells (neurons and glial cells) in all neurodegenerative diseases. In Parkinson’s disease and related disorders, the key protein that accumulates and aggregates is called “alpha-synuclein.” Presumably, when a protein like alpha-synuclein abnormally folds and aggregates, the abnormal form of the protein can become toxic to the neuron, eventually leading to cell death. Equally, the protein may no longer be able to carry out its normal function. This begs the question – what does alpha synuclein actually do? Most evidence to date points to alpha-synuclein being involved in the transport of other proteins and chemicals around the cell, by closely associating with vesicles that are small circular containers enclosed by fat (“lipid) membranes. But alpha-synuclein is not just found associated with these vesicle membrane. It is found away from the membrane and it’s been unclear what it does there. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA / 09.06.2022

MedicalResearch.com Interview with: Benjamin N. Rome MD Instructor, Harvard Medical School Internal Medicine Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital MedicalResearch.com:  What is the background for this study? What are the main findings?  Response: Manufacturers of brand-name drugs are granted periods, free from direct competition, during which they can set and raise prices as they choose. We found that the prices for newly marketed brand-name drugs increased by 20% per year from 2008 to 2021. In 2020 and 2021, nearly half of new drugs were launched at a price greater than $150,000 per year, compared with 9% of drugs in 2008-2013. These dramatic trends are only partly explained by changes in the types of drugs coming to market. (more…)
Annals Internal Medicine, Author Interviews, Brigham & Women's - Harvard, Diabetes, Heart Disease / 07.06.2022

MedicalResearch.com Interview with: HoJin Shin, BPharm, PhD Postdoctoral Research Fellow Division of Pharmacoepidemiology and Pharmacoeconomics Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston, Massachusetts MedicalResearch.com:  What is the background for this study?  Response: The public health burden of cardiovascular disease has been increasing in people with diabetes along with the burden of diabetes itself.
  •  Cardiovascular disease affects approximately one-third of the population with type 2 diabetes and accounts for     50%–80% of their mortality
  • 1 in 10 people in the US has diabetes
Since 2008, the US FDA has recommended post-approval cardiovascular outcome trials to ensure the safety of new glucose-lowering drugs responding to this growing burden of cardiovascular disease in type 2 diabetes and the potential increase in cardiovascular risk with certain existing glucose-lowering drugs (e.g., rosiglitazone). Notably, SGLT-2i have demonstrated superiority to placebo in reducing the risk of cardiovascular events, including hospitalization for heart failure. Consequently, beginning in 2018, clinical guidelines in the US have recommended SGLT-2i as a preferred second-line treatment for patients with type 2 diabetes and cardiovascular disease. As the paradigm of second-line pharmacological treatment for type 2 diabetes has shifted to include the management of cardiovascular risk in addition to glycemic control, this further raised the question of whether SGLT-2i should be advanced to first-line treatment. Since 2019, SGLT-2i have been recommended as a first-line agent for patients with type 2 diabetes and cardiovascular disease by the European guidelines (the European Society of Cardiology and the European Association for the Study of Diabetes). In the absence of head-to-head RCTs, non-randomized studies using real-world data could provide information on whether SGLT-2i may have greater cardiovascular benefits over metformin more timely than randomized clinical trials among both patients with and without existing CVD. Therefore, we evaluated the risk for cardiovascular events among adults with T2D who initiated treatment with first-line SGLT-2i versus metformin in clinical practice. (more…)
Abuse and Neglect, Brigham & Women's - Harvard, Melatonin, Sleep Disorders / 24.05.2022

MedicalResearch.com Interview with: Jeanne Duffy, MBA, PhD Associate Professor of Medicine Division of Sleep and Circadian Disorders Harvard Medical School MedicalResearch.com:  What is the background for this study?  Response: Aging is associated with changes in sleep timing, quality and duration, and even older adults without chronic medical problems have shorter and more disrupted sleep than young adults. Many prescription sleep aids increase the risk of nighttime falls, have adverse effects on next‐day cognition, and are associated with increased mortality, and so are not recommended for long-term use in older adults. In previous studies, we and others have shown that melatonin, a hormone secreted at night, increases sleep duration in young adults but only when administered during the day when endogenous melatonin levels are low. We wanted to explore whether melatonin could improve the sleep of healthy adults and whether, like young adults, its impact depends on when during the day the person is trying to sleep. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Education, Health Care Systems, Sleep Disorders / 20.05.2022

MedicalResearch.com Interview with: Dr Matthew D Weaver M.P.H., Ph.D. Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women's Hospital Boston, Massachusetts MedicalResearch.com:  What is the background for this study?  Response: The name “resident” stems from the historical practice of resident-physicians residing in hospitals as part of their training. Even after that practice abated, it was common for resident physicians to work 36 consecutive hours followed by 12 or fewer hours of rest. In 1989, the state of New York restricted resident physicians to work no more than 24 consecutive hours and no more than 80 hours per week as part of collective intervention to improve patient safety. The Accreditation Council for Graduate Medical Education (ACGME) then followed in 2003 by limiting work hours to an average of 80 per week over a month and no more than 30 consecutive hours of work. Evidence accumulated demonstrating an association between shifts lasting ≥24 hours and adverse resident and patient safety. As a result, the Institute of Medicine convened a review and report on the issue, ultimately concluding that no resident should work more than 16 consecutive hours without sleep. This recommendation, combined with evidence following the 2003 rules, led the ACGME to issue new rules in 2011 that limited first-year resident physicians to work no more than 16 consecutive hours. Our study compares resident-reported patient safety outcomes before and after this 2011 policy change. (more…)
Author Interviews, Brigham & Women's - Harvard, Cognitive Issues, Exercise - Fitness / 23.04.2022

MedicalResearch.com Interview with: Robert A. Stern, Ph.D. Professor of Neurology, Neurosurgery, and Anatomy & Neurobiology Director of Clinical Research, BU CTE Center Senior Investigator, BU Alzheimer’s Disease Research Center Boston University School of Medicine MedicalResearch.com:  What is the background for this study?  Response: The link between playing American football at the professional level and later-life brain disorders like chronic traumatic encephalopathy – or CTE -- and ALS has received increasing attention over the past 15 years. Previous research has shown that former NFL players are more likely to die from CTE and amyotrophic lateral sclerosis (ALS) and more likely to report cognitive impairment, behavioral changes, and dementia during life. Despite previous research focusing on the later-life effects of playing American football at the professional level, the long-term effects of college football participation remain largely unknown. We had two goals for this new investigation. The first was to conduct a survey of the current overall health status, including cognitive and other neurological disorders, of older former college American football players compared with men in the general population. The second goal was to examine the mortality rate and causes of death in a cohort of older former college football players. The target population for this study was all 447 former Notre Dame football players who were listed as seniors on the varsity rosters during the 1964-1980 seasons. This was the era of legendary coaches Ara Parseghian and Dan Devine. I should add that this study was fully independent of the University of Notre Dame. (more…)
Aging, Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Genetic Research, Nature / 20.04.2022

MedicalResearch.com Interview with: Michael B. Miller, MD, PhD Instructor, Harvard Medical School Department of Pathology Brigham and Women's Hospital MedicalResearch.com:  What is the background for this study? Would you explain what is meant by somatic genetic changes and how they might occur?  Response: Changes, also called mutations, in the DNA sequence of genes can be passed from parents to their children, and explain why many diseases run in families. This kind of DNA change is called a germline mutation and is present in every cell in a person’s body. Gene mutations can also occur in a subset of cells of a person, in which case they are called somatic mutations. Somatic mutations are well known as a cause of cancer, and recent research has found that somatic mutations can also happen in non-cancerous cells that appear otherwise normal. Recent studies have even found that somatic mutations are present in neurons, cells in the brain that transmit electrical signals and play an important role in how the brain functions. Furthermore, in neurons, somatic mutations increase with age, so we set out to understand if somatic mutations might be playing a role in age-related brain diseases like Alzheimer’s. (more…)
Author Interviews, Brigham & Women's - Harvard, Fertility, Heart Disease, JACC / 19.04.2022

MedicalResearch.com Interview with: Emily Lau, MD, MPH Cardiologist Instructor in Medicine, Harvard Medical School Director, Menopause, Hormones & Cardiovascular Disease Clinic Massachusetts General Hospital MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Emerging data suggest that a woman’s reproductive history influences her future risk of heart disease. Infertility is a reproductive risk factor that affects ~14% of women but has not been rigorously studied with respect to its relationship with cardiovascular disease risk. We studied over 38,000 women enrolled in the Women’s Health Initiative and found that infertility was associated with greater risk of heart failure. In particular, we found that the association was driven by greater risk of heart failure with preserved ejection fraction, a form of heart failure that is far more common among women. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Genetic Research, Nature / 18.04.2022

MedicalResearch.com Interview with: Jason Vassy, MD, MPH Brigham and Women's Hospital Division of General Internal Medicine & Primary Care Brigham’s Precision Population Health at Ariadne Labs and VA Boston  MedicalResearch.com:  What is the background for this study?    Response: A person’s risk of developing diseases such as type 2 diabetes or breast cancer may be influenced by thousands of genetic differences, the effects of which can be combined to derive a single score, often called a polygenic risk score (PRS). PRS might be useful to help patients and their physicians make tailored decisions about their health care, but several challenges to the clinical implementation of PRS remain. Most importantly, most PRS are less accurate in individuals of non-European descent, since most genomic research to date has been conducted in European populations. Another key challenge is that physicians and patients will need support to understand polygenic risk score and use them to make medical decisions. Clinical guidelines do not yet exist to help a physician know whether and how they should treat a patient with a high-risk score differently than an average-risk patient. We designed the Genomic Medicine at VA (GenoVA) Study to address some of these challenges. (more…)
AACR, Author Interviews, Brigham & Women's - Harvard, Cancer Research / 18.04.2022

MedicalResearch.com Interview with: Ajit Johnson Nirmal PhD Instructor of Medicine, DFCI, HMS Laboratory of systems pharmacology Harvard Medical School MedicalResearch.com:  What is the background for this study?  Response: Like many other types of cancers, melanoma arises from gene mutations within cells that impact cell growth and division. These abnormal cells should be rapidly eliminated by our immune system, however, the failure to do so leads to the development of cancer. Hence researchers have long been interested to study the tumor environment that nurtures and sustains these dangerous cells. In the past, researchers have used single-cell technologies to delineate the cell types and cell states that make up the tumor microenvironment. However, the spatial relationships between these cell types and how they organize themselves such as to provide a favorable environment for the tumor to develop remains unknown. In the last couple of years, researchers have developed a new suite of new technologies called spatial omics which includes CYCIF a method that was developed at Sorger lab. Using this method, we can not only measure the molecular information of cells at a single cell level but also their spatial context. This allows us to build a google map like view of the skin with melanoma and study what is exactly happening that allows the tumors to develop. (more…)
Author Interviews, Brigham & Women's - Harvard, Neurology, Pain Research / 29.03.2022

MedicalResearch.com Interview with: William R. Renthal, MD, PhD Director of Research, John R. Graham Headache Center Department of Neurology Brigham and Women's Hospital Assistant Professor of Neurology, Harvard Medical School MedicalResearch.com:  What is the background for this study?  Response: We know that a nervous system structure called the trigeminal ganglion plays a critical role in migraine headache, but the cell types that exist in this structure are poorly understood. We have used cutting-edge, single-cell genomic technologies to profile the genes expressed within each trigeminal ganglion cell type in both human and mouse with the goal of identifying molecular features that could allow us to inhibit head pain selectively without affecting other cell types. (more…)
Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Sleep Disorders / 18.03.2022

MedicalResearch.com Interview with: Peng Li, Ph.D. Assistant Professor of Medicine, Harvard Medical School Research Director, Medical Biodynamics Program (MBP) Division of Sleep and Circadian Disorders Associate Physiologist, Brigham and Women's Hospital MedicalResearch.com:  What is the background for this study?  Response: People commonly see increased sleep during daytime in older adults. In people with Alzheimer’s disease or dementia, daytime drowsiness or sleepiness are even more common. Prior studies have showed protective effects of short naps on cognitive performance and alertness acutely, while also there are studies that have demonstrated more daytime naps are associated with faster cognitive decline in the long-term. We sought to investigate whether daytime napping behavior predicts future development of Alzheimer’s dementia. And we noted that there had been no studies to date that have documented the longitudinal profile of daytime napping during late life objectively. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Chocolate, Heart Disease, Supplements / 16.03.2022

MedicalResearch.com Interview with: Howard D. Sesso, ScD, MPH Associate Professor of Medicine Division of Preventive Medicine Brigham and Women's Hospital MedicalResearch.com:  What is the background for this study? How does the amount of flavanols in the study arm compare to what might be obtained in a typical diet? Response: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a randomized, double-blind, placebo-controlled clinical trial that tested the effects of two promising dietary supplements on cardiovascular disease (CVD) and cancer in 21,442 older adults. Cocoa flavanols have been shown to have favorable vascular effects in small and short-term clinical trials. The 500 mg/day flavanols tested in COSMOS exceeds that readily obtained in the diet typically from cocoa, tea, grapes, and berries. Of note, flavanol content in not typically listed on food labels. COSMOS also tested a multivitamin, the most common dietary supplement taken by US adults and previously linked with a potential modest reduction in cancer in a previous long-term trial of men conducted by our research group at the Division of Preventive Medicine at Brigham and Women’s Hospital. (more…)
Author Interviews, Brigham & Women's - Harvard, Infections, Multiple Sclerosis, Science / 15.01.2022

MedicalResearch.com Interview with: Kassandra L. Munger Sc.D. Senior Research Scientist Alberto Ascherio MD Dr.P.H. Professor of Epidemiology and Nutrition Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: An infectious cause of MS has been hypothesized for decades. Research over the past 20 years conducted by our group and others has strongly suggested a role for EBV infection including that EBV-negative individuals have a near zero risk of developing MS, having a history of infectious mononucleosis (caused by EBV infection) increases the risk of MS 2-fold, and healthy individuals have higher risks of MS with higher antibody levels against EBV antigens.  Ideally, to prove causality a randomized clinical controlled trial would be conducted; however, this not a feasible approach in this case. Given that nearly 95% of the adult population is infected with EBV and MS is a rare disease, we utilized the Department of Defense Serum Repository which stores over 60 million serum samples from over 10 million US Military active duty personnel. From this large resource, we were able to identify a cohort who were EBV negative when they joined the military and we followed them for whether they had a primary infection with EBV and then for who developed MS. (more…)
Author Interviews, Brigham & Women's - Harvard, Circadian Rhythm, Diabetes, Occupational Health, Science, Weight Research / 06.12.2021

MedicalResearch.com Interview with: Sarah L. Chellappa, MD PhD Medical Chronobiology Program Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women’s Hospital Division of Sleep Medicine, Harvard Medical School Boston, MA Department of Nuclear Medicine Faculty of Medicine and University Hospital Cologne University of Cologne, Cologne, Germany. Frank A.J.L. Scheer, M.Sc., Ph.D. Professor of Medicine. Medical Chronobiology Program Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women’s Hospital Division of Sleep Medicine, Harvard Medical School Boston, MA MedicalResearch.com: What is the background for this study? Would you explain the difference between the central circadian ‘clock’ and endogenous circadian glucose rhythms?  Response: Night work increases diabetes risk. This increased risk is not fully explained by differences in lifestyle, family history, and/or socioeconomic status, thus other mechanisms are likely involved. Laboratory studies in humans have shown glucose intolerance in both non-shift workers and shift workers exposed to simulated night work. Animal experimental data suggests that this may be in part due to a misalignment between central and peripheral rhythms. Central circadian rhythms (e.g., body temperature) are primarily modulated by the central circadian “clock”, which is located in the brain’s suprachiasmatic nucleus and is responsible for synchronizing our physiology and behavior with the 24-hour cycle. Peripheral rhythms, including endogenous circadian glucose rhythms, are likely modulated by peripheral “clocks” across the body that play an integral role in modulating the circadian expression of physiology, including metabolic functions. These central and peripheral clocks share a common molecular mechanism underlying their circadian rhythm generating capacity, including transcription-translation feedback loops of circadian “clock” genes.  (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, NEJM, Vaccine Studies / 02.12.2021

MedicalResearch.com Interview with: Dr. Barbra Dickerman, PhD CAUSALab investigator and instructor Department of Epidemiology Harvard T.H. Chan School of Public Health  MedicalResearch.com: What is the background for this study? Response: Early randomized trials showed that the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines were both remarkably effective at preventing symptomatic disease, when comparing each vaccine with no vaccine. However, head-to-head comparisons of these vaccines have been lacking, leaving open the question of which vaccine is more effective.  In this study, we analyzed the VA’s high-quality databases in a way that emulated the design of the hypothetical trial that would have answered this question. Specifically, we used the findings from the original trials to benchmark our methods and then extended them to provide novel evidence for the comparative effectiveness of these two vaccines in a real-world setting and across diverse subgroups and different time periods. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lipids / 16.11.2021

MedicalResearch.com Interview with: Nicholas A. Marston, MD, MPH Thrombolysis in Myocardial Infarction (TIMI) Study Group Brigham and Women’s Hospital Harvard Medical School Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: There has been recent debate about how much of lipid-associated cardiovascular risk is from LDL cholesterol versus triglycerides. However, genetic studies suggest that apolipoprotein B is actually the primary driver of atherosclerotic risk. Since there is exactly one apoB lipoprotein on each lipid particle (LDL, IDL, VLDL), its measurement is a surrgate for the total number of apoB-containing lipoproteins. So in this study, we asked the question: Do common measures of cholesterol concentration, triglyceride concentration, or their ratio carry predictive value for cardiovascular risk beyond the number of apo-B containing lipoproteins? (more…)