Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, JAMA, Nutrition / 07.05.2024

MedicalResearch.com Interview with: Marta Guasch-Ferré, PhD Associate Professor and Deputy Head of Section, Section of Epidemiology University of Copenhagen Group Leader, Novo Nordisk Foundation Center for Basic Metabolic Research Adjunct Associate Professor, Department of Nutrition Harvard TH Chan School of Public Health MedicalResearch.com: What is the background for this study? Response:  Olive oil is rich in monounsaturated fats and contains compounds with antioxidant activity that may play a protective role for the brain. Olive oil as part of a Mediterranean diet appears to have a beneficial effect against cognitive decline. Higher olive oil intake was previously associated with a lower risk of cardiovascular disease and mortality. But its association with dementia mortality was unknown. (more…)
Author Interviews, Brigham & Women's - Harvard, Mental Health Research, NIH / 19.04.2024

MedicalResearch.com Interview with: Sharon Dekel PhD Principal Investigator Director of the Postpartum Traumatic Stress Disorders Research Program Department of Psychiatry, Massachusetts General Hospital Department of Psychiatry, Harvard Medical School Boston, MA, 02114 MedicalResearch.com: What is the background for this study? Response: Maternal psychopathologies affect a significant number of American women and are the leading complications of childbirth and a significant contributor to maternal death. Maternal (physical) morbidity in the US remain the highest among all countries in the West, suggesting that some women will have a traumatic childbirth experience. The most common mental illness associated with trauma is posttraumatic stress disorder (PTSD). PTSD stemming from childbirth is estimated to affect 6% of delivering women (https://pubmed.ncbi.nlm.nih.gov/28443054/). In high-risk groups, for example women who have unscheduled Cesareans the rate is estimated at 20% or higher (https://pubmed.ncbi.nlm.nih.gov/31041603/.). Although we screen for postpartum depression in hospitals in the USA there is no screening for what we define as childbirth-related PTSD (CB-PTSD). The overarching goal of the Dekel Lab is to develop novel and patient-friendly screening tools to identify women with this disorder. As importantly traumatic childbirth disproportionality affects Black and Latina women (https://pubmed.ncbi.nlm.nih.gov/35598158/). (more…)
Author Interviews, Brigham & Women's - Harvard, Infections, JAMA, Multiple Sclerosis, Neurological Disorders / 19.03.2024

MedicalResearch.com Interview with: Marianna Cortese, MD, PhD Senior Research ScientistDepartment of Nutrition Harvard T.H. Chan School of Public HealthBoston, MA 02115   MedicalResearch.com: What is the background for this study? Response: In a study published in Science in 2022, we reported compelling evidence that infection with the Epstein-Barr virus is the leading cause of Multiple Sclerosis. This is a follow-up study to investigate more in depth whether the antibody response to EBV is distinct in individuals with MS compared to individuals without MS and whether there is a part of EBV that the immune response is particularly targeting. For this purpose we assessed the immune response to all protein parts (peptides) of EBV and their association with MS. Previous studies could only look at parts of EBV and this is the first study looking at all EBV peptides. Antibodies to EBV (especially to a protein called EBNA1) are known to be overall higher in individuals with MS, so we also tested whether immune response overall or the immune response to specific EBV protein parts was more important. If the immune response to a specific EBV protein part (peptide) would be standing out or distinguishing individuals with MS, we hypothesized, it could point to a specific mechanism of how EBV may cause MS, i.e. it could point for example towards “molecular mimicry”, which is when antibodies targeting a pathogen start targeting a body-own structure (for example in the brain) which resembles the protein parts of the pathogen. (more…)
AHA Journals, Author Interviews, Biomarkers, Brigham & Women's - Harvard, Heart Disease / 27.02.2024

MedicalResearch.com Interview with: Rosangela Akemi Hoshi, Ph.D. Lemann Foundation Cardiovascular Research Postdoctoral Fellowship Center for Lipid Metabolomics Divisions of Preventive and Cardiovascular Medicine Brigham and Women's Hospital Boston, MA  MedicalResearch.com: What is the background for this study? Would you describe the IgG N-glycan profile? Response: Glycans are sugar coatings of proteins, made of monosaccharide building blocks, that are involved in a variety of biological pathways.  Different sugar structures can dictate or modify the protein’s activity through specific interactions with cellular receptors. For example, proteins lacking glycans have a reduced level or a complete loss of function. Glycans are of such importance that the 2022 Nobel Prize in chemistry was awarded for glycan-based science. In this study, we examined glycans attached to Immunoglobulins G (IgG) and their link with incidence of cardiovascular disease (CVD) due to their impact on IgG inflammatory properties. Since inflammation is not only a cause, but also an aggravating factor and a mediator of a worse prognosis in cardiometabolic disorders and CVD, we investigated whether different glycan structures may characterize an at-risk phenotype for CVD development. Determining glycan profiles involved in multiple conditions can serve prognostic and diagnostic purposes. Yet, unlike other types of macromolecules, glycans are still not as much explored, characterizing a promising but underappreciated class that should be further investigated. (more…)
Author Interviews, Brigham & Women's - Harvard, Genetic Research, Hearing Loss, Lancet, Pediatrics / 29.01.2024

MedicalResearch.com Interview with: Zheng-Yi Chen, D.Phil. Department of Otolaryngology-Head and Neck Surger Harvard Medical School Boston, MA MedicalResearch.com: What is the background for this study?  Would you briefly explain the process and indication Response: This clinical trial is to use gene therapy to treat a type of genetic hearing loss. Genetic hearing loss mainly affects children. One in 600 newborns can have genetic hearing loss. There is no drug treatment for any type of hearing loss except for cochlear implants, which have limitations. This study focuses on a type of genetic hearing loss, DFNB9, due to a missing gene called Otoferlin. Without Otoferlin,  children are born with complete hearing loss and without the capacity to speak. The goal of the trial is to study if gene therapy is safe and efficacious in treating children so they can regain hearing and the ability to speak. (more…)
Author Interviews, Brain Injury, Brigham & Women's - Harvard, Inflammation / 14.01.2024

MedicalResearch.com Interview with: Samir Mitragotri Ph.D. Hiller Professor of Bioengineering Hansjorg Wyss Professor of Biologically Inspired Engineering Area Chair, Bioengineering Core Faculty Member, Wyss Institute for Biologically Inspired Engineering Harvard John A. Paulson School Of Engineering And Applied Sciences MedicalResearch.com: What is the background for this study? Response: Traumatic brain injury (TBI) has a heavy burden on the world, affecting ~70 million people globally each year. Despite its prevalence, there are no clinically approved treatments beyond symptom management. There is an urgent need to develop effective therapies to alleviate the damage caused by TBI.   MedicalResearch.com:  What do macrophages typically do?  As part of the innate immune system, macrophages migrate to areas of injury to eat pathogens or debris and manage inflammation in response to injury or infection. However, in the majority of cases of TBI, there is no actual infection from a foreign pathogen, leading to excessive inflammation that spreads damage beyond the initial impact. (more…)
Author Interviews, Brigham & Women's - Harvard, Dental Research, JAMA, Respiratory / 18.12.2023

MedicalResearch.com Interview with: Michael Klompas MD, MPH, FIDSA, FSHEA Hospital Epidemiologist Brigham and Women’s Hospital Professor of Medicine and Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute MedicalResearch.com: What is the background for this study? Can teeth be safely brush in patients who are comatose, intubated or have NG tubes? Response: Pneumonia is thought to occur when secretions from the mouth get into the lungs.  Since there are many microbes in the mouth, there’s a risk that secretions from the mouth that get into the lungs will lead to pneumonia.  Toothbrushing may lower this risk by decreasing the quantity of microbes in the mouth. It is indeed safe and appropriate to brush the teeth of someone who is comatose, intubated, or who has an NG tube.  Indeed, our study found that the benefits of toothbrushing were clearest for patients receiving mechanical ventilation. (more…)
Author Interviews, Brigham & Women's - Harvard, Lancet, Pediatrics, Vitamin D / 05.12.2023

MedicalResearch.com Interview with: Dr Ganmaa Davaasambuu MD PhD Associate Professor Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: The crucial role of vitamin D in facilitating calcium absorption from the diet and promoting calcium deposition in bones (known as 'mineralization') has been a long-established understanding. Furthermore, some observational studies have reported an association between low vitamin D levels and a heightened risk of bone fractures in children. This raised the possibility that vitamin D supplements could potentially play a role in decreasing fracture risk in children with initially low baseline levels. However, clinical trials assessing the causal link between low vitamin D status and reduced fracture risk were necessary, and such trials had not been conducted before. (more…)
Author Interviews, Brigham & Women's - Harvard, Gastrointestinal Disease, Obstructive Sleep Apnea, Technology / 18.11.2023

MedicalResearch.com Interview with: Giovanni Traverso MD PhD Karl Van Tassel (1925) Career Development Professor Department of Mechanical Engineering Koch Institute of Integrative Cancer Research Division of Gastroenterology Brigham and Women’s Hospital Harvard Medical School, Boston, MA, USA   MedicalResearch.com: What is the background for this study? Response: I think its always important to acknowledge that this is a big team effort.  We have the teams from MIT, Celero Systems, West Virgnia University (WVU) and Brigham and Women’s Hospital (BWH) all working together on this.   For this study, Celero prototyped the devices that we tested in pre-clinical (Swine) models and in a first-in-human study with the team at WVU. Our lab focuses on the development of ingestible devices for drug delivery and sensing and these have informed the development of these efforts as you can see. MedicalResearch.com: What types of vital signs are measurable in this fashion? Response: Heart rate and respiratory rate. (more…)
Author Interviews, Brigham & Women's - Harvard, Endocrinology, Fertility, Lancet, OBGYNE / 25.07.2023

MedicalResearch.com Interview with: Raymond M. Anchan, MD, Ph.D. Director, Stem Cell Biology and Regenerative Medicine Research Laboratory Assistant Professor, Harvard Medical School Obstetrics/Gynecology Center for Infertility and Reproductive Surgery Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: As a reproductive endocrinologist, I have the privilege of caring for patients who unfortunately experience premature ovarian insufficiency- Some of these patients are as young as 17 yo. Additionally, a significant number of patients over the years have been reproductive age women who have breast cancer and ovarian failure from chemotherapy.  These patients have been my inspiration to try to find a treatment for them.  Since my earlier days as a neurobiologist and stem cell scientist, it was a natural course for me to seek cell-based therapies that are patient specific using autologous iPSCs. (more…)
Author Interviews, Biomarkers, Brigham & Women's - Harvard, Diabetes, Endocrinology / 26.06.2023

MedicalResearch.com Interview with: Dr. Bita Zahedi MD MA Endocrinologist Massachusetts General Hospital MedicalResearch.com: What is the background for this study? Response: The purpose of this study was to develop and validate a measure of dietary advanced glycation end-products (AGEs) to investigate the role of dietary AGEs in diabetic disease processes.  AGEs are a group of highly reactive compounds involved in the pathophysiology of diabetic complications, such as microvascular disease, cardiomyopathy, and possibly bone health. AGEs form through a nonenzymatic reaction between reducing sugars and free amino groups of proteins, lipids, and nucleic acids, also known as a Maillard or browning reaction. Endogenous AGE formation and accumulation is a normal part of metabolism and aging, however the process of glycation can be enhanced by hyperglycemia, hyperlipidemia, and increased oxidative stress. Additionally, AGEs can be absorbed from exogenous sources via consumption of various food items. Prior studies demonstrate that skin AGEs are predictive of Dietary AGEs (dAGEs) which are naturally present in certain uncooked foods, mainly animal-derived products, furthermore the method of food preparation can result in significant AGE formation. Considering the ubiquitous intake of dAGEs, it is possible that the consumption of exogenous AGEs contribute to AGE-induced oxidative stress, inflammation, and its subsequent detrimental sequalae. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, Ophthalmology / 16.06.2023

MedicalResearch.com Interview with: Ali Hafezi-Moghadam, Ph.D., M.D Director, Molecular Biomarkers Nano-Imaging Laboratory (MBNI) Associate Professor of Radiology, Harvard Medical School Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? Response: “It is very easy to answer many fundamental biological questions” said Richard Feynman in his 1959 address, where he also offered his simple and ingenious solution: “you just look at the thing!”[1]. As a biologist, I am familiar with the challenges surrounding looking at things in the context of life. There is no single device or technology that lets me simply see the answers to my questions. How does diabetes harm the tissues in the body? When exactly does the pathology start and which molecules and cells are involved? Trying to answer these questions, I have spent the past two decades innovating new ways of quantifying expression of molecules in the living organism [2]. At the same time to study diabetes, we needed a realistic rodent model that mirrors the human disease. In collaboration with KC Hayes[3], we first introduced the Nile grass rat (NGR, Arvicanthis niloticus), a gerbil that recapitulates the main features of the human type 2 diabetes [4]. For visualization of early changes, the eye offers a unique site. Much of my lab’s work focused on the first effects of diabetes in the retina, the site of the neurons that perceive light in the back of the eye [5], [6], [7]. In recent studies, we focused on how diabetes affects the lens in the eye of our animals [8], [9]. Diabetes is a major risk factor for cataract formation, a condition during which the lens loses its original transparency to visible light. How diabetic cataracts are formed is not well understood. A popular and prevailing theory, termed “sugar cataracts”, has been around for over half a century. According to the sugar hypothesis of cataracts, the excess levels of the sugar molecule, glucose, in the lens are transformed through the polyol pathway into the sugar-alcohol sorbitol. The resulting osmotic dysbalance leads to swelling of the fiber cells and opacity of the lens. Even though the sugar hypothesis has never been proven, it was generally accepted and remained unchallenged for a very long time. That is where our latest experimental results became relevant. (more…)
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…)