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…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Surgical Research / 27.10.2021

MedicalResearch.com Interview with: Joel S. Weissman, PhD Deputy Director/Chief Scientific Officer Center for Surgery and Public Health Brigham and Women's Hospital/Harvard Medical School Professor of Surgery (Health Policy) Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Over time, the military health system has been shifting care for its soldiers and their families away from big military treatment facilities (MTFs), allowing soldiers and their families to get care from civilian hospitals.  But this has had an unintended consequence.  Unfortunately, it means that military surgeons are getting fewer cases, and they are worried about maintaining their skills as surgeons.  But some surgeries count more than others to help prepare the surgeon for battlefield casualties.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Cost of Health Care, JAMA / 20.10.2021

MedicalResearch.com Interview with: Anita Katharina Wagner, PharmD, MPH, DrPH Associate Professor of Population Medicine Director, Ethics Program, Point32Health (parent company of Harvard Pilgrim Health Care and Tufts Health Plan) Co-Director, HMS Fellowship in Health Policy and Insurance Research Co-Director, Center for Cancer Policy and Program Evaluation (CarPE) Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The expectation for new cancer drugs is that they help patients live better longer. Increasingly more cancer drugs are approved without documented quality of life or overall survival benefits.   At the same time, cancer drug prices are rising.  We studied use of and spending on selected new cancer drugs among patients with employer-sponsored health insurance. We found that among 37348 patients who received one or more of 44 oral targeted cancer drugs, the proportion of patients who received a drug without documented overall survival benefit increased from 13% in 2011 to 59% in 2018.  By 2018, spending on drugs without documented overall survival benefit accounted for 52% of the $3.5 million spend on the 44 drugs since 2011. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Stroke / 30.09.2021

MedicalResearch.com Interview with: Daniel E. Singer, MD Professor of Medicine, Harvard Medical School Professor in the Department of Epidemiology Harvard T.H. Chan School of Public Health Division of General Internal Medicine Massachusetts General Hospital Boston, MA, 02114 MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) raises the risk of ischemic stroke 4-5-fold and this risk is largely reversible by oral anticoagulants (OAC). These facts are part of the core knowledge of internal medicine and the basis of multiple guidelines. They are based on studies of patients with persistent or predominantly “heavy burden” paroxysmal AF completed in the 1990s. More recent studies using cardiac implantable devices (CIEDs: implantable defibrillators, pacemakers, etc) which have the capacity to monitor heart rhythm continuously have found that many older patients have brief, often undiagnosed, episodes of AF. Several of these studies have found that strokes occur during periods of sinus rhythm temporally distant from a preceding episode of AF. This has led to a widespread suspicion that AF is not a direct causal risk factor but a risk “marker” indicating the presence of other truly causal features like a diseased left atrium (atrial myopathy). If the risk marker hypothesis is correct, then long-term anticoagulation is needed even for brief and rare episodes of AF (assuming the patient’ s CHA2DS2-VASc score is high enough). The key problem with prior prospective studies using CIEDs was that only a small number of strokes were observed leading to inadequate statistical power. Our study addressed this power problem by linking the very large Optum electronic health record database which could identify ischemic strokes with the Medtronic CareLink database of long-term, continuous heart rhythm records of patients with CIEDs. We ended up studying 891 individuals who had an ischemic stroke and had 120 days of continuous heart monitoring prior to the stroke. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Kidney Disease, Transplantation / 27.09.2021

MedicalResearch.com Interview with: Joel T. Adler, MD, MPH Department of Surgery, Brigham and Women’s Hospital Center for Surgery and Public Health Brigham and Women’s Hospital Boston, Massachusetts  MedicalResearch.com: What is the background for this study? Response: For patients who require renal replacement therapy for failed kidneys, kidney transplantation increased length of life and improves quality of life.  For many of these patients, their dialysis centers are the source of referral for evaluation for transplantation.  These dialysis centers have a number of publicly-reported quality measures, but they largely focus on the provision of dialysis care and not how often the centers’ patients undergo a kidney transplant.  Because these higher-rated facilities provide better dialysis care, we wanted to know if that benefit also spilled over into higher transplant listing rates. (more…)
Anesthesiology, Author Interviews, Brigham & Women's - Harvard, Opiods, Surgical Research / 21.09.2021

MedicalResearch.com Interview with: Andres Zorrilla Vaca, MD Resident Physician Brigham and Women’s Hospital Boston, Massachusetts  MedicalResearch.com: What is the background for this study? Response: The background for this study was Enhanced Recovery After Surgery, also known as ERAS protocols. They basically consisted of a bundle of interventions that are performed preoperatively, intraoperatively and postoperatively with the aim of enhancing patient recovery and reducing complications. This protocol in our institution started with a thorough preoperative counseling which includes, smoking cessation, pain and analgesia education, ERAS program expectations, pulmonary rehabilitation based on pulmonary function tests and incentive spirometry. On the day of surgery, prolonged fasting is avoided and a carbohydrate loading is given orally 2 hours before surgery. Our protocol also included a standardized multimodal analgesic regimen consisting of tramadol ER 300mg p.o. and gabapentin 300mg p.o., intraoperative acetaminophen 1gm i.v., posterior intercostal nerve blockade with liposomal bupivacaine 266mg prior to incision, intraoperative 30mg ketorolac upon wound closure and scheduled postoperative acetaminophen 1g p.o. q 6hrs and ketorolac 15mg i.v. q 6 hrs, as well as additonal interventions recommended by ERAS Society Guidelines. As a general rule, preoperative sedatives (midazolam) are avoided as premedication and prophylaxis against nausea and vomiting (ondansetron, dexamethasone and scopolamine) is administered. Patients are kept euvolemic by using validated goal-directed fluid therapy algorithms (stroke volume variation and cardiac output) and normothermia is maintained throughout the procedure. (more…)
Asthma, Author Interviews, Brigham & Women's - Harvard, Circadian Rhythm, Occupational Health, PNAS, Pulmonary Disease, Sleep Disorders / 11.09.2021

MedicalResearch.com Interview with: Frank Scheer, PhD, MSc Professor and Director of the Medical Chronobiology Program Division of Sleep and Circadian Disorders Brigham and Women’s Hospital Steve Shea, PhD Professor and Director Oregon Institute of Occupational Health Sciences MedicalResearch.com: What is the background for this study? Response: For hundreds of years, people have observed that asthma severity often worsens in the nighttime. As many as 75 percent of people with asthma—20 million people in the U.S.—report experiencing worsening asthma severity at night. One longstanding question has been to what degree the body’s internal circadian clock—as opposed to behaviors, such as sleep and physical activities—contributes to worsening of asthma severity. Our research used long term intensive monitoring throughout two circadian protocols in dim light and without time cues to carefully isolate the influence of the circadian system from the other factors that are behavioral and environmental, including sleep. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, OBGYNE, Pediatrics, Weight Research / 28.08.2021

MedicalResearch.com Interview with: Emily Oken MD MPH Professor, Harvard Medical School Professor in the Department of Population Medicine Associate Director and Advisor, Oliver Wendell Holmes Society. Professor, Department of Nutrition, Harvard School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this study of over 11,000 mothers and children, we found that a mothers with higher weight in late pregnancy had children with poorer performance on tests of cognition and behavior in childhood and adolescence. The findings are consistent with results from studies in other populations around the world, as well as animal experiments.  This research suggests that maternal nutrition is important for child health over the long-term, and specifically provides support for mothers to try to achieve healthy weight and nutritional status during pregnancy. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Immunotherapy, Kidney Disease, NEJM / 18.08.2021

MedicalResearch.com Interview with: Toni K. Choueiri, MD Director, Lank Center for Genitourinary Oncology Director, Kidney Cancer Center Jerome and Nancy Kohlberg Chai Professor of Medicine, Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The standard of care for patients diagnosed with locoregional RCC is partial or total nephrectomy. Nearly half of patients will eventually experience disease recurrence following nephrectomy and no standard, globally approved adjuvant therapy options are currently available for this population. The phase 3 KEYNOTE-564 study met its primary objective of demonstrating a statistically significant and clinically meaningful improvement in disease-free survival with pembrolizumab vs placebo as adjuvant therapy for patients with RCC post nephrectomy, supporting pembrolizumab as a potential new standard of care for patients at high risk of disease recurrence following surgery. (more…)
Author Interviews, Brigham & Women's - Harvard, Electronic Records, JAMA, Pediatrics, Primary Care / 09.07.2021

MedicalResearch.com Interview with: Lisa Rotenstein, MD, MBA Assistant Medical Director Population Health and Faculty Wellbeing Department of Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Our previous work in JAMA Internal Medicine demonstrated significant differences in time spent on the electronic health record (EHR) by specialty, and specifically showed that primary care clinicians spent significantly more total and after-hours time on the EHR than surgical and medical specialty counterparts. Primary care clinicians spent twice as long as surgical colleagues on notes, and received more than twice as many messages from team-mates, five times as many patient messages, and fifteen times as many prescription messages each day. Given these findings, the heavy administrative burden placed on primary care clinicians, and previous data about burnout among primary care clinicians, we wanted to better understand differences in time spent on the EHR among the different types of primary care clinicians. (more…)
Author Interviews, Brigham & Women's - Harvard, Medical Imaging, Neurological Disorders / 02.07.2021

MedicalResearch.com Interview with: Michael Ferguson, PhD Instructor in Neurology | Harvard Medical School Lecturer on Neurospirituality | Harvard Divinity School Center for Brain Circuit Therapeutics Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? Response: Over 80% of the global population consider themselves religious with even more identifying as spiritual, but the neural substrates of spirituality and religiosity remain unresolved. MedicalResearch.com: What are the main findings? Where is this circuit located in the brain? What other effects does this circuit control or influence? Response: We found that brain lesions associated with self-reported spirituality map to a human brain circuit centered on the periaqueductal grey. (more…)
Author Interviews, Brigham & Women's - Harvard, Chocolate, Weight Research / 24.06.2021

MedicalResearch.com Interview with: Frank A. J. L. Scheer, PhD, MSc, Neuroscientist and Marta Garaulet, PhD, Visiting Scientist 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: We and others have shown that not only “what” but also “when” we eat relates to obesity and weight loss
  • Meal timing can influence circadian rhythms and eating a high energy and high sugar food, such as chocolate, either at night or in the morning may have a different effect on the circadian system, and consequently on body weight and metabolism.
  • Milk chocolate has a name for contributing to weight gain due to its high fat, sugar and caloric content. Chocolate eating habit has been associated with long-term weight gain especially in postmenopausal females who are particularly vulnerable to weight gain.
(more…)
Author Interviews, Brigham & Women's - Harvard, Primary Care, Surgical Research, Weight Research / 10.06.2021

MedicalResearch.com Interview with: Alexander Turchin, MD, MS Director of Informatics Research Division of Endocrinology, Diabetes and Hypertension Associate Professor of Medicine, Harvard Medical School Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: There is an epidemic of obesity in the U.S.: over 40% of adults are obese. Obesity causes numerous complications, ranging from heart attacks to cancer. Bariatric surgery is one of the most effective ways to treat obesity, but very few patients utilize it; it is unclear why.  (more…)
Author Interviews, Brigham & Women's - Harvard, Journal Clinical Oncology, Prostate Cancer, Radiation Therapy / 04.06.2021

MedicalResearch.com Interview with: Anthony D'Amico, MD, PhD Professor and Chief of Genitourinary Radiation Oncology Brigham and Women's Hospital and Dana-Farber Cancer Institute MedicalResearch.com: What is the background for this study? Response: 3 randomized trials published in Sept, 2020 in the Lancet and Lancet Oncology concluded that delivering radiation therapy (RT) after surgery for prostate cancer   when the PSA rises signaling recurrence (i.e. early salvage RT) as opposed to when the PSA is undetectable (i.e. adjuvant RT) did not compromise subsequent cancer progression. However these trials may have missed the benefit of adjuvant RT because a minority of men (9 to 17% of the study cohorts) were found to have adverse factors at prostatectomy which are associated with cancer progression and death from prostate cancer. Specifically, men with adverse pathology at prostatectomy comprise the vast majority of men who go on to die from prostate cancer and therefore have the most to gain from adjuvant RT. Yet, given the results of the 3 randomized trials many physicians are no longer offering adjuvant RT, even in men with adverse pathology at surgery. (more…)
Author Interviews, Brigham & Women's - Harvard, Clots - Coagulation, Hematology, Neurological Disorders, Pain Research / 22.05.2021

MedicalResearch.com Interview with: Daniel Chasman, PhD Pamela Rist, ScD, Yanjun Guo, MD, PhD Division of Preventative Medicine Brigham and Women’s Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been speculation in the field about relationships between coagulation and migraine susceptibility for some time, but previous research has been largely inconclusive. In this study, we leveraged Mendelian randomization, a mode of genetic analysis that can support or refute potential causal effects on a health outcome, to examine whether hemostatic factors may contribute to risk of MA. (more…)
Asthma, Author Interviews, Brigham & Women's - Harvard, Race/Ethnic Diversity / 09.05.2021

MedicalResearch.com Interview with: Justin Salciccioli, MBBS, MA Research Fellow in Medicine Elliot Israel, MD Professor of Medicine, Harvard Medical School Pulmonary and Critical Care, Rheumatology, Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Asthma attacks account for almost 50% of the cost of asthma care, which costs $80 billion each year in the United States. Asthma is more severe in African-American/Black and Hispanic/Latinx patients, with these groups having double the rates of attacks and hospitalizations as the general population. The PREPARE study is an ongoing national clinical trial for African American/Black and Hispanic/Latinx adults with moderate-to-severe asthma from different U.S. cities in which reporting of asthma control and asthma exacerbations was monitored entirely remotely. With the arrival of the Covid19 pandemic, several studies suggested that asthma exacerbations may have decreased during the pandemic. However, multiple reports have suggested people were avoiding health services because of the pandemic, making it difficult to tell whether exacerbations truly decreased or whether people were simply avoiding their doctors. This is the first study done to assess asthma exacerbations before and during the pandemic that is unlikely to be impacted by patient healthcare avoidance. (more…)
Author Interviews, Brigham & Women's - Harvard, Colon Cancer, Gastrointestinal Disease, Sugar / 06.05.2021

MedicalResearch.com Interview with: Jinhee Hur, PhD Research Fellow Department of Nutrition Harvard T.H. Chan School of Public Health Boston, MA 02115 MedicalResearch.com: What is the background for this study? Response: Early-onset colorectal cancer (EO-CRC, age <50 years at diagnosis) is rapidly rising in the US since the mid-1980s, with an unclear understanding of its etiology and contributors to the rise. Sugar-sweetened beverages (SSBs) exert adverse metabolic repercussions throughout the life course, including insulin resistance and inflammation. Higher SSB intake can induce obesity, which has been linked to risk of EO-CRC. A recent experimental study also suggests that high fructose corn syrup, a primary sweetener in SSBs, may promote colon tumor growth, independent of metabolic dysregulation. In the US, SSB consumption has dramatically increased during the 2nd half of the 20th century, and adolescents and young adults have been the heaviest SSB drinkers across all age groups. Thus, we expect SSBs may be an emerging risk factor for EO-CRC and likely contribute to the rising incidence of EO-CRC. (more…)