Author Interviews, Autism, Brigham & Women's - Harvard, Education, Pediatrics / 21.12.2020

MedicalResearch.com Interview with: Andrey Vyshedskiy PhD Boston University, Boston MedicalResearch.com: What is the background of ImagiRation? https://imagiration.com/ Response: ImagiRation is a Boston-based startup with links to MIT, Harvard, and Boston University. ImagiRation has developed a highly innovative adaptive language therapy application for children with autism, Mental Imagery Therapy for Autism (MITA). MedicalResearch.com: How is the Mental Imagery Therapy for Autism program delivered? Response: MITA language therapy is administered by parents at home. MITA application works on all smartphones and tablet devices and is designed for children ages 2 to 12 years. (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, End of Life Care / 14.12.2020

MedicalResearch.com Interview with: Isaac Chua, MD, MPH Division of General Internal Medicine and Primary Care Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Patient surveys have shown that most people prefer to die at home at the end-of-life. However, during the initial wave of the COVID-19 pandemic, anecdotal evidence from our colleagues and findings from a prior study published in the Journal of the American Geriatrics Society suggested that majority of COVID-19 decedents died in a medical facility. However, less is known about care intensity at the end-of-life according to place of death among patients who died of COVID-19. Therefore, we characterized end-of-life care by place of death among COVID-19 decedents at Mass General Brigham (MGB), the largest health system in Massachusetts.  (more…)
Author Interviews, BMC, Breast Cancer, Brigham & Women's - Harvard, Cancer Research, Diabetes, Nutrition / 10.12.2020

MedicalResearch.com Interview with: Tengteng Wang, PhD, MSPH, MBBS Postdoctoral Research Fellow Department of Epidemiology Harvard T.H. Chan School of Public Health Channing Division of Network Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Type 2 diabetes (T2D) has been associated with poor progression of breast cancer. Moreover, having a breast cancer diagnosis may also increase the risk of developing T2D. Therefore, identifying strategies for T2D prevention among breast cancer survivors may play a key role in improving their survival outcomes. One approach may be through a diabetes risk reduction diet (DRRD), a dietary pattern comprised of 9 components that has been associated with 40% lower T2D risk in a previous Nurses’ Health Study publication.1 However, no studies to date have evaluated the association between adherence to the DRRD (as measured by the DRRD score) and survival outcomes following breast cancer. In this prospective cohort study among 8,320 breast cancer survivors, we found that greater adherence to the diabetes risk reduction diet after diagnosis was associated with a statistically significant 31% lower risk of overall mortality. Reduced breast cancer-specific mortality was also observed, which was more pronounced (20% lower risk) among those who improved adherence after diagnosis compared to women with consistently low DRRD adherence before and after diagnosis. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Genetic Research, Melanoma, Prostate Cancer / 23.11.2020

MedicalResearch.com Interview with: Saud H AlDubayan, M.D. Instructor in Medicine, Harvard Medical School Attending Physician, Division of Genetics, Brigham and Women's Hospital Computational Biologist, Department of Medical Oncology, Dana-Farber Cancer Institute Associate Scientist, The Broad Institute of MIT and Harvard  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The overall goal of this study was to assess the performance of the standard method currently used to detect germline (inhered) genetic variants in cancer patients and whether we could use recent advances in machine learning techniques to further improve the detection rate of clinically relevant genetic alterations. To investigate this possibility, we performed a head to head comparison between the current gold-standard method for germline analysis that has been universally used in clinical and research laboratories and a new deep learning analysis approach using germline genetic data of thousands of patients with prostate cancer or melanoma. This analysis showed that across all different gene sets that were tested, the deep learning-based framework was able to identify additional cancer patients with clinically relevant germline variants that went undetected by the standard method. For example, several patients in our study also had germline variants that are associated with an increased risk of ovarian cancer, for which the surgical removal of the ovaries (at a certain age) is highly recommended. However, these genetic alterations were only identified by the proposed deep learning framework.     (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Fertility, OBGYNE / 19.11.2020

MedicalResearch.com Interview with: Jennifer Yland Doctoral Student in Epidemiology Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Worldwide, about 22% of reproductive-aged women used hormonal contraception last year. Long-acting reversible contraceptive (LARC) methods, which include intrauterine devices (IUDs), implants, patches, and injectable contraceptives, have become increasingly popular. However, little is known about the return to fertility after use of different contraceptives, particularly LARC methods. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Prostate Cancer, Social Issues / 18.11.2020

MedicalResearch.com Interview with: David-Dan Nguyen, MPH Research Fellow | Center for Surgery and Public Health Brigham and Women's Hospital Medical Student | McGill University  MedicalResearch.com: What is the background for this study? Response: In 2017, the US Preventive Services Task Force updated its recommendation for PSA screening for prostate cancer from a grade D to a grade C for men aged 55 to 69 years. This updated recommendation endorsed shared decision making and harmonizes with the guidelines of the American Urological Association and the American Cancer Society which also recommend shared decision making for PSA screening. Shared decision making is a meaningful dialogue between the physician and the patient that namely includes a review of risks and expected outcomes of screening as well as the patient’s preferences and values. Understandably, the patient’s ability to critically assess the medical information provided (i.e. their health literacy) likely influences this process. We sought to characterize the effect of health literacy on shared decision making for PSA screening. We used data from 2016 when PSA screening for prostate cancer was not recommended by the US Preventive Services Task Force — in other words, we also sought to understand how health literacy impacted screening rates in the context of countervailing guidelines on PSA screening. (more…)
Author Interviews, Brigham & Women's - Harvard, Dermatology, JAMA, McGill, Mental Health Research / 17.11.2020

Editor's note: This piece discusses suicide. If you have experienced suicidal thoughts or have lost someone to suicide and want to seek help, you can contact the Crisis Text Line by texting "START" to 741-741 or call the Suicide Prevention Lifeline at 800-273-8255.  MedicalResearch.com Interview with: David-Dan Nguyen, MPH Research Fellow | Center for Surgery and Public Health, Brigham and Women's Hospital Medical Student | McGill University MedicalResearch.com: What is the background for this study? Response: There is ongoing concern about the side-effects of finasteride, a drug used for the management of alopecia and benign prostatic hyperplasia. These concerns have led to the coining of the “post-finasteride syndrome” which remains controversial. Indeed, there is conflicting evidence on the post-finasteride syndrome/adverse events associated with finasteride. We wanted to contribute to this conflicting body of evidence by examining suicidality, depression, and anxiety reports linked to finasteride use using the WHO’s pharmacovigilance database, VigiBase. Such pharmacovigilance databases are useful for the study of rare adverse events that are suspected to be associated with medication use. (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus / 05.11.2020

MedicalResearch.com Interview with: Duane Wesemann, MD, PhD Div. of Rheumatology, Immunology and Allergy Brigham and Women's Hospital Boston, MA 02115 Wesemann Lab   MedicalResearch.com: What is the background for this study? Response: There is a lot of variability in how long antibodies to pathogens are produced in humans.  Some infections and vaccinations like measles induce high levels of antibodies that can be produced for a lifetime.  Other infections or vaccinations induce only short lived antibody responses. Also, some people make longer lasting antibodies compared to others.   We wanted to ask what the antibody durability dynamics looked like after COVID-19 and if we could tease out any insights—both with regard to COVID-19 as well as in general.  (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Occupational Health / 03.11.2020

MedicalResearch.com Interview with: Fan-Yun Lan, MD, MS PhD candidate in Population Health Sciences | Environmental Health Graduate School of Arts and Sciences & T.H. Chan School of Public Health Harvard University MedicalResearch.com: What is the background for this study? Response: Existing evidence has indicated that essential workers are heavily affected by the COVID-19 pandemic, as they are not able to benefit from mitigation policies. Their occupational exposures increase their own risk to SARS-CoV-2 infection, and increase the risk of secondary transmissions to their colleagues, families and communities. Research, however, has largely focused on healthcare workers with relatively limited literature investigating non-healthcare essential workers. (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Insomnia, Obstructive Sleep Apnea, Sleep Disorders / 29.10.2020

MedicalResearch.com Interview with: Salma Batool-Anwar, MBBS, MPH Instructor, Harvard Medical School Pulmonary and Critical Care, Sleep Medicine Brigham and Women's Faulkner Hospital MedicalResearch.com: What is the background for this study? Response: A well functioning sleep-wake cycle is vital to our health and prevention of chronic diseases. During previous disaters sleep disturbances have been reported. When Massachusetts governor declared a state of emergency in March’20, we hypothesized that sleep duration would be adversely affected by covid-19 related lockdown and stress. The study was approved by the institutional review board and information was collected retrospectively using the electronic medical records.  (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lifestyle & Health, Nutrition / 26.10.2020

MedicalResearch.com Interview with: Samia Mora, MD MHS Associate Professor, Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA 02215 @SamiaMoraMD MedicalResearch.com: What is the background for this study? Response: Couples, both married couples and domestic partners, are likely to share similar environmental exposures, adopt similar behavior patterns, and have similar characteristics. However, the degree to which couples share similar levels of cardiovascular (CV) risk factors and behaviors is uncertain. If high levels of poor CV risk factor measures and behaviors are common in both members of a couple, programs that target improvement of these risk factors and behaviors may simultaneously benefit CV health in both members of the couple. (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Inflammation, JAMA / 21.10.2020

MedicalResearch.com Interview with: David E. Leaf, MD, MMSc, FASN Assistant Professor of Medicine, Harvard Medical School Director of Clinical and Translational Research in Acute Kidney Injury Division of Renal Medicine, Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: The data for this study were derived from a multicenter cohort study of over 4,000 critically ill patients with COVID-19 admitted to ICUs at 68 sites across the US, as part of the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID). STOP-COVID was initiated by David E. Leaf, MD, MMSc and Shruti Gupta, MD, MPH, from the Division of Renal Medicine at Brigham and Women’s Hospital and Harvard Medical School. It was initiated in March, 2020 as an unfunded, grassroots network, and now includes over 400 collaborators from 68 sites across the US. Using this data, we used a ‘target trial emulation’ approach to examine whether early administration of the monoclonal antibody, tocilizumab, reduces mortality in critically ill patients with COVID-19. Target trial emulation, a novel method of analyzing observational data, is the idea of simulating a randomized control trial to reduce bias.  (more…)
Author Interviews, Brain Injury, Brigham & Women's - Harvard, JAMA / 25.09.2020

MedicalResearch.com Interview with: Maria Gabriela Figueiro Longo, MD, MSc Department of Radiology, Massachusetts General Hospital Harvard Medical School, Boston MedicalResearch.com: What is the background for this study? What are the main findings? Response: Transcranial low-level light therapy (3LT) has been shown to be effective in animal models of traumatic brain injury. Our goal was to assess the 3LT in humans with acute TBI. We tested (1) safety, and (2) any effect in the brain in a measurable way. We found positive results for both - there was no event adverse during the trial related to the 3LT; and we found some differences in the brain MRI diffusivity parameters in the patients who received light therapy compared to the sham group. The study was not powered for clinical evaluation, although there was a trend towards lower symptom burden in the treated group. (more…)
Author Interviews, Brigham & Women's - Harvard, Fertility, Technology / 16.09.2020

MedicalResearch.com Interview with: Hadi Shafiee, PhD Assistant Professor, Harvard Medical School Brigham and Women's Hospital Department of Medicine MedicalResearch.com: What is the background for this study? What are some of the characteristics that AI uses to identify blastocysts witha better chance of successful implantation?  Response: In-vitro fertilization (IVF), while a solution to many infertile couples is still extremely inefficient with a success rate of nearly 30% and is both mentally, physically, and economically taxing to patients. The IVF process involves the insemination of eggs and the culture of embryos externally in a fertility lab before transferring the developed embryo to the mother. A major challenge in the field is deciding on the embryos that need to be transferred during IVF, such that chances of a healthy birth are maximal and any complications for both mother and child are minimal. Currently, the tools available to embryologists when making such are extremely limited and expensive, and thus, most embryologists are required to make these life-altering decisions using only their observational skills and expertise. In such scenarios, their decision-making process is extremely subjective and tends to be variable. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Dermatology / 09.09.2020

MedicalResearch.com Interview with: Jennifer Huang, MD  Dr. Huang is a pediatric dermatologist at Boston Children’s Hospital and Dana-Farber Cancer Institute. She is an Associate Professor of Dermatology at Harvard Medical School. Dr. Huang is a member of the Society for Pediatric Dermatology. Connie Zhong, MD, MSc Dr. Zhong is an intern at Brigham and Women’s Hospital She will be doing her dermatology residency at the Harvard Combined Dermatology Program. She is a member of the Society for Pediatric Dermatology.  MedicalResearch.com: What is the background for this study? Response: Pediatric nonmelanoma skin cancers (NMSC) are rare and when they do occur, are often associated with genetic/predisposing skin conditions or iatrogenic risk factors. There are some pediatric patients who develop NMSCs who do not have identifiable risk factors. The objective of our study was to describe the demographic and clinical features of these children without identifiable risk factors and compare them with those who have either genetic or iatrogenic risk factors. We conducted a retrospective study at 11 tertiary care institutions across North America through the Pediatric Dermatology Research Alliance (PeDRA) (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Dermatology / 03.09.2020

MedicalResearch.com Interview with: Yin Zhang MD Research Fellow in Medicine Brigham and Women's Hospital and Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Among modern hair dyes, permanent hair dye is the most popular type, and is the most aggressive and extensively used type that has posed the greatest potential concern about cancer risk. Monitoring and investigating the carcinogenic hazard to people from personal use of permanent hair dyes has major public health implications. In 2008, the World Health Organization's International Agency for Research on Cancer, after comprehensive reviewed prior evidence, classified occupational exposure to hair dyes as a probable carcinogen to humans (group 2A), whereas personal use of hair dyes was not classifiable as to its carcinogenicity to humans (Group 3). Data on hair dye safety has also been continuously monitored by the USFDA. Prior epidemiological evidence may have been influenced by not discriminating between personal and occupational exposure, an inability to distinguish types and colors of hair dyes used, imprecise assessment of several critical domains of exposure history (duration, frequency and cumulative dose), and inadequate control for potential confounding. (more…)
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, Emergency Care, JAMA, Surgical Research / 01.09.2020

MedicalResearch.com Interview with: Sarabeth Spitzer, MD Co-Chair of Board, Scrubs Addressing the Firearm Epidemic (SAFE) Department of Surgery, Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Firearm injury is a significant cause of morbidity and mortality in the United States, resulting in almost 40,000 deaths annually in the United States, but very little is known about the epidemiology of nonfatal firearm injuries. Nonfatal firearm injuries can have significant long-term morbidity and are associated with significant cost. We found that there were over 81,000 nonfatal firearm injuries in California over the study period. Over the period, there was a decrease in nonfatal firearm injuries by 38.1%, driven primarily by a decrease in assault injuries.   (more…)
Author Interviews, Brigham & Women's - Harvard, Gastrointestinal Disease, Technology / 27.08.2020

MedicalResearch.com Interview with: Giovanni Traverso, MB, BChir, PhD Gastroenterologist and biomedical engineer Division of Gastroenterology at BWH Instructor of medicine at Harvard Medical School MedicalResearch.com: What is the background for this study? Response: We began working on this project with the goal to develop liquid drug formulations that could offer an easier-to-swallow alternative to capsules, especially for children. We started to think about whether we could develop liquid formulations that could form a synthetic epithelial lining that could then be used for drug delivery, making it easier for the patient to receive the medication by providing drugs in extended release formats. We discovered that an enzyme called catalase could help assemble molecules of dopamine into the polymer (poly-dopamine). These polymers have muco-adhesion properties, which means that after polymerization, the polymer can attach to the tissue very strongly. Also, catalase is found throughout the digestive tract, with especially high levels in the upper region of the small intestine. This is the first example, to the best of our knowledge, of small intestinal targeting system enabled through in-situ tissue-enzyme-catalyzed polymerization. The coating lasts up to 24 hours, after which it is shed and excreted based on experiments we conducted in pigs. (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, JAMA, Social Issues / 21.08.2020

MedicalResearch.com Interview with: Monik Carmen Jimenez, Sc.D Assistant Professor of Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: We wanted to get a comprehensive picture of the epidemiology of COVID-19 in carceral facilities that included jails and was not restricted solely to prisons. We utilized publicly available data collected in Massachusetts, pursuant to a court order. These data included prison and jail systems and were used to calculate rates of confirmed cases of COVID-19 and testing rates among incarcerated individuals. We were also able to compare those to changes in the population size within each system. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Dermatology, JAMA / 14.08.2020

MedicalResearch.com Interview with: Maryam M. Asgari, MD MPH Professor Department of Dermatology, Massachusetts General Hospital Department of Population Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? What are Topical Calcineurin Inhibitors used for?  Response: Topical calcineurin inhibitors (TCIs) are FDA approved for the treatment of atopic dermatitis (though they are used off-label to treat a wide range of inflammatory conditions of the skin, including psoriasis, seborrheic dermatitis, and contact dermatitis).  There are currently two drugs available – tacrolimus and pimecrolimus – both of which carry a black box label warning users about the potential for increased skin cancer risk.  The risk associated with keratinocyte carcinoma, the most common cancer (defined as basal cell carcinoma and squamous cell carcinoma), remains poorly defined because findings from large-scale post-marketing surveillance studies are lacking.  (more…)
Author Interviews, Brigham & Women's - Harvard, Exercise - Fitness, Race/Ethnic Diversity, Social Issues / 03.08.2020

MedicalResearch.com Interview with: Marc Weisskopf, PhD, ScD Cecil K. and Philip Drinker Professor of Environmental Epidemiology and Physiology Departments of Environmental Health and Epidemiology Harvard T.H. Chan School of Public Health Boston, MA 02115  MedicalResearch.com: What is the background for this study? Response: There is a long history of health disparities by race. We were interested to see whether these also show up in professional football players, with the thought that perhaps the advantages that come with being an elite athlete in a sport (e.g. related to income, potential access to carte, prestige) might minimize health disparities. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Heart Disease, JAMA / 28.07.2020

MedicalResearch.com Interview with: Frank Wharam, MD, MPH Department of Population Medicine Harvard Medical School and Harvard Pilgrim Healthcare Institute Boston, MA 02215 MedicalResearch.com: What is the background for this study? Response:  There is substantial concern that high-deductible health plans increase people’s risk of major adverse health events such as heart attack and stroke. No studies have examined this question. This study examines the effects of a transition to a high-deductible health plan on the risk of major adverse cardiovascular outcomes (myocardial infarction and stroke). The study group included individuals with risk factors for cardiovascular disease who were continuously enrolled in low-deductible (<$500) health plans during a baseline year followed by up to 4 years in high-deductible (≥$1000) plans after an employer-mandated switch. The matched control group included individuals with the same risk factors who were contemporaneously enrolled in low-deductible plans.  We examined time to first major adverse cardiovascular event, defined as myocardial infarction or stroke.  (more…)
Annals Internal Medicine, Author Interviews, Brigham & Women's - Harvard, Osteoporosis / 28.07.2020

MedicalResearch.com Interview with: Daniel Hal Solomon, MD, MPH Associate Physician, Brigham and Women's Hospital Professor of Medicine, Harvard Medical School Brigham and Women's Hospital Department of Medicine Rheumatology, Immunology Boston, MA 02115 Editor’s note: Prolia® is the trade name for denosumab.  MedicalResearch.com: What is the background for this study? Response: We conducted this study to assess whether delays in denosumab (injections were associated with an increased risk of fractures. In a prior study, we found that the improvements in bone mineral density were reduced among patients who delayed injections. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Dental Research, Esophageal, Gastrointestinal Disease / 24.07.2020

MedicalResearch.com Interview with: Mingyang Song, MD, ScD. Division of Gastroenterology Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School Department of Nutrition and Department of Epidemiology Harvard T.H. Chan School of Public Health Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: Recent studies showed a presence of dysbiotic oral microbiome in patients with esophageal and gastric cancer, suggesting a link between oral health and these cancers. However, how periodontal disease and tooth loss may influence the risk of these cancers has been inconsistent.  MedicalResearch.com: What are the main findings? Response: Our findings support a possible role of oral health in the development of upper GI cancer. Individuals with periodontal disease and tooth loss are at higher risk of developing esophageal and gastric adenocarcinoma. The risk is particularly high for individuals with both periodontal disease and tooth loss.  (more…)
Author Interviews, Brigham & Women's - Harvard, Geriatrics, Lipids / 08.07.2020

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: Statins are cholesterol lowering medications that have been proven to prevent heart attacks, strokes and death in middle-aged adults. Current guidelines for cholesterol lowering therapy are uncertain as to treatment for older adults due to a lack of available data, even though older adults are at the highest risk of heart disease and death. (more…)
Author Interviews, Brigham & Women's - Harvard, Cognitive Issues, Sleep Disorders / 01.07.2020

MedicalResearch.com Interview with: Dr. Rebecca Robbins, PhD MS Fellow at Brigham & Women's Hospital and Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Sleep difficulties are common among older adults and are associated with cognitive decline. We used data collected over 10 years from a large, nationally representative longitudinal survey of adults over the age of 50 in the U.S. We examined the relationship between specific sleep difficulties and cognitive function over time. MedicalResearch.com: What are the main findings?  Response: Our results show that early difficulty falling asleep and early morning awakenings, when experienced "most nights" of the week, were each associated with worse cognitive function. Conversely, reports of waking feeling rested was associated with better cognitive function, over time.   (more…)
Author Interviews, Brigham & Women's - Harvard, Critical Care - Intensive Care - ICUs, NEJM, Pediatrics / 24.06.2020

MedicalResearch.com Interview with: Christopher P. Landrigan, MD, MPH Chief, Division of General Pediatrics, Boston Children’s Hospital Director, Sleep and Patient Safety Program, Brigham and Women's Hospital William Berenberg Professor of Pediatrics, Harvard Medical School Boston Children's Hospital Boston, MA 02115 MedicalResearch.com: What is the background for this study? Response: An enormous body of literature demonstrates that sleep deprivation adversely affects the safety and performance of resident physicians, as well as individuals across other occupations.  Resident physicians are at greatly increased risk of suffering motor vehicle crashes and needlestick injuries, and are at substantially increased risk of making medical errors, when working on traditional schedules that include 24-hour shifts. We previously conducted a randomized controlled trial in two intensive care units that found resident physicians made 36% fewer medical errors when a scheduling intervention was introduced that eliminated 24-hour shifts but held resident workload constant. The current study, ROSTERS, was a 6-center study that again introduced a scheduling intervention to eliminate 24-hour shifts in intensive care units.  Due to varying resources and unit organization across sites, each hospital developed its own staffing plan to accommodate the intervention​. (more…)
Author Interviews, Brigham & Women's - Harvard, Cognitive Issues, Heart Disease, JACC, Lipids / 23.05.2020

MedicalResearch.com Interview with: Robert P. Giugliano, MD, SM Senior Investigator, TIMI Study Group Cardiovascular Medicine Brigham and Women's Hospital Professor of Medicine Harvard Medical School Boston, MA  MedicalResearch.com: What is the background for this study? Response: Some prior studies had suggested that lipid lowering therapies were associated with impaired cognition.  We sought to explore this question in a prospectively designed substudy of the large FOURIER randomized, double-blind clinical trial utilizing patient self-surveys administered the end of the study to determine whether patients themselves noticed any changes in cognition over the duration of the trial. The survey tool was a shortened version of the Everyday Cognition Questionnaire (see attached) that asks patients 23 questions that assess memory and executive function (including subdomains of planning, organization, and divided attention). The questions are in the format of "Compared to the beginning of the study, has there been any change in .....", and are graded as 1=better/no change, 2=questionable/occasionally worse, 3=consistently a little worse, 4=consistently much worse. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Heart Disease, Race/Ethnic Diversity, Statins / 14.05.2020

MedicalResearch.com Interview with: Dr. Ankur Pandya, PhD Assistant Professor of Health Decision Science Department of Health Policy and Management Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: The 2013 ACC-AHA cholesterol treatment guidelines greatly expanded statin medication eligibility for individuals between the ages of 40-75 years without known cardiovascular disease, and there was some concern that African Americans at "intermediate risk" per those guidelines could be (arguably) overtreated with statins. The 2018 ACC-AHA guidelines included coronary artery calcium assessment for individuals at intermediate cardiovascular disease risk; those with a "zero" calcium score and no other risk factors would now change the eligibility (from indicated statin to not indicated). (more…)
Author Interviews, Brigham & Women's - Harvard, Gender Differences, Genetic Research, Nature / 13.05.2020

MedicalResearch.com Interview with: Nolan Kamitaki PhD Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Previous work from our lab found that the strongest common genetic association to schizophrenia is driven in part by copy number variation of the C4 genes.  Given that lupus and Sjogren's syndrome, two autoimmune disorders, have association patterns that span the same region of the human genome, we wondered if part of the signal for these diseases may also arise from variation of C4 given that both have hypocomplementemia as a characterizing trait.   The other main finding is that these associations appear to be sex-biased, where the protection from each additional copy of the C4 gene was greater in men than in women.  When we went back to the data used in the previous study from our lab association C4 variation to schizophrenia, we found that the effect was stronger in men there as well.  Although the expression of C4 at the RNA level does not appear to differ between men and women, we saw that men had more C4 protein in both cerebrospinal fluid and blood plasma, suggesting that this may explain the greater genetic association in men. (more…)