Author Interviews, Cognitive Issues, COVID -19 Coronavirus, Imperial College, NEJM / 29.02.2024 Interview with: Prof. Adam Hampshire Ph.D. Faculty of Medicine, Department of Brain Sciences Professor in Restorative Neurosciences Imperial College London What is the background for this study? Response: Cognitive symptoms after coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are well-recognized. Whether objectively measurable cognitive deficits exist and how long they persist are unclear. (more…)
Author Interviews, Cognitive Issues, COVID -19 Coronavirus, Imperial College, Lancet / 28.07.2021 Interview with: Dr. Adam Hampshire PhD Faculty of Medicine Department of Brain Sciences Imperial College London What is the background for this study? Response: During 2020 I was leading a study that sought to map the distribution of cognitive abilities and aspects of mental health across the UK population. The study generated a lot of interest because it was a collaboration with BBC2 Horizon, leading to ~390,000 participants. When the pandemic began to escalate in the UK a number of my colleagues at Imperial and elsewhere contacted me to note that the study could be used to investigate the impact of both the pandemic and direct illness on daily life, mental health and cognition. I had been thinking along similar lines so decided to add questionnaires about peoples' experiences with the pandemic and Covid-19 illness. (more…)
Author Interviews, Gastrointestinal Disease, Imperial College, Probiotics, Pulmonary Disease, Weight Research / 16.05.2021 Interview with: Benjamin Mullish PhD NIHR Academic Clinical Lecturer Department of Metabolism Digestion and Reproduction Imperial College What is the background for this study? Which probiotic did you use and why?  Response: We recently reported the results of a randomized, double-blind placebo-controlled trial in which participants who were overweight or with obesity (aged between 30-65 years of age) were randomized to receive probiotics or placebo for six months.  The primary focus was on weight loss and metabolism.  The probiotic used was Lab4P, containing three different strains of Bifidobacteria and two of Lactobacilli, which have shown to be safe and efficacious for use in rodent models and earlier clinical studies. Of note, probiotics have also been shown to have other beneficial effects upon human health.  Previous studies have suggested that they may have a role in preventing upper respiratory tract infections (URTIs) in healthy people and children; however, this has not been explored in older people or overweight/ people with obesity, even though such groups have higher rates of URTIs. We looked back at our trial, and reviewed symptom diaries completed by participants daily during the study.  We were looking at recorded symptoms most consistent with upper respiratory tract symptoms (including cough, wheezing and headache), and explored if rates of these were different between those participants taking probiotics compared to placebo over the six month course of the study.   (more…)
Author Interviews, C. difficile, Gastrointestinal Disease, Imperial College, Infections, Transplantation / 30.04.2020 Interview with: Prof. Julian Marchesi PhD Professor of Digestive Health Faculty of Medicine, Department of Metabolism, Digestion and Reproduction   Dr. Benjamin Mullish PhD Faculty of Medicine, Department of Metabolism, Digestion and Reproduction NIHR Clinical Lecturer Imperial College London What is the background for this study? Response: Many patients are colonized with bacteria that are resistant to nearly all the antibiotics that we currently have. This antibiotic resistance is a huge public health problem, not least because it may lead to the scenario where a bacterial species moves from the gut and into the bloodstream, causes an infection, and cannot be treated. Such scenarios particularly occur in patients who are particularly prone to getting multiple and frequent courses of antibiotics; this may include patients with particular kidney conditions (who may be vulnerable to recurrent urinary tract infections (UTIs)), and patients with blood cancers (such as leukaemia, who have weak immune systems and are therefore prone to infections). Furthermore, in both sets of patients, to help treat their disease, they may be offered transplants, either a new kidney or new bone marrow. When this transplant happens, the clinician needs to ‘switch off’ their immune system to allow the transplant to work. When the immune system is dialled down, it can no longer stop any invading bacteria, increasing the chance of antibiotic resistance bacteria causing infections, which frequently leads to patient death.  (more…)
Author Interviews, Genetic Research, Heart Disease, Imperial College, JAMA / 19.02.2020 Interview with: Dr. Ioanna Tzoulaki Imperial College London What is the background for this study? Response: Considerable progress has been made in identifying genetic variants that are associated with heart disease. We aimed to investigate whether genetic information can be used to assess the risk of individuals developing heart disease in the future and whether genetic tests can improve current risk assessment strategies which are based on easy to measure factors such as age, sex, smoking status, cholesterol levels, blood pressure and presence of type 2 diabetes. (more…)
Author Interviews, Brain Cancer - Brain Tumors, Imperial College / 20.08.2019 Interview with: Georgios Giamas, (Dr. Biol. Hum.) Professor of Cancer Cell Signalling Director of Research and Knowledge Exchange University of Sussex -School of Life Sciences Visiting Professor, Imperial College, London What is the background for this study? Response: This study focuses on Glioblastoma (GBM), which is one of the most aggressive solid tumours for which treatment options and biomarkers are limited. What are the main findings? - Glioblastoma cells produce nanosized vesicles (aka: extracellular vesicles) that contain specific protein signatures, which can indicate the behaviour and phenotype of the respective cells of origin. -We have identified and described certain vesicle-associated biomarkers that correspond to the most aggressive brain cancers. -Our results can provide insights for the development of new diagnostic and therapeutic methods as well as personalized treatment strategies (more…)
Author Interviews, Genetic Research, Heart Disease, Imperial College, JAMA / 12.07.2019 Interview with: Ben Cordon, PhD NIHR Post-doctoral Academic Clinical Fellow Specialist Registrar training in cardiology  James SWarePhD, MRCP  Reader in Genomic Medicine Group head within the Cardiovascular Genetics & Genomics Unit Imperial College London What is the background for this study?   Response: Non-ischaemic dilated cardiomyopathy is a common cause of heart failure and carries the risk of life-threatening ventricular arrhythmia. An implantable cardioverter defibrillator (ICD) can be life-saving in this condition. However, the decision to implant an ICD is not one that can be taken lightly - ICD insertion carries its own risks, such as infection or inappropriate shocks, and our ability to predict who will benefit from a device is currently far from perfect. Genetic sequencing is affordable and widely available and for DCM, like many diseases, it is hoped that genetic stratification may one day help deliver personalised management. In DCM, variants in the Lamin A/C gene for example are known to cause a phenotype with early and severe arrhythmias and, as a result, international guidelines advocate a lower threshold for ICD insertion in these patients. However, Lamin A/C is an infrequent cause of DCM. The commonest known genetic cause of DCM are protein-truncating variants in the gene encoding Titin (TTNtv), accounting for ~15% of DCM cases. We wanted to know if this group had a higher risk of arrhythmia than the general DCM population. Earlier work from our group on this topic found that patients with TTNtv-associated DCM were more likely to have a clinical history of arrhythmia (composite of atrial and ventricular arrhythmia, including NSVT), at the time of their initial DCM diagnosis. But it was unclear if this was driven by ventricular arrhythmia, atrial arrhythmia, or both or if it would translate into a long-term risk of potentially dangerous ventricular arrhythmia of the sort for which an ICD can be life-saving. In another study we analysed a larger cohort of ambulant DCM patients but did not find an increased risk of ventricular arrhythmia – but this was a relatively low-risk group, with comparatively mild symptoms (NHYA I/II heart failure) and moderately impaired LV function. As a result, the overall arrhythmic event rate was low, meaning that the power to detect differences between the TTNtv and non-TTNtv groups was reduced. (more…)
Author Interviews, Heart Disease, Imperial College, Lipids, NEJM, Statins / 13.03.2019 Interview with: Prof. Kosh Ray, MB ChB, MD, MPhil Faculty of Medicine, School of Public Health Chair in Public Health (Clinical) Imperial College London What is the background for this study? What are the main findings? Response: Bempedoic acid is the first in class of a new therapy for lowering LDL cholesterol. This is the largest and longest study to date with this therapy and involved about 2200 pts with patients with either established cardiovascular disease or familial hypercholestrolaemia and in whom LDL was > 70mg/dl or 1.8 mmol/L despite maximally tolerated statins. %0% were on high intensity statins and the majority of the rest on moderate intensity. The aim was to show long term safety 1 year and efficacy at 24 weeks and at 1 year.  (more…)
AHA Journals, Author Interviews, Imperial College, Mineral Metabolism, Stroke / 27.10.2018 Interview with: Dipender Gill Imperial College Healthcare NHS Trust London, United Kingdon What is the background for this study? What are the main findings? Response: Iron status has previously been associated with risk of various types of cardiovascular disease, including stroke. However, the observational research methodologies that identified these associations can be affected by confounding from environmental factors and reverse causation. We used randomly allocated genetic variants that affect iron status to investigate its effect on risk of different types of ischemic stroke, and found evidence to support that higher iron status increases risk of cardioembolic stroke. (more…)
AACR, Author Interviews, Cancer Research, Imperial College, Kidney Disease / 20.08.2018 Interview with: Dr. David C. Muller PhD Faculty of Medicine, School of Public Health Research Fellow in Epidemiology and Biostatistics Imperial College, London What is the background for this study? What are the main findings? Response: Our colleagues in the U.S. have been working on KIM-1 for years, particularly in the context of chronic kidney disease. Recently they found that KIM-1 is also elevated at the time of diagnosis of kidney cancer. We wanted to see if KIM-1 concentrations could predict the chances of a future diagnosis of kidney cancer. We found that KIM-1 was a strong predictor of being diagnosis with kidney cancer in the next 5 years. We also found that higher pre-diagnostic KIM-1 was associated with worse survival after diagnosis.  (more…)
Allergies, Author Interviews, Fish, Imperial College, Nutrition, OBGYNE, Omega-3 Fatty Acids, Probiotics / 02.03.2018 Interview with: Dr Robert Boyle, Reader in Paediatric Allergy Department of Medicine Imperial College London What is the background for this study? Response: Diet in early life may influence whether or not an infant develops allergies or autoimmune disease. We undertook a project for the UK Food Standards Agency to evaluate the evidence for this. What are the main findings?  Response: We found that a probiotic supplement during the last 2-4 weeks of pregnancy and during breastfeeding may reduce an infant’s chances of developing eczema; and that omega-3 fatty acid supplements taken from the middle of pregnancy (20 weeks gestation) through the first few months of breastfeeding may reduce an infant’s chances of developing food allergy. We also found links between longer duration of breastfeeding and improved infant health, but for most other variations in diet during pregnancy or infancy we did not find evidence for a link with allergies or autoimmune disease. (more…)
Author Interviews, Hepatitis - Liver Disease, Imperial College, Technology / 14.02.2018 Interview with: Marcus Dorner, PhD Non-Clinical Senior Lecturer in Immunology Wellcome Trust Investigator Imperial College London Department of Medicine, Section of Virology School of Medicine London United Kingdom What is the background for this study? What are the main findings? Response:  Hepatitis B virus (HBV) infection globally affects over 250 million people and is currently not curable. This infection can lead to liver cirrhosis and liver cancer and is among the leading causes for liver transplantation. Unfortunately, HBV is among the most difficult viruses to study in the laboratory, since model systems are not very good at recapitulating what happens in infected humans. We have just described the first model to effectively change this. Using an artificial “Liver-on-a-Chip”, we have developed a tool, which can potentially revolutionise how we study viral infections by merging the study of viruses with tissue engineering. This model is over 10,000-fold more susceptible to HBV infection and accurately mimics, what happens in an infected patient. This can now be utilised to develop novel and potentially curative therapies, which would benefit millions of people currently living with chronic HBV infection.  (more…)
Author Interviews, Brain Injury, Imperial College, Pediatrics / 30.11.2017 Interview with: “Baby” by Victor is licensed under CC BY 2.0Dr Chris Gale Clinical Senior Lecturer in Neonatal Medicine Imperial College London and Consultant Neonatologist at Chelsea and Westminster Hospital NHS Foundation Trust What is the background for this study? What are the main findings? Response: As part of a drive to make England a safer place to give birth, the Department of Health in England has set a target of reducing the number of babies that incur brain injury during or soon after birth by 20% by 2020 and to halve them by 2030. Before now United Kingdom health services did not have a standard definition of brain injury in babies and there has been no systematic collection of data for this purpose. With colleagues and in collaboration with the Department of Health, we have devised a practical way to measure the incidence rate of brain injury in babies using routinely recorded data held in the National Neonatal Research Database. The research estimated that 3,418 babies suffered conditions linked to brain injury at or soon after birth in 2015, which equates to an incidence rate of 5.14 per 1,000 live births. For preterm births (babies born at or less than 37 weeks) the rate was 25.88 per 1,000 live births in 2015, almost six times greater than the rate for full-term births, which was 3.47 per 1,000 live births. Overall, the research found that the most common type of condition that contributed brain injuries was damage caused by lack of oxygen to the brain, called hypoxic ischaemic encephalopathy; this is seen mainly in term babies. For preterm babies, the largest contributor to brain injuries is from bleeding into and around the ventricles of the brain, a condition called periventricular haemorrhage. It is also the first time that brain injuries in babies have been measured using data gathered routinely during day to day clinical care on NHS neonatal units. The use of routine data required no additional work for clinical staff and provides a valuable way to measure the effectiveness of interventions to reduce brain injury. (more…)
Author Interviews, BMJ, Imperial College, Surgical Research / 15.11.2017 Interview with:     Professor JT Powell PhD, MD, FRCPath Faculty of Medicine, Department of Surgery & CancerImperial College London What is the background for this study? Response: The mortality from ruptured abdominal aortic aneurysm (AAA) remains very high causing about 6000 deaths each year in the UK.  The only hope for survival is an emergency operation to repair the burst aorta.  Even so the mortality may be as high as 45% within a month of repair using open surgery. It has been suggested that minimally invasive repair using keyhole or endovascular techniques would lower the mortality to about 25% within a month of repair.  However not all shapes of aorta are suitable for endovascular repair (also called EVAR). (more…)
Author Interviews, Heart Disease, Imperial College, Medical Imaging, Surgical Research / 19.03.2017 Interview with: Dr. Justin Davies PhD Senior Reserch Fellow and Hononary Consultant Cardiologist National Heart and Lung Institute, Imperial College London What is the background for this study? Response: We know from the FAME study that compared to angiography alone, FFR guided revascularization improves long-term clinical outcomes for our patients. Despite this, adoption of FFR into everyday clinical practice remains stubbornly low. One major factor for this is the need for adenosine (or other potent vasodilator medications) in order to perform an FFR measurement. Adenosine is expensive, unpleasant for the patient, time consuming and even potentially harmful. iFR is a newer coronary physiology index that does not require adenosine for its measurement. In the prospective, multi center, blinded DEFINE FLAIR study, 2492 patients were randomly assigned to either FFR guided revascularisation or iFR guided revascularization and followed up for a period of 1 year. (more…)
Author Interviews, BMJ, Cancer Research, Imperial College, Pediatrics, Weight Research / 01.03.2017 Interview with: Dr Maria Kyrgiou MSc, PhD, MRCOG Clinical Senior Lecturer & Consultant in Gynaecologic Oncology IRDB - Department of Surgery and Cancer, Imperial College London West London Gynaecological Cancer Centre, Queen Charlotte's & Chelsea-Hammersmith Hospital, Imperial Healthcare NHS Trust What is the background for this study? What are the main findings? Response: Obesity has become a major public health challenge and it's prevalence worldwide has more than doubled amongst women n the last four decadesExcess body weight has been associated with an increased risk of developing and dying from numerous cancers. Although the reported associations may be potentially causal, some of the associations may be flawed due to inherent study biases such as residual confounding and selective reporting of positive results. We included 204 meta-analyses investigating associations between adiposity and the development or death from 36 primary cancers and their sub-types. Adiposity was associated with a higher risk of developing esophageal adenocarcinoma, gastric cardia, colon and rectal cancer in men, biliary tract system, pancreatic, postmenopausal breast among HRT non-users, endometrial, ovarian, and kidney cancer and multiple myeloma. (more…)
Allergies, Author Interviews, Immunotherapy, Imperial College, JAMA / 16.02.2017 Interview with: Stephen R. Durham, MD Imperial College, London, and Royal Brompton and Harefield Hospitals NHS Foundation Trust London, United Kingdom What is the background for this study? What are the main findings? Response: Allergic rhinitis affects 1 in 4 the UK population and may compromise sleep and work/school performance and be associated with bronchial asthma. When nasal steroids and antihistamines do not work or cause side effects, allergen immunotherapy is an alternative. Immunotherapy using high doses of grass pollen allergen as monthly injections or daily tablets under the tongue are highly effective. Treatment for 3 years not only gives sustained improvement on treatment but also long-term benefits and disease remission for at least 2-3 years after stopping treatment. This single centre study at Imperial College London and Royal Brompton Hospital London included 106 adults with severe Hayfever followed up for 3 years, 2 years on treatment and 1 year after stopping treatment. In this double-blind trial, 3 randomised groups took sublingual immunotherapy, subcutaneous immunotherapy and placebo treatment. 92 completed the trial. Results showed that 2 years treatment with both modalities did not result in persistent benefit at year 3, although the researchers found that both treatments were effective compared to placebo during years 1 and 2. (more…)
Author Interviews, BMJ, Imperial College, Nutrition / 10.12.2016 Interview with: Dr. Dagfinn Aune Department of Epidemiology and Biostatistics School of Public Health Imperial College London St. Mary's Campus London  UK What is the background for this study? What are the main findings? Response: There is a growing body of evidence suggesting that intake of nuts may reduce the risk of coronary heart disease, but the relation between nut intake and other diseases like cancer and stroke, and the relation with mortality and less common causes of death is not clear. Also it is not clear how much nuts are needed to reduce the risk. So our current meta-analysis reviewed the data from 20 studies (29 publications) on nut intake and different health outcomes. We found that a nut intake of approximately one serving per day (28 g/d or a handful) was associated with a reduced risk of coronary heart disease (by 30%), total cancer (15%), all-cause mortality (22%) and mortality from respiratory disease (50%), diabetes (40%), and infections (75%), although there were few studies in the latter three analyses. We found that most of the benefit was observed up to an intake of around 20 grams per day. Similar results were found for total nuts, tree nuts and peanuts (which are botanically defined as legumes), but peanuts were also associated with reduced risk of stroke, while only tree nuts were associated with reduced cancer risk. We also calculated the number of deaths that potentially could be avoided, under the assumption that the observed associations are causal, and arrived at 4.4 million deaths in North and South America, Europe, Southeast Asia and the Western Pacific (unfortunately we did not have data on nut intake from West Asia and Africa so we were not able to include those areas). (more…)
Author Interviews, BMJ, Cancer Research, Cost of Health Care, Imperial College / 11.11.2016 Interview with: Peter Wise MD Charing Cross Hospital and Imperial College School of Medicine London, UK What is the background for this analysis? Response: As a medical ethicist, I wished to know how much patients with advanced – metastatic – cancer knew about the drugs that were being used to treat it. What were their perceptions of likely treatment success and how did that tally with our knowledge of what drugs could actually achieve – and at what cost to the body and to the pocket. Did patients actually have a choice – and how did the drugs get approved for use in the first place? (more…)
Author Interviews, FASEB, Heart Disease, Imperial College, Pain Research, Pharmacology / 17.10.2016 Interview with: Dr Nicholas Kirkby BHF Intermediate Fellow | Vascular Biology National Heart & Lung Institute | Imperial College London London What is the background for this study? What are the main findings? Response: We know drugs like ibuprofen, called ‘non-steroidal anti-inflammatory drugs’ cause an increase in the risk of heart attacks. These side effects cause very real concerns for the many millions of people who rely on them. They are also the reason why there are no new drugs in this class and why they have been withdrawn (2011) for use as a preventative treatment for colon cancer. Previous research from our group suggests that L-arginine supplements may prevent the cardiovascular side effects caused by these drugs. Our findings here suggest that a particular formulations of ibuprofen, called ibuprofen arginate, which is already available in many parts of the world, can act like an L-arginine supplement and that this could potentially protect the cardiovascular system. (more…)
Author Interviews, Imperial College, Stroke, Technology / 06.10.2016 Interview with: Dr Paul Bentley MA MRCP PhD Clinical Senior Lecturer in Clinical Neuroscience Honorary Consultant Neurologist Neurology Dept Imperial College NHS Healthcare Trust Charing Cross Hospital London What is the background for this study? What are the main findings? Response: gripAble was designed to help people with arm disability practise physiotherapy when a physiotherapist is not available, or in between physiotherapy sessions. We know that the amount of physiotherapy provision in the UK, after stroke or arm injury, is typically below that which is recommended by professional bodies. Furthermore, increasing research suggests that higher-intensity training can boost functional outcomes. The innovation was designed to help people with a range of disabilities including severe paralysis engage with computer games with their weak arm. At the same time its designed to be portable for use at home or in bed, and low-cost. gripAble also enables remote measurement and monitoring of arm function, by setting users a series of calibrated tasks played out on the tablet screen. This way doctors and physiotherapists can assess the needs of a patient, and gain an idea of how well a patient is responding to home physiotherapy. (more…)
Author Interviews, Genetic Research, Imperial College, Nutrition / 26.07.2016 Interview with: Prof. Majid Ezzati, PhD Faculty of Medicine, School of Public Health Chair in Global Environmental Health Imperial College, London Adjunct Professor of Global Health and Department of Global Health and Population Harvard T.H. Chan School of Public Health What is the background for this study? What are the main findings? Response: Human height is strongly influenced by the environment that we grow up in, from pregnancy through to late adolescence. If we have good nutrition, few illnesses and good healthcare, we are more likely to grow taller. In turn, height has a strong effect on our health in adulthood. Taller people on average live longer, have lower risk of heart disease (although they do have slightly elevated risks of some cancers). We have collated the largest-ever database of height. We analysed 1472 studies with measured height on 18.6 million individuals. We made estimates of height for 18-year-old men and women from 1914 and 2014. Height has increased in every country in the world, but this has been very uneven. The tallest men in the world are now the Dutch, and the tallest women are the Latvians. The countries that have seen the most growth are South Korea for women and Iran for men. We have seen large increases in height in East Asia, and stagnation in much of the West over the last few decades. In parts of Africa height has actually decreased by 5-10 cm over this period. (more…)
Author Interviews, Cancer Research, Imperial College / 21.03.2016 Interview with: Dr Olivier E Pardo PhD Team Leader Imperial College Division of Cancer Hammersmith Hospital London UK What is the background for this study? What are the main findings? Dr. Pardo: Metastatic dissemination, the ability of tumour cells to go and colonise organs distant from the primary disease site, is the principal cause for failing to cure patients with cancer. This is particularly true in the case of breast cancer where resection of local disease offers good chances of cure but metastatic dissemination that may appear at a later stage carries very poor prognosis. Surgical resection is also the only true curative strategy for localised lung cancer. Hence, a better understanding of the mechanisms controlling the dissemination of tumour cells is likely to propose novel targets for combination therapy that will improve the survival of cancer patients. Here, we showed that an enzyme, named MARK4, controls the ability of lung and breast cancer cells to move and invade. When we lower MARK4 levels, it prevents cancer cells from moving by changing their internal architecture, making them unfit to invade. Consequently, these cells were unable to efficiently form metastasis in mouse cancer models. Confirming the role of this enzyme in cancer, we show that breast and lung cancer patients with increased levels of MARK4 in their tumours have poorer prognosis. We found that what controls the levels of MARK4 in cells is miR-515-5p, a small oligonucleotide sequence called a microRNA. When present in the cells, miR-515-5p prevents the expression of MARK4. Incidentally, the loss of miR-515-5p correlates with increased metastasis and poorer prognosis in mouse cancer models and patients, respectively. (more…)
Abuse and Neglect, BMJ, Imperial College, Microbiome, OBGYNE / 23.02.2016 Interview with: Dr. Aubrey Cunnington Faculty of Medicine, Department of Medicine Clinical Senior Lecturer Imperial College, London Medical Research: What is the background for this study? What are the main findings? Dr. Cunnington: We noticed that increasing numbers of women who were having Caesarean section deliveries at our hospitals were requesting for their vaginal fluid to be swabbed onto their babies after birth – a process often termed “vaginal seeding”. The idea behind this, is that it transfers all the natural bacteria (microbiota) from the mother’s vagina to the baby. We know that early on in life, babies born by Caesarean section have different bacteria living on their bodies and in their guts to those of babies born by vaginal delivery. Some people think these differences in the microbiota may be responsible for differences in long-term health, although a causal link is unproven. The hope is that vaginal seeding might reduce the risk of the baby developing some diseases like obesity and asthma in the future. Unfortunately we are a long way from having the evidence to show that this is possible, and we do not know whether vaginal seeding is really safe. Babies born by elective Caesarean section are at lower risk of transfer of some potentially harmful bacteria and viruses from the birth canal, but these harmful bacteria and viruses could be transferred to the baby on a swab and potentially cause a devastating infection. Editor's note:  'Vaginal Seeding' is also known as "microbirthing",    (more…)
Author Interviews, Imperial College, Pulmonary Disease, Toxin Research / 23.02.2016 Interview with: Dr Rebecca Ghosh, Research Associate  Small Area Health Statistics Unit (SAHSU) MRC-PHE Centre for Environment and Health Imperial College London St Mary's Campus, Norfolk Place, London  Medical Research: What is the background for this study? What are the main findings? Dr. Ghosh: Since the 1950s a lot of evidence has accumulated that high levels of air pollution cause harmful effects on health.  However there is limited evidence on the very long term (>25 years) effects of air pollution.  Our study is one of the longest running to date looking at air pollution and mortality, following 368,000 people in England and Wales for 38 years.  We estimated air pollution exposures throughout England & Wales for 1971, 1981, 1991 and 2001 using data from historic air pollution monitoring networks, the first time this has been done. We found that air pollution exposure in 1971 was still associated with a small increased risk of death in 2002-9, over 30 years later, suggesting that harmful effects of air pollution are extremely long-lasting.  However, risks from an individual’s past exposures waned over time and their more recent exposures gave the highest mortality risks. (more…)
Author Interviews, Imperial College, Parkinson's / 23.09.2015

Dr. Ilse S. Pienaar Honorary Lecturer in Neuroscience at Imperial College London (& Snr. Lecturer in Cellular Pathology, Northumbria University) Centre for Neuroinflammation & Neurodegeneration Division of Brain Sciences Faculty of Medicine Imperial College London Hammersmith Hospital Campus London United Interview with: Dr. Ilse S. Pienaar Honorary Lecturer in Neuroscience at Imperial College London (& Snr. Lecturer in Cellular Pathology, Northumbria University) Centre for Neuroinflammation & Neurodegeneration Division of Brain Sciences Faculty of Medicine Imperial College London Hammersmith Hospital Campus London United Kingdom   Medical Research: What is the background for this study? What are the main findings? Dr. Pienaar: A highly heterogeneous brainstem structure, the pedunculopontine nucleus (PPN) has been deemed a promising target for the delivery of deep-brain stimulation (DBS), to alleviate aspects of Parkinson's disease (PD), especially gait and postural instability. However, optimal therapeutic targeting of the PPN has been hampered due to DBS being unable to discriminate between cell types being targeted. We optomised a novel technique, Designer Receptors Exclusively Activated by Designer Drugs (DREADD) in a rat model of PD, by which to target only the PPN cholinergic neurons. A series of behavioral tests revealed that selective stimulation of the PPN cholinergics completely reverses gait problems and postural instability in the PD rats. (more…)
Author Interviews, BMJ, Imperial College / 21.06.2015

Mr. Angus Turnbull Imperial College School of Medicine, London Interview with: Mr. Angus Turnbull Imperial College School of Medicine, London UK Medical Research: What is the background for this study? What are the main findings? Mr. Turnbull: Autopsy has been used to advance medical knowledge and understanding of pathological processes for millennia but increasing evidence indicates its decline in the UK and elsewhere. This study not only confirms that but suggests autopsy for learning purposes has almost disappeared. In the United Kingdom autopsy is divided into medico-legal autopsy (that required by law under the jurisdiction of HM Coroner) and consented autopsy (performed with the consent of the bereaved or their family). Over the past half-century, small single site studies have noted a marked decline in consented autopsy rates, however there has been no study for over 20 years to determine the extent of the decline nationwide. This study examined all acute NHS Trusts within England, NHS Boards in Scotland and Wales and Social Care Trusts in Northern Ireland. We found that the average autopsy rate (the percentage of adult inpatient deaths which under go consented autopsy) in the United Kingdom in 2013 was only 0.7%. The study showed that in nearly a quarter (23%) of all NHS Trusts in the United Kingdom, consented autopsy is now extinct. These findings may have implications for training, for research and for learning from mortality – a key aspect of patient safety. (more…)
Author Interviews, Diabetes, Diabetologia, Imperial College, Nutrition / 02.06.2015

Dagfinn Aune, PhD student Norwegian University of Science and Technology and Imperial College Interview with: Dagfinn Aune, PhD student Norwegian University of Science and Technology and Imperial College London Medical Research: What is the background for this study? What are the main findings? Response: There are more than 360 million people worldwide that are affected by diabetes, and this number is projected to increase to more than 550 million by 2030, with serious consequences for the health and economy of both developed and developing countries. While previous research has found an association between increased dietary fibre intake and a reduced risk of developing type 2 diabetes, most of these data come from the United States, and amounts and sources of fiber intake differ substantially between countries. In this article the we evaluated the associations between total fiber as well as fiber from cereal, fruit, and vegetable sources, and new-onset type 2 diabetes in a large European cohort across eight countries, in the EPIC-InterAct Study (and included 12403 type 2 diabetes cases and 16835 sub-cohort members). We also conducted a meta-analysis where we combined the data from this study with those from 18 other independent studies from across the globe. We found that participants with the highest total fiber intake (more than 26 g/day) had an 18% lower risk of developing diabetes compared to those with the lowest total fiber intake (less than 19g/day), after adjusting for the effect of other lifestyle and dietary factors. When the results were adjusted for body mass index (BMI) as a marker of obesity, higher total fiber intake was found to be no longer associated with a lower risk of developing diabetes, suggesting that the beneficial association with fiber intake may be mediated at least in part by BMI. In other words, dietary fiber may help people maintain a healthy weight, which in turn reduces the chances of developing type 2 diabetes. In a meta-analysis of the EPIC-InterAct study and 18 other independent studies (>41000 type 2 diabetes cases) we found that the risk was reduced by 9% for each 10 g/day increase in total fiber intake and 25% for each 10 g/day increase in cereal fiber intake. There was no statistically significant association between fruit or vegetable fiber intake and diabetes. (more…)
Author Interviews, Heart Disease, Imperial College, JAMA, Outcomes & Safety / 01.04.2015

intra-aortic balloon pump, Interview with: Sayan Sen, PhD International Centre for Circulatory Health, National Heart and Lung Institute Imperial College London London, United Kingdom Medical Research: What is the background for this study? What are the main findings? Dr. Sayan Sen: Intra-aortic balloon pumps (IABP) are often used in Acute Myocardial Infarction, particularly in patients with cardiogenic shock. We analysed the available Randomized Controlled Trials (RCT) and observational studies, spanning 30 years, to establish the evidence for this use. There is no identifiable group of patients with Acute Myocardial Infarction that have been demonstrated to derive a mortality benefit from insertion of an IABP. The studies, including over 17000 patients, have studied mortality in patients receiving IABP in comparison to mortality of patients that received no IABP in the era of no reperfusion, fibrinolysis and primary percutaneous intervention.  This lack of mortality reduction with IABP in AMI is consistent in patients with and without cardiogenic shock across both RCTs and observational studies; questioning the continued use of this technology in Acute Myocardial Infarction. (more…)