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Author Interviews, Columbia, Depression, Hearing Loss, JAMA / 08.01.2019

MedicalResearch.com Interview with: Justin S. Golub, MD, MS Assistant Professor Otology, Neurotology, and Skull Base Surgery Department of Otolaryngology-Head and Neck Surgery Columbia University Vagelos College of Physicians and Surgeons NewYork-Presbyterian/Columbia University Irving Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Age-related hearing loss is extremely common, yet few people do anything about it. We studied a population of over 5,000 individuals and found that hearing loss was related to feelings of depression. The worse the hearing loss, the worse the symptoms of depression. Even people with just mild hearing loss had nearly two times the odds of depressive symptoms compared to normal hearing people. Among people with moderate hearing loss, the odds of depressive symptoms were four times as high. These statistics take into account various factors that can cause both hearing loss and depression, such as age and demographic background.  (more…)
Author Interviews, Cost of Health Care, University of Pittsburgh / 08.01.2019

MedicalResearch.com Interview with: Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective of our study was to answer a research question of high policy relevance: to what extent are rising drug costs due to inflation in the prices of existing products versus the market entry of new, more expensive drugs. We found that rising prices of brand-name drugs are largely driven by manufacturers increasing prices of medications that are already in the market rather than to the entry of new products. In contrast, increases in costs of specialty and generic drugs were driven by the entry of new drugs. (more…)
ALS, Author Interviews, Brigham & Women's - Harvard, Cognitive Issues, JAMA, Multiple Sclerosis / 08.01.2019

MedicalResearch.com Interview with: Michael Fralick, MD, FRCPC, SM, PhD (Cand) Clinical Associate, General Internal Medicine St Michael’s Hospital Phillipson Scholar, Clinician Scientist Program, University of Toronto PhD Candidate, IHPME, University of Toronto Affiliated Faculty, Program On Regulation, Therapeutics, And Law, Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital, Harvard University MedicalResearch.com: What is the background for this study? What are the main findings? Response: This medication is a pill that combines two ingredients: dextromethorphan (the active ingredient in cough syrup) and quinidine (used to increase the concentration of dextromethorphan). The medication was primarily studied and evaluated in patients with amyotrophic lateral sclerosis (ALS)   or (multiple sclerosis) MS, but anecdotal evidence suggested it was being prescribed to patients with dementia. We used data from two nationwide healthcare databases to understand how the medication was being used in routine care. (more…)
Author Interviews, JAMA, Johns Hopkins, Social Issues / 06.01.2019

MedicalResearch.com Interview with: Megan Wallace, DrPH Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Local health departments are often evaluated on a nationwide or statewide basis, however, given diversity among counties that exists even at the state level, we felt there might be a better way to group health departments for evaluation. In this study, we created county-level clusters using local characteristics most associated with the outcomes of interest, which were smoking, motor vehicle crash deaths, and obesity. We then compared county-level percentile rankings for the outcomes within sociodemographic peer clusters vs nationwide rankings. We identified 8 groups of counties with similar local characteristics. Percentile ranks for the outcomes of interest often differed when counties were compared within their peer groups in comparison with a nationwide scale.  (more…)
Author Interviews, Columbia, Genetic Research, Kidney Disease / 03.01.2019

MedicalResearch.com Interview with: Emily E. Groopman, B.A Departments of Medicine Hammer Health Sciences, and the Department of Epidemiology Columbia University, New York MedicalResearch.com: What is the background for this study? Response: Exome sequencing (ES), targeted capture of the protein-coding segments of the human genome, is quickly becoming a first-line diagnostic tool in clinical medicine, particularly for pediatric disorders and cancer. However, the utility of ES has not been investigated for the majority of constitutional disorders in adults, including for chronic kidney disease (CKD), which collectively affects more than 1 in 10 individuals worldwide. Thus, we performed ES in 3,315 patients with CKD drawn from two independent cohorts, and evaluated the diagnostic yield and the clinical implications of genetic findings. The cohort was predominantly adult (91.6% of patients aged >21 years), ethnically diverse, and encompassed the major CKD subtypes, broadly reflective of the demographic and clinical features of United States CKD patient population. (more…)
Annals Internal Medicine, Author Interviews, Beth Israel Deaconess, Cost of Health Care, Heart Disease, Lipids / 02.01.2019

MedicalResearch.com Interview with: Dhruv S. Kazi, MD, MSc, MS Associate Director Richard A. and Susan F. Smith Center for Outcomes Research Boston MA 02215 Associate Director Cardiac Critical Care Unit Beth Israel Deaconess Medical Center  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The ODYSSEY Outcomes trial found that addition of alirocumab to statin therapy reduces the incidence of a composite of cardiovascular death, myocardial infarction, and stroke among patients with a recent history of a myocardial infarction and elevated low-density lipoprotein cholesterol. We modeled the cost-effectiveness of alirocumab and found that, at the March 2018 price of the drug, it would not be cost-effective (either relative to statin alone or statin + ezetimibe) for this indication. We found that a large price-reduction would be required to meet the cost-effectiveness threshold of $100,000 per quality-adjusted life year. Shortly after the preliminary findings of this study were released, both manufacturers of PCSK9 inhibitors announced large price reductions in order to improve access to these drugs. (more…)
Author Interviews, Johns Hopkins, Kidney Disease, Sugar / 02.01.2019

MedicalResearch.com Interview with: Casey M. Rebholz, PhD, MS, MNSP, MPH, FAHA Assistant Professor, Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Core Faculty, Welch Center for Prevention, Epidemiology, and Clinical Research Baltimore, MD 21287 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Individual beverages have been previously shown to influence risk of a wide range of cardiometabolic diseases. Less is known about beverage consumption and kidney disease risk. In this study population, we found that one such beverage pattern consisted of soda, sugar-sweetened beverages, and water, and that higher adherence to the sugar-sweetened beverage pattern was associated with greater odds of developing incident kidney disease, even after accounting for demographic characteristics and established risk factors.  (more…)
Author Interviews, NEJM, Pediatrics, Smoking, Tobacco, Tobacco Research, University of Michigan / 30.12.2018

MedicalResearch.com Interview with: Richard Miech Ph.D Professor Principal Investigator, Monitoring the Future Institute for Social Research University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Every year Monitoring the Future conducts a survey to examine trends in adolescent substance use.  We draw a random sample of schools from a list of all schools in the United States and conduct our survey in ~400 schools.  Our survey is representative of U.S. 8th, 10th, and 12th grade students.  In other words, our results are what you would find if you surveyed every single 8th, 10th, and 12th graders in the United States, within the bounds of a small sampling error of a few percentage points. An increase in vaping is the big news for 2018.  In 10th and 12th grade the increase in nicotine vaping was the largest we've ever seen for any substance in the past 43 years.  As a result of this increase in nicotine vaping, overall use of nicotine increased as well, which suggests that vaping is drawing youth into nicotine use.  We also saw a significant increase in marijuana vaping. (more…)
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, UCSF / 27.12.2018

MedicalResearch.com Interview with: Oanh Kieu Nguyen, MD, MA Assistant Professor Division of Hospital Medicine Zuckerberg San Francisco General Hospital UCSF MedicalResearch.com: What is the background for this study? Response: In U.S. citizens and permanent residents with kidney failure or end-stage renal disease (ESRD), having health insurance, Medicare, or Medicaid guarantees access to regularly scheduled hemodialysis 2-3 times per week, the evidence-based standard of care for ESRD. This treatment helps people live relatively normal lives. In 40 of 50 U.S. states, undocumented immigrants with ESRD have limited access to hemodialysis because they are not eligible for any form of federal assistance including Medicare or Medicaid, and must wait until they are life-threateningly ill to receive dialysis through a hospital emergency department, a situation called “emergency-only hemodialysis.” There are an estimated 6,500 undocumented individuals in the U.S. suffering from ESRD. A unique opportunity made it feasible for uninsured undocumented immigrants with ESRD receiving emergency-only dialysis in Dallas, Texas, to enroll in private, commercial health insurance plans in 2015 and made it possible for researchers to compare scheduled vs. emergency-only dialysis among undocumented immigrants with ESRD. This natural experiment included 181 undocumented immigrants, 105 of whom received insurance coverage and enrolled in scheduled dialysis and 76 of whom remained uninsured.  (more…)
Author Interviews, Breast Cancer, NIH, OBGYNE / 27.12.2018

MedicalResearch.com Interview with: Dale P. Sandler, Ph.D. Chief, Epidemiology Branch National Institute of Environmental Health Sciences NIH MedicalResearch.com: What is the background for this study? Response: Not having children is a well-established risk factor for breast cancer, but most of this evidence comes from studies of postmenopausal women since breast cancer before menopause is relatively uncommon. There is growing evidence that some risk factors differ for premenopausal and postmenopausal breast cancer – for example obesity which increases risk for breast cancer after menopause but appears to be protective before menopause. There was some evidence that breast cancer risk increased shortly after pregnancy. It was thought that this risk lasted for 5 to ten years. Studies were unable to fully characterize the duration of this increase in risk or evaluate factors such as breast feeding, age at birth, or family history of breast cancer that could modify the relationship between recent pregnancy and breast cancer risk. Breast cancer before menopause or age 55 is relatively rare, and few individual studies are large enough to answer these questions. To answer these questions, we formed the Breast Cancer Collaborative Group, a pooling project involving 20 prospective cohort studies. We included 890,000 women from 15 of these long-term studies across three continents, including over 18,000 incident breast cancer cases.  (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity, Stanford / 26.12.2018

MedicalResearch.com Interview with: Fatima Rodriguez, MD, MPH, FACC Assistant Professor Cardiovascular Medicine Stanford University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The “Hispanic Paradox” is an idea based on some epidemiological observations that Hispanics have lower disease prevalence and mortality (across a wide spectrum of disease states), despite adverse risk profiles and lower socioeconomic status than their non-Hispanic white counterparts. Our study is unique in that it includes a Hispanic population with overall high educational attainment followed longitudinally. In contrast to prior work in this area, we found no evidence in support of the Hispanic paradox for estimated atherosclerotic cardiovascular disease risk, atherosclerotic disease (as measured by CAC), or overall mortality. (more…)
Accidents & Violence, Author Interviews, JAMA, Sexual Health, UCSD / 26.12.2018

MedicalResearch.com Interview with: John W. Ayers, PhD, MA Vice Chief of Innovation | Assoc. Professor Div. Infectious Disease & Global Public Health University of California San Diego MedicalResearch.com: What is the background for this study?   Response: The greatest barrier to understanding trends around sexual violence is they are largely hidden because victims are unable speak up publicly. Moreover, ongoing monitoring relies on proxies that underreport the scale of the problem such as police or medical records where only the most severe instances or a fraction of all instances of sexual violence are represented. As a result, we know very little about the scale of America's sexual violence problem. It was this backdrop that inspired #MeToo to call on victims to publicly voice their stories thereby revealing the scale of the problem. Our goal was to, for the first time, assess how this change inspired the public to engage with sexual violence issues. By tracking private aggregate internet search query trends we can begin to understand the scale of public engagement with issues around sexual violence including the precise motivation for a search, such as reporting episodes of sexual violence or learning how to prevent sexual violence. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Emory, Obstructive Sleep Apnea, Race/Ethnic Diversity, Sleep Disorders / 26.12.2018

MedicalResearch.com Interview with: Dayna A. Johnson PhD Department of Epidemiology Emory University Atlanta, GA MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are several studies that have determined that African Americans have the highest prevalence of hypertension and are the most likely to have uncontrolled hypertension compared to other racial/ethnic groups. We were interested in studying whether sleep apnea contributed to hypertension control among African Americans. We found that participants with sleep apnea were more likely to have resistant hypertension than those without sleep apnea. In particular, individuals with severe sleep apnea had the highest risk of resistant hypertension. Most of the participants with measured sleep apnea were undiagnosed (96%).  (more…)
Author Interviews, Dermatology, JAMA, NYU / 19.12.2018

MedicalResearch.com Interview with: Nicholas A. Soter, MD The Ronald O. Perelman Department of Dermatology New York University School of Medicine New York, New York MedicalResearch.com: What is the background for this study? Response: Nearly 50% of patients with chronic spontaneous urticarial (CSU) (hives) incompletely respond to first-line therapy with H-1 antihistamines. However, in the current literature, there is limited evidence to guide the treatment of CSU after maximal therapy with antihistamines fails.  Two small, randomized, controlled trials suggest that dapsone, which is an antimicrobial therapeutic agent with anti-inflammatory properties, may be a useful second-line therapeutic agent. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, OBGYNE, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: Krista F. Huybrechts, MS PhD Associate Professor of Medicine Brigham and Women’s Hospital Harvard Medical School Boston, MA 02120  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Pregnant women often experience nausea and vomiting, particularly during the first trimester.  Early treatment is recommended to relieve symptoms and prevent progression to hyperemesis gravidarum.  Although not formally approved for this indication, ondansetron is the most frequently prescribed treatment for nausea and vomiting in pregnancy in the US: 22% of pregnant women reportedly used ondansetron in the US in 2014. Despite this common use, the available evidence on the fetal safety of ondansetron is limited and conflicting, and the possibility of a doubling in risk of cleft palate and cardiac malformations has been raised. We therefore evaluated the association between ondansetron exposure during the first trimester of pregnancy, the period of organogenesis, and the risk of congenital malformations in a cohort of 1,816,414,publicly insured pregnancies using the nationwide Medicaid Analytic eXtract data for 2000-2013.  A total of 88,467 women (4.9%) were exposed to ondansetron during the first trimester.  After adjusting for a broad range of potential confounding variables, we found no association with cardiac malformations (RR = 0.99; 95% CI, 0.93 – 1.06)  and congenital malformations overall (RR = 1.01; 95% CI, 0.98 – 1.05). For oral clefts, we found a 24% increase in risk (RR=1.24; 95% CI, 1.03 – 1.48), which corresponds to an absolute risk of 2.7 per 10,000 births (95% CI, 0.2 – 5.2 per 10,000 births).  These findings were consistent across sensitivity analyses, conducted to address potential misclassification and confounding bias.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cannabis, JAMA, Mental Health Research, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: Sharon Levy, MD, MPH Director, Adolescent Substance Use and Addiction Program Boston Children's Hospital Associate Professor of Pediatrics Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​For this study we analyzed data that were collected as part of a larger survey study that recruited a sample of adolescents who were coming to the doctor's office for routine medical care.  We asked them a lot of questions about their health, school, extracurricular activities, plans for the future, substance use patterns and problems associated with use among other things. The main finding was that among the participants who reported marijuana use in the past year, many of them, more than 40%, said that they had experienced either an hallucination, or paranoia/anxiety related to their use. Kids who used more frequently and those who met criteria for a substance use disorder were more likely to experience these symptoms, as were those who had symptoms of depression (more…)
Author Interviews, Johns Hopkins, Kidney Disease, Transplantation / 18.12.2018

MedicalResearch.com Interview with: Chirag R Parikh, M.B.B.S., Ph.D. Director,Division of Nephrology Professor of Medicine School of Medicine, Johns Hopkins University Baltimore, Maryland 21287  MedicalResearch.com: What is the background for this study? Response: The initial study idea stemmed from our earlier cohort studies of predictors of delayed graft function after kidney transplantation.  We previously found that kidneys from donors with Acute Kidney Injury (AKI) were more often discarded than kidneys from donors without AKI, and transplanted donor AKI kidneys were at increased risk for delayed graft function. It was important to determine whether that increased risk for delayed graft function also translated into worse long-term outcomes for recipients of kidneys from donors with AKI. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Mediterranean Diet, Women's Heart Health / 10.12.2018

MedicalResearch.com Interview with: Samia Mora, MD, MHS Associate Professor of Medicine Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Mediterranean diet is rich in plants (nuts, seeds, fruits, vegetables, whole grains, legumes) and olive oil, and includes moderate intake of fish, poultry, dairy, and eggs, and alcohol, and rare use of meats and sweets.The Mediterranean diet has been associated with lower risk of cardiovascular disease (CVD) events but the precise mechanisms through which Mediterranean diet intake may reduce long-term risk of CVD are not well understood. We aimed to investigate the biological mechanisms that may mediate this cardiovascular benefit. Using a prospective study of 25,994 initially healthy women enrolled in the Women’s Health Study who were followed up to 12-years, we evaluated potential mediating effects of a panel of biomarkers (in total 40 biomarkers) that represent different CVD pathways and clinical factors. Higher baseline intake of a Mediterranean-type diet was associated with approximately one quarter lower risk of CVD events during the 12 year follow up. For the MED-CVD risk reduction, biomarkers of inflammation, glucose-metabolism/insulin-resistance, and adiposity contributed most to explaining the association, with additional contributions from pathways related to blood pressure, lipids – in particular HDL or triglyceride-rich lipoprotein metabolism, and to a lesser extent LDL cholesterol, branched chain amino acids, and small molecule metabolites.  (more…)
ADHD, Author Interviews, Autism, JAMA, Pediatrics, UC Davis / 10.12.2018

MedicalResearch.com Interview with: Meghan Miller, Ph.D. Assistant Professor Department of Psychiatry & Behavioral Sciences UC Davis MIND Institute Sacramento, CA 95817 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study evaluated within-diagnosis sibling recurrence and sibling cross-aggregation of ADHD and autism spectrum disorder among later-born siblings of diagnosed children. We specifically chose to include only families who had at least one subsequent child after the diagnosis of an older child because failing to do so could bias recurrence risk estimates. We found that, compared to later-born siblings of non-diagnosed children, later-born siblings of children with autism were more likely to be diagnosed with autism or with ADHD. Likewise, compared to later-born siblings of non-diagnosed children, later-born siblings of children with ADHD were more likely to be diagnosed with ADHD or with autism. (more…)
Author Interviews, Brigham & Women's - Harvard, Social Issues / 05.12.2018

MedicalResearch.com Interview with: Dr. Rishi Wadhera, MD  Cardiology Fellow Brigham and Women's Hospital Harvard Medical School. MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In the United States, an estimated half a million people are homeless on any given night. In recent years, policy efforts to improve the health of homeless individuals have intensified, but there is little large-scale, contemporary data on how these efforts have impacted patterns of acute illness in this vulnerable population. In this study, we examined trends, causes, and outcomes of hospitalizations among homeless individuals in three states – Massachusetts, Florida, and California – from 2007 to 2013. We found that hospitalization rates among homeless adults increased over this period of time. Strikingly, over one-half of these hospitalizations were for mental illness and substance use disorder. More broadly, homeless adults were hospitalized for a very different set of reasons compared with demographically similar non-homeless adults. In addition, homeless individuals had longer lengths of hospitalization but lower total costs per hospitalization. (more…)
Author Interviews, Blood Pressure - Hypertension, Duke, Heart Disease, JAMA / 05.12.2018

MedicalResearch.com Interview with: Taku Inohara MD, PhD Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina Department of Cardiology Keio University School of Medicine, Tokyo, Japan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Transcatheter aortic valve replacement (TAVR) has been increasingly used for treating patients with severe aortic stenosis. Owing to the advancement of TAVR technology, the mortality and heart failure (HF) readmission after TAVR is decreasing over time, but 4.3% experienced readmission due to HF and 23.7% died within 1 year after TAVR. Inhibition of the renin-angiotensin system (RAS) with angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin-receptor blockers (ARBs) is known to improve clinical outcomes in patients with heart failure, but there remains unknown whether a RAS inhibitor is associated with a reduction in mortality and heart failure readmission after TAVR. Using the STS/ACC TVT Registry, a nationwide TAVR Registry in the US, we analyzed 15896 propensity-matched patients who underwent TAVR and found that receiving a prescription for a RAS inhibitor at discharge, compared with no prescription, was associated with a reduced risk for mortality ( 12.5% vs 14.9%) and HF readmission (12.0% vs 13.8%). (more…)
Author Interviews, Brigham & Women's - Harvard, Social Issues / 05.12.2018

MedicalResearch.com Interview with: Professor Tyler VanderWeele Ph.D John L. Loeb and Frances Lehman Loeb Professor of Epidemiology Harvard University MedicalResearch.com: What is the background for this study? What are the key points of the paper?   Response: Several prior studies have suggested that religious service attendance is associated with lower rates of divorce. However, many of these studies have been with small samples and have not had rigorous study designs. In addition, most studies have focused on women earlier in life and there has been little research on the effects of religious service attendance on divorce later in life. While divorce rates in the United States in general has been falling, it has in fact been increasing for middle-aged groups, doubling between 1990 and 2010. In our study we found that among women in mid- to late- life, regular religious service attendance was subsequently associated with 50% lower divorce rates over the following 14 years of the study. We also found that among those who were widowed, religious service attendance was associated with a 49% increase in the likelihood of remarrying over the 14 years of the study. (more…)
Author Interviews, Infections, NIH, Ophthalmology / 05.12.2018

MedicalResearch.com Interview with: Top, retina of a control patient. Bottom, retina from a patient with CJD. Arrowheads point to abnormal prions in the outer plexiform layer (opl), and the asterisk (*) marks more diffuse prions in the inner plexiform layer (ipl).Orrù et al., mBioByron Caughey, Ph.D. Senior Investigator Chief, TSE/prion Biochemistry Section Laboratory of Persistent Viral Diseases NIH/NIAID Rocky Mountain Laboratories Hamilton, MT 59840 USA  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Corneal transplants have caused the transmission of Creutzfeldt-Jakob disease (CJD) in at least two cases, and pathological prion protein has been detected in the retinas of the eyes of sporadic CJD cases. To build on these previous indications of prions in eye tissue, we tested the distribution of prions in various components of eyes from 11 sCJD decedents. We applied a highly sensitive surrogate test for prions (RT-QuIC) that indicated that all of the sCJD cases had prions in multiple parts of their eye, including the cornea and sclera, which is the white outer surface of the eye. Retinas were usually contained the highest levels, in some cases approaching levels in the brain. Some other parts such as the cornea, lens and vitreous had much lower, but detectable, levels.  (more…)
Author Interviews, FDA, JAMA, Medical Imaging / 04.12.2018

MedicalResearch.com Interview with: Aldo Badano, Ph.D. Deputy Director, Division of Imaging, Diagnostics, and Software Reliability Office of Science and Engineering Laboratories Center for Devices and Radiological Health Silver Spring, MD 20993 Aldo Badano, Ph.D. Deputy Director, Division of Imaging, Diagnostics, and Software Reliability Office of Science and Engineering Laboratories Center for Devices and Radiological Health Silver Spring, MD 20993  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Expensive and lengthy clinical trials can delay regulatory evaluation of innovative technologies, affecting patient access to high-quality medical products. Although computational modeling is increasingly being used in product development, it is rarely at the center of regulatory applications. Within this context, the VICTRE project attempted to replicate a previously conducted imaging clinical trial using only computational models. The VICTRE trial involved no human subjects and no clinicians. All trial steps were conducted in silico. The fundamental question the article addresses is whether in silico imaging trials are at a mature development stage to play a significant role in the regulatory evaluation of new medical imaging systems. The VICTRE trial consisted of in silico imaging of 2986 virtual patients comparing digital mammography (DM) and digital breast tomosynthesis (DBT) systems. The improved lesion detection performance favoring DBT for all breast sizes and lesion types was consistent with results from a comparative trial using human patients and radiologists.  (more…)
Author Interviews, Cannabis, University of Pennsylvania / 02.12.2018

MedicalResearch.com Interview with: Daniel Romer PhD Annenberg Public Policy Center The University of Pennsylvania Philadelphia, PA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has found some troubling relations between adolescent cannabis use and subsequent increases in conduct problems and other unhealthy consequences.  These studies were done in New Zealand in the late 90’s and we wanted to re-examine those relationships using more contemporary data in the US. We had data on 364 adolescents who were followed from age 13 to 19 in Philadelphia that could provide a more up to date picture of the effects of using cannabis on one important outcome, conduct disorder.  We also wanted to use more sensitive methods than had been used in prior research that would enable us to examine reciprocal relations between cannabis use and c (CP).  That is, it might be the case that youth with CP are prone to using cannabis and that this helps to explain why there appears to be a relation over time between cannabis use and CP rather than cannabis use leading to CP. Our findings supported that hypothesis.  There was no prospective relation between changes in cannabis use and subsequent changes in conduct problems.  Instead, changes in conduct problems were found to predict changes in use of cannabis.  Youth with conduct problems also affiliated more with peers who used cannabis, adding further to their own use.  There was also no evidence that youth who used cannabis sought out peers who used it apart from the effects of CP. Finally, both use of cannabis and  conduct problems predicted subsequent development of a mild cannabis use disorder (CUD).  (more…)
Author Interviews, Baylor College of Medicine Houston, Infections, Microbiome, OBGYNE, Vaccine Studies / 30.11.2018

MedicalResearch.com Interview with: Sasirekha Ramani, PhD Assistant Professor Molecular Virology and Microbiology Baylor College of Medicine Houston, TX MedicalResearch.com: What is the background for this study? Response: This work pertains to Rotavirus, a leading cause of diarrhea and vomiting in children under the age of 5 years. In this paper, we described our work with a rotavirus strain that almost exclusively causes neonatal infections. For many years, we have been trying to understand why this strain primarily infects newborns and why infection in some babies is associated with gastrointestinal symptoms while others are asymptomatic. A few years ago, we showed that this particular virus binds to developmentally-regulated glycans (sugars) in the gut as receptors. As the baby grows, these sugars get modified, and that potentially explains why infection with this virus is primarily restricted to neonates. However, we didn’t really have to answer to why there are differences in association with clinical presentations. (more…)
Annals Internal Medicine, Author Interviews, Columbia, Genetic Research, Kidney Disease / 27.11.2018

MedicalResearch.com Interview with: Hila Milo Rasouly, PhD Postdoctoral research scientist Ali Gharavi Lab Columbia University MedicalResearch.com: What is the background for this study? Response: Genome sequencing is increasingly used in clinical medicine to help make a clinical diagnosis and make predictions about potential future complications. The diagnostic yield and limitations for different indications are still being worked out.  We are interested in studying the applications of genome sequencing for chronic kidney diseases. It is estimated that 10% of adults have chronic kidney disease (CKD), and amongst them, 10% are caused by single-gene (Mendelian) forms of disease. The American College of Medical Genetics and Genomics developed guidelines on how to interpret genetic variants in order to make a genetic diagnosis. Our lab has been engaged in studying the yield and impact of genetic testing for  CKD, and in the course of our research, we realized that a very large number of individuals have genetic variants that may be classified as pathogenic based on automated application of the guidelines. However, in majority of these cases, the genetic variant was much too frequent in the population to be plausibly disease-causing or did not match up well with the clinical diagnosis. This led us to wonder about the risk of false-positive genetic diagnosis. To analyze this risk for false-positive genetic diagnosis, we analyzed the genome sequence of 7,974 self-reported healthy adults. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Diabetes, Occupational Health / 24.11.2018

MedicalResearch.com Interview with: "Night Shift" by Yuchung Chao is licensed under CC BY-ND 3.0Dr. Zhilei Shah PhD Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety Ministry of Education Key Lab of Environment and Health, School of Public Health Tongji Medical College, Huazhon University of Science and Technology Wuhan,  China MedicalResearch.com: What is the background for this study? Response: Shift work has progressed in response to changes in economic pressure and greater consumer demand for 24-hour services. There are many economic advantages to increased shift work, including higher employment, increased services to customers, and improved trade opportunities. Currently, one in five employees in the U.S. works nonstandard hours in the evening, night, or rotating shifts. However, shift work, especially night shift work, has been associated with a higher risk of chronic diseases, including type 2 diabetes, cardiovascular disease, and several types of cancer. Compelling evidence has shown that body weight and lifestyle behaviors, such as smoking, diet, and physical activity can influence type 2 diabetes risk. Among shift workers, excess adiposity and increased smoking are frequently and consistently reported, whereas the evidence on physical activity and diet is mixed. Additionally, no previous study has examined the joint associations of rotating night shift work duration and unhealthy lifestyle factors with risk of type 2 diabetes, or evaluated their potential interactions. Therefore, we prospectively assessed the joint association of rotating night shift work and established type 2 diabetes lifestyle risk factors with risk of type 2 diabetes and quantitatively decomposed the proportions of the joint association to rotating night shift work alone, to lifestyle alone and to their interaction in two large US cohorts. (more…)