MedicalResearch.com - Latest news, interviews, and insights into medical research, health and wellness, fitness and addiction.
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lipids / 03.08.2018

MedicalResearch.com Interview with: Marc S. Sabatine, MD, MPH Chairman | TIMI Study Group Lewis Dexter, MD, Distinguished Chair in Cardiovascular Medicine Brigham and Women's Hospital Professor of Medicine | Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Low-density lipoprotein cholesterol (LDL-C) is a well-established risk factor for cardiovascular disease. The initial statin trials studied patients with high levels of LDL-C, and showed a benefit by lowering LDL-C. We and others did studies in patients with so-called “average” levels of LDL-C (120-130 mg/dL), and also showed clinical benefit with lowering. (more…)
Author Interviews, Cost of Health Care, JAMA, Medicare, UCSF / 01.08.2018

MedicalResearch.com Interview with: Andrew B. Bindman, MD Professor of Medicine PRL- Institute for Health Policy Studies University of California San Francisco MedicalResearch.com: What is the background for this study?   Response: The purpose of this study was to evaluate the use and impact of a payment code for transitional care management services which was implemented by Medicare in. The transition of patients from hospitals or skilled nursing facilities back to the community often involves a change in a patient’s health care provider and introduces risks in communication which can contribute to lapses in health care quality and safety. Transitional care management services include contacting the patient within 2 business days after discharge and seeing the patient in the office within 7-14 days. Medicare implemented payment for transitional care management services with the hope that this would increase the delivery of these services believing that they could reduce readmissions, reduce costs and improve health outcomes. (more…)
Author Interviews, Duke, Genetic Research, Neurology, Pediatrics / 30.07.2018

MedicalResearch.com Interview with:  Paul C Marcogliese, Ph.D. Postdoctoral Associate, Laboratory of Dr. Hugo Bellen Department of Molecular and Human Genetics Baylor College of Medicine Houston, Texas 77030 Loren D. Pena, MD PhD Division of Human Genetics Cincinnati Children's Hospital Medical Center Department of Pediatrics University of Cincinnati Cincinnati, OH 45229 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Undiagnosed Diseases Network (UDN) is a multi-site collaboration across the US that seeks to help diagnose patients with rare disorders that are ill-defined. Dr. Loren D.M. Pena and Dr. Vandana Shashi at the Duke-Columbia clinical site of the UDN had seen a patient with a severe neurological disorder. While the patient had no symptoms at birth, the patient began falling at about 3 years of age, eventually losing motor coordination and developing seizures. In the interim, the regression has progressed to a severely debilitating state. Re-analysis of the participant’s exome data by our site bioinformatician at Columbia (Nicholas Stong) in Dr. David Goldstein’s laboratory revealed a truncating variant in the single exon gene IRF2BPL that could be the candidate disease-causing gene. The UDN clinicians at Duke then contacted the UDN Model Organism Screening Center (MOSC) led by Dr. Hugo Bellen at Baylor College of Medicine and the Howard Hughes Medical Institute for functional analysis. In parallel, four more patients were found with truncating mutations causing a similar disorder though the UDN and GeneMatcher.org. Additionally, two patients with missense variants in IRF2BPL were identified that displayed seizures and some developmental delay or autism spectrum disorder but no motor regression. Work in MOSC by Dr. Paul Marcogliese using fruit flies revealed that the IRF2BPL truncating variants are severe loss of function mutations and one of the missense variants was a partial loss of function. Additionally, it was found that the fruit fly IRF2BPL gene, called pits, is expressed in the neurons of the adult fly brain. Lowering the levels of pits by about 50% in fly neurons leads to progressive behavioural abnormalities and neurodegeneration. By combining the human genetics, bioinformatics and model organism data, IRF2BPL was found to be a novel disease-causing gene in humans. (more…)
Author Interviews, Brigham & Women's - Harvard, Gender Differences, Occupational Health, Sexual Health / 30.07.2018

MedicalResearch.com Interview with: Brittany M. Charlton, ScD, Assistant Professor Harvard Medical School Harvard T.H. Chan School of Public Health Boston Children's Hospital Boston, MA MedicalResearch.com: What is the background for this study? Response: Research has shown that nearly half of all sexual minorities (e.g., lesbian, gay, and bisexual individuals) experience employment discrimination in their lifetime, which may lead to many other disparities, including health insurance coverage, healthcare access, and ultimately health-related quality of life (e.g., pain, anxiety). (more…)
Author Interviews, Cannabis, McGill, Pulmonary Disease / 30.07.2018

MedicalResearch.com Interview with: Sara Abdallah, PhD Student, first author and Dennis Jensen, PhD Associate Professor, Department of Kinesiology and Physical Education Associate Dean – Infrastructure, Faculty of Education Director, McGill Research Center for Physical Activity and Health Canada Research Chair in Clinical Exercise & Respiratory Physiology Associate Member, Translational Research in Respiratory Diseases Program Research Institute of the McGill University Health Center MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Many patients with chronic obstructive pulmonary disease (COPD) suffer from severe breathlessness at rest and on minimal exertion despite receiving optimal drug therapy for their underlying disease (e.g., bronchodilators). In these patients, breathlessness significantly diminishes exercise capacity and quality of life. Thus, research focused on identifying adjunct therapies for management of breathlessness in patients with advanced COPD is clinically relevant. A series of studies conducted in the 1970’s found that smoked cannabis caused bronchodilation (i.e., improved airway function) in healthy individuals and in patients with asthma. More recently, it has been demonstrated that delta-9 (∆9)-tetrahydrocannabinol (THC, the major cannabinoid constituent of cannabis) inhibits cholinergic contractions in isolated human bronchi and that a positive association exists between measure of lung function (e.g., forced expiratory volume in 1-sec) and cannabis use in patients with COPD. These studies lead us to hypothesize that inhalation of vaporized cannabis may alleviate exertional breathlessness and improve exercise tolerance in patients with advanced COPD by improving airway function at rest and during exercise. (more…)
Author Interviews, Biomarkers, NYU, Pediatrics, Pulmonary Disease / 29.07.2018

MedicalResearch.com Interview with: Dr. Mikhail Kazachkov MD Director of Pediatric Pulmonology Hassenfeld Children’s Hospital NYU Langone Medical Center  MedicalResearch.com: What is the background for this study? How common is the problem of chronic cough in children?  Is it more common in children with allergies, asthma or reflux? Response: Chronic cough is one of the leading causes of pediatric referrals to subspecialty physicians.  Its prevalence in the general pediatric population may approach 3% (Galassi et al, Epidemiol. Prev. 2005;29,Suppl.:9–13). It is important to recognize that the main causes of chronic cough in children are completely different for those in adults.  Specifically, gastroesophageal reflux and postnasal drip are not considered to be important causes of cough in children.  Cough variant asthma, although is a common cause of cough in adults, does not seem to be frequently diagnosed and a cause of chronic cough in children. The main cause of chronic wet cough in children is protracted bacterial bronchitis (Chang et al, Chest. 2017 Apr;151:884-890).  It is important to recognize that neurologically impaired children have completely different pathogenesis of chronic cough, which is mostly related to aspiration into the lower airway and development of aspiration-related lung disease. (more…)
Author Interviews, Genetic Research, Osteoporosis, PLoS, Stanford / 29.07.2018

MedicalResearch.com Interview with: Stuart Kim PhD Professor of Developmental Biology, Emeritus Bio-X Affiliated Faculty James H. Clark Center Stanford University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Osteoporosis is caused by a reduction in bone mass, and leads to a high incidence of bone fracture because the weakened bone is less able to withstand the stress of slips and falls. Osteoporosis affects millions of elderly, is responsible for as many as 50% of fractures in women and 25% of fractures in men over the age of 50, and accounts for $19 billion in annual health care costs in the US. Identification of people with an increased genetic risk for osteoporosis could reduce the incidence of bone fracture. Low BMD is also a risk factor for stress fractures. For athletes and military personnel undergoing harsh rigors of training, stress fractures are common injuries that limit playing time, military effectiveness and competitive success. Using data from UK Biobank, a genome-wide association study identified 1,362 independent SNPs that clustered into 899 loci of which 613 are new. These data were used to train a genetic algorithm using 22,886 SNPs as well as height, age, weight and sex as predictors. Individuals with low genetic scores (about 2% of those tested) showed a 17-fold increase in risk for osteoporosis and about a 2-fold increase in risk of fractures. (more…)
Author Interviews, Cocaine, Gastrointestinal Disease, PLoS, Surgical Research, Vanderbilt, Weight Research / 27.07.2018

MedicalResearch.com Interview with: Aurelio Galli, Ph.D. Professor of Molecular Physiology & Biophysics and Psychiatry & Behavioral Science Associate Director for Research Strategy Vanderbilt Brain Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study builds on evidence that bile acids influence the brain’s reward system. Bile acids are normally released from the gall bladder into the upper part of the small intestine, where they emulsify fats for absorption, before being recycled further down the small intestine. In bile diversion surgery, an experimental treatment for weight loss, bile is released at the end of the small intestine, increasing the amount of bile acids that enter the general circulation. Mice treated with this surgery have less appetite for high-fat foods, which suggests that bile acids affect brain reward pathways. We demonstrated that mice receiving the surgery also showed less preference for the cocaine-associated chamber, indicating that cocaine was probably less rewarding. (more…)
Author Interviews, Eli Lilly, Lancet, Pharmacology, Rheumatology, UCLA / 26.07.2018

MedicalResearch.com Interview with: Daniel J. Wallace M.D., FACP, MACR Associate Director, Rheumatology Fellowship Program Board of Governors, Cedars-Sinai Medical Center Professor of Medicine, Cedars-Sinai Medical Center David Geffen School of Medicine Center at UCLA In affiliation with Attune Health Beverly Hills, Ca 90211 MedicalResearch.com: What is the background for this study? What are the main findings?   Response: This is the first positive study of systemic lupus erythematosus (SLE) using baricitinib,  a small oral molecule that blocks the JAK system. The human kinome consists of 500 genes and helps regulate cell surface receptor interaction. While agents that inhibit certain pathways are approved for rheumatoid arthritis and certain malignancies, this is the first study of its kind in SLE. (more…)
Author Interviews, Duke, JAMA, Schizophrenia / 26.07.2018

MedicalResearch.com Interview with: Richard Keefe PhD Professor in Psychiatry and Behavioral Sciences Duke Institute for Brains Sciences MedicalResearch.com: What is the background for this study? What are the main findings? Response: A lot of studies have shown that cognitive deficits are present in young people at risk for psychosis. There have been calls for investigations of the idea that cognition declines over time in the young people who are at highest risk, but longitudinal studies are hard to conduct so not much work has been done to address this question. The main finding from our study is that the cognitive architecture – the way the various aspects of cognitive functioning appear to be organized in each individual’s brain based upon their pattern of performance – changes over time in those young people who are in the midst of developing psychosis. Interestingly, cognitive architecture also becomes more disorganized in those whose high-risk symptoms do not remit over a two year period, and is related to the functional difficulties they may be having. The young people whose high risk symptoms were present at the beginning of the study but remitted later actually improved cognitively over the two year period of the study. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, JAMA, Pediatrics, University of Pittsburgh / 25.07.2018

MedicalResearch.com Interview with: Idris V.R. Evans, M.D.,MA Assistant Professor Department of Critical Care Medicine University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings? Response: New York State issued a state-wide mandate in 2013 for all hospitals to develop protocols for sepsis recognition and treatment. This mandate was called “Rory’s Regulations” in honor of Rory Staunton, a boy who died from sepsis in 2012. Pediatric protocols involved a bundle of care that included blood cultures, antibiotics, and an intravenous fluid bolus within 1–hour. We analyzed data collected by the NYS Department of Health on 1,179 patients from 54 hospitals and found that the completion of the pediatric bundle within 1 hour was associated with a 40% decrease in the odds of mortality.  (more…)
Author Interviews, Brigham & Women's - Harvard, Genetic Research, Microbiome / 24.07.2018

MedicalResearch.com Interview with: A. Sloan Devlin, PhD Assistant Professor Department of Biological Chemistry and Molecular Pharmacology Harvard Medical School MedicalResearch.com: What is the background for this study? Response: It is known that the microbiome, the collection of bacteria that live in and on our bodies, influences the development of metabolic diseases including diabetes and obesity. The ways in which the microbiome affects host metabolism, however, are poorly understood. One reason for this lack of understanding is because the gastrointestinal tract contains hundreds of species of bacteria producing many different kinds of metabolites. Untangling the effects of these bacteria and the molecules they make is a significant challenge. In this study, we decided to concentrate on a group of metabolites found in the human gut called bile acids. When we eat a meal, these compounds are released into the gastrointestinal tract where they act as detergents that aid in digestion. Once these molecules reach the lower gastrointestinal tract, the gut bacteria residing there chemically modify these compounds, producing a pool of over 50 different bile acids total. Imbalances in this bile acid pool are thought to influence the progression of diet-induced obesity. However, it is unclear which specific bile acids are responsible for either beneficial or detrimental effects on host metabolism. We set out to address this question by first identifying a selective type of bacterial enzyme called a bile salt hydrolase, then by genetically deleting this enzyme from a common gut bacterium and investigating how this change affected host metabolism. (more…)
Author Interviews, JAMA, Stroke, UCLA / 24.07.2018

MedicalResearch.com Interview with: Kristina Shkirkova Doctoral Student in Neuroscience Zilkha Neurogenetic Institute University of Southern California Los Angeles, CA MedicalResearch.com: What is the background for this study? Response: Stroke is the second leading cause of death and a leading cause of adult disability worldwide. Stroke onset is sudden with symptoms progressing rapidly in the first hours after onset. The course of symptom progression after stroke is not well studied in the ultra-early window before hospital arrival and during early postarrival period. There is an urgent need to characterize the frequency, predictors, and outcomes of neurologic deterioration among stroke patients in the earliest time window. (more…)
AHA Journals, Author Interviews, Heart Disease, Lipids, Menopause, University of Pennsylvania, Women's Heart Health / 19.07.2018

MedicalResearch.com Interview with: Samar R. El Khoudary, Ph.D., M.P.H. BPharm, FAHA Associate Professor Department of Epidemiology University of Pittsburgh Graduate School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is based on the current measurements used to determine cardiovascular disease risk in postmenopausal women. Higher levels of HDL “good cholesterol” as measured by the widely available clinical test, HDL-Cholesterol, may not always be indicative of a lower risk of cardiovascular disease in postmenopausal women. HDL is a family of particles found in the blood that vary in sizes, cholesterol contents and function. HDL particles can become dysfunctional under certain conditions such as chronic inflammation. HDL has traditionally been measured as the total cholesterol carried by the HDL particles, known as HDL cholesterol. HDL cholesterol, however, does not necessarily reflect the overall concentration, the uneven distribution, or the content and function of HDL particles. We looked at 1,138 women aged 45 through 84 enrolled across the U.S. in the Multi-Ethnic Study of Atherosclerosis (MESA), a medical research study sponsored by the National Heart, Lung and Blood Institute of the National Institutes of Health (NIH). MESA began in 1999 and is still following participants today. We assessed two specific measurements of HDL: the number and size of the HDL particles and total cholesterol carried by HDL particles. Our study also looked at how age when women transitioned into post menopause, and the amount of time since transitioning, may impact the expected cardio-protective associations of HDL measures. Our study points out that the traditional measure of the good cholesterol, HDL cholesterol, fails to portray an accurate depiction of heart disease risk for postmenopausal women. We reported a harmful association between higher HDL cholesterol and atherosclerosis risk that was most evident in women with older age at menopause and who were greater than, or equal to, 10 years into post menopause. In contrast to HDL cholesterol, a higher concentration of total HDL particles was associated with lower risk of atherosclerosis. Additionally, having a high number of small HDL particles was found beneficial for postmenopausal women. These findings persist irrespective of age and how long it has been since women became postmenopausal. On the other hand, large HDL particles are linked to an increased risk of cardiovascular disease close to menopause. Women are subject to a variety of physiological changes in their sex hormones, lipids, body fat deposition and vascular health as they transition through menopause. We are hypothesizing that the decrease of estrogen, a cardio-protective sex hormone, along with other metabolic changes, can trigger chronic inflammation over time, which may alter the quality of HDL particles. Future studies should test this hypothesis. The study findings indicate that measuring size and number of HDL particles can better reflect the well-known cardio-protective features of the good cholesterol in postmenopausal women. (more…)
Author Interviews, Biomarkers, Infections, NEJM, University of Pittsburgh / 19.07.2018

MedicalResearch.com Interview with: David T. Huang, MD, MPH Associate Professor, Critical Care Medicine, Emergency Medicine, Clinical and Translational Science Director, MACRO (Multidisciplinary Acute Care Research Organization) Director, CRISMA Administrative Core (Clinical Research, Investigation, and Systems Modeling of Acute illness) University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: The overuse of antibiotics has become a serious threat to global public health, causing antibiotic resistance and increasing health care costs. Physicians have long known that antibiotics are usually unnecessary for acute bronchitis and for some other cases of lower respiratory tract infections, and that antibiotics treat only bacterial infections, not viral. But in daily practice, many physicians often prescribe them. Previous research had reported that using a biomarker blood test and following an antibiotic guideline tied to the test results could reduce antibiotic use in lower respiratory tract infections. In February 2017, the U.S. Food and Drug Administration approved the biomarker test that measures procalcitonin – a peptide that typically increases in bacterial infections, but not viral. We conducted the Procalcitonin Antibiotic Consensus Trial (ProACT) trial to evaluate whether a procalcitonin antibiotic prescribing guideline, implemented for the treatment of suspected lower respiratory tract infection with reproducible strategies, would result in less exposure to antibiotics than usual care, without a significantly higher rate of adverse events. The ProACT trial involved 14 predominately urban academic hospitals. We enrolled 1,656 adult patients who presented to the hospital emergency department and were initially diagnosed with a lower respiratory tract infection. All the patients were tested for their procalcitonin levels, but the results were shared only with the physicians of the patients randomly assigned to procalcitonin-guided antibiotic prescription. (more…)
Author Interviews, BMJ, Boehringer Ingelheim, McGill, Pharmacology / 19.07.2018

MedicalResearch.com Interview with: Samy Suissa, PhD Director, Centre for Clinical Epidemiology, Lady Davis Institute Professor, Departments of Epidemiology and Biostatistics and of Medicine McGill University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sulfonylureas are widely used oral antidiabetic drugs that are recommended as second-line treatments after first-line metformin to treat patients with type 2 diabetes. While their safety has been studied extensively, studies in patients with poorly controlled diabetes in need of pharmacotherapy escalation have been sparse and limited. Our study evaluated whether adding or switching to sulfonylureas after initiating metformin treatment is associated with increased cardiovascular or hypoglycaemic risks, compared with remaining on metformin monotherapy. Using a large cohort of over 77,000 patients initiating treatment with metformin monotherapy, we found that adding or switching to sulfonylureas is associated with modest increases of 26% in the risk of myocardial infarction and 28% in the risk of death, as well as an over 7-fold major increase in the risk of severe hypoglycaemia leading to hospitalisation. In particular, we found that switching from metformin to sulfonylureas was associated with higher risks of myocardial infarction and death, compared with adding sulfonylureas to metformin.  (more…)
Author Interviews, Environmental Risks, PLoS, UCSF / 12.07.2018

MedicalResearch.com Interview with: Lara Cushing PhD Assistant Professor of Health Education, College of Health and Social Sciences San Francisco State University San Francisco, CA 94132 MedicalResearch.com: What is the background for this study? Response: More and more countries are adopting cap-and-trade programs as a way to reduce emissions of greenhouse gases to address climate change. These efforts can lead to short-term health benefits because when you reduce greenhouse gas emissions, you usually also reduce emissions other harmful air pollutants that can cause cardiovascular disease, asthma and cancer. However, environmental equity concerns were raised early on about whether cap-and-trade would result in localized differences in emissions reductions that would also result in uneven reductions in harmful co-pollutants, such as particulate matter and air toxics. This is because companies can trade pollution permits under a cap-and-trade system and choose to buy more permits rather than reduce their emissions locally. Prior studies show that low income communities and communities of color are much more likely to live near polluting industries. (more…)
Author Interviews, Exercise - Fitness, Microbiome, UCSF / 12.07.2018

MedicalResearch.com Interview with: James R. Bagley, PhD Assistant Professor of Kinesiology Director, Muscle Physiology Lab Co-Director, Exercise Physiology Lab Research Director, Strength & Conditioning Lab San Francisco State University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The human body contains many billions of bacteria cells, and the type of bacteria in your gastrointestinal tract (termed gut microbiota) has been linked to certain diseases. Most of your gut microbiota falls into two categories: Firmicutes (F) or Bacteroidetes (B). The relative gut F/B ratio has been used to assess microbiota health. Our study was the first to examine potential relationships among F/B ratio and cardiorespiratory fitness, body composition, and diet in healthy young men and women We recruited 37 healthy adults to undergo a battery of physiological tests and collected stool samples to analyze their gut F/B ratio using qPCR. We found that F/B ratio was significantly correlated with cardiorespiratory fitness, but with no other variables. In fact, this correlation was so strong that a person’s fitness level explained ~22% of the variance in their gut bacteria composition. (more…)
Author Interviews, NYU, Sexual Health, Sleep Disorders / 11.07.2018

MedicalResearch.com Interview with: Dustin T. Duncan, ScD Associate Professor Director, NYU Spatial Epidemiology Lab Department of Population Health NYU School of Medicine NYU Langone Health MedicalResearch.com: What is the background for this study? Response: Sleep and sleep hygiene have emerged as one of the major determinants of health and wellbeing (alongside good diet, regular exercise, and not smoking). However, a small number of studies have used population-representative samples to examine sexual orientation disparities in sleep. Our study aimed to fill this gap in knowledge. (more…)
Annals Internal Medicine, Author Interviews, Emory, Endocrinology, Heart Disease, Sexual Health, Thromboembolism / 10.07.2018

MedicalResearch.com Interview with: Michael Goodman, MD, MPH Professor of Epidemiology Director, MD/MPH program Emory University School of Public Health Atlanta, GA  30322 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is a concern that hormone therapy may be associated with higher risk of certain cardiovascular problems such as heart attacks, stroke and formation of blood clots (“venous thromboembolism”). To study this concern we examined data on 4,960 transgender and gender non-conforming people enrolled in Kaiser Permanente health systems in Georgia, Northern California, and Southern California. They were matched to 48,686 cisgender men and 48,775 cisgender women.  Below are the main findings
  • Rates of venous thromboembolism in all transwomen were approximately twice as high as the rates among cisgender men or cisgender women. The data for stroke and myocardial infarction demonstrated little difference between transwomen and cisgender men, but 80% to 90% higher rates among transwomen compared to cisgender women.
  • When the analyses focused specifically on transwomen who started therapy with female hormone estrogen at Kaiser Permanente, the incidence of both venous thromboembolism and stroke was more clearly elevated relative to either reference group.  There was evidence that incidence of both of these conditions among transwomen was particularly increased two to six years after estrogen initiation. By contrast, the association between estrogen therapy and myocardial infarction was less evident due to relatively few observed events.
  • Transmen did not appear to have significantly higher rates of venous thromboembolism, ischemic stroke, or myocardial infarction than their non-transgender counterparts, but this group was rather young and included a relatively small proportion of participants who initiated their hormone therapy during the study.
(more…)
Author Interviews, Pediatrics, Smoking, Tobacco, Tobacco Research, University Texas / 10.07.2018

MedicalResearch.com Interview with: “hookah” by Ksenia M is licensed under CC BY 2.0Cheryl L. Perry, Ph.D. Professor of Health Promotion and Behavioral Sciences The Rockwell Distinguished Chair in Society and Health University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, Texas MedicalResearch.com: What is the background for this study? What are the main findings? Response: There have been large changes in the social environment over the past 10 years that have affected tobacco use among youth and young adults. These include social media, e-cigarettes, and new regulations aimed at preventing use among youth. Historically, nearly all onset of tobacco use, particularly cigarettes, occurred prior to high school graduation by age 18. Some recent national cross-sectional data suggested that onset might be occurring among young adults. We decided to explore, with national and Texas data, whether onset of tobacco use was more likely to occur among young adults. We did this by analyzing data from 3 studies over one year. (more…)
Author Interviews, Columbia, Neurology / 09.07.2018

MedicalResearch.com Interview with: Andrew Goldman PhD Laboratory for Intelligent Imaging and Neural Computing Department of Biomedical Engineering, Columbia University Presidential Scholar in Society and Neuroscience, Columbia University Andrew Goldman PhD Laboratory for Intelligent Imaging and Neural Computing Department of Biomedical Engineering, Columbia University Presidential Scholar in Society and Neuroscience, Columbia University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many Western musicians have difficulty improvising, despite having extensive training and experience. These musicians learn about and use similar musical structures in their playing (like chords, scales, rhythmic patterns, etc.) as experienced improvisers, but they may know about them in different ways. In other words, different musicians have different ways of knowing and learning about similar musical structures. To understand which ways of knowing facilitate the ability to improvise contributes to an understanding of how people are able to use knowledge creatively. Western music provides an important opportunity to compare these different ways of knowing because in other improvisatory domains of behavior (like speaking), it is difficult to find people who know how to do it but cannot improvise with it (e.g., if you know a language, you can very likely improvise with that language). In order to advance our understanding of these improvisatory ways of knowing, we compared musicians with varying degrees of improvisation experience in a task that tested how they categorized musical chords. In Western music, different chords are theorized to have similar “functions.” For example, on a guitar, there are different ways to play a C chord, and you could often substitute one for the other. You might even play another chord in place of the C chord and have it sound similar, or lead to a similar subsequent harmony. Improvisers often use notation that specifies classes of chords rather than specific realizations (versions) of a chord whereas those who do not typically improvise use notation that specifies the full realization of the chord. By analogy, one chef might use a recipe that calls for “citrus” (in music, a class of musical chord) while another chef’s recipe might specifically call for “lemon” (in music, a specific realization of a functional class of chords). We tested whether improvisers categorize similar-functioning harmonies as more similar to each other than different-functioning harmonies, and compared how less experienced improvisers categorize the same harmonies. Our task required the musicians to listen to a series of repeating harmonies (the “standard” stimuli) and pick out occasional chords that were different in any way (the “deviant” stimuli). Some deviant stimuli were different versions of the standard chord (like limes in place of lemons) and some deviant stimuli were chords with different musical functions (like bananas instead of lemons). The more experienced improvisers were better at detecting the function deviants than the exemplar deviants whereas the less experienced improvisers showed little difference in their ability to detect the two types of deviants. In other words, because improvisers categorize the different versions of the same chord as similar, they have a relatively harder time picking out the similarly functioning harmonies. This was measured using behavioral data, and electroencephalography (EEG), which can be used to provide a neural measure of how different stimuli are perceived to be from each other. (more…)
Author Interviews, Colon Cancer, JNCI, NIH, Vitamin D / 09.07.2018

MedicalResearch.com Interview with: Stephanie J. Weinstein, M.S., Ph.D.  Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, NIH   MedicalResearch.com: What is the background for this study?   Response: Vitamin D, known for its role in maintaining bone health, is hypothesized to lower colorectal cancer risk via several pathways related to cell growth and regulation. Previous prospective studies have reported inconsistent results for whether higher concentrations of circulating 25-hydroxyvitamin D, the accepted measure of vitamin D status, are linked to lower risk of colorectal cancer. The few randomized clinical trials of vitamin D supplementation and colorectal cancer completed thus far have not shown an effect; but study size, relatively short supplementation duration, and only moderate compliance may have contributed to their null findings. To address inconsistencies in prior studies on vitamin D, and to investigate associations in population subgroups, we harmonized and analyzed participant-level data from over 5,700 colorectal cancer cases who had blood collected before colorectal cancer diagnosis, and 7,100 matched cancer-free controls. Study participants were drawn from 17 prospective cohorts from the United States, Europe, and Asia and were followed for an average of 5.5 years (range: 1 – 25 years). We used a single, widely accepted assay and laboratory for new vitamin D measurements and calibrated existing vitamin D measurements. In the past, substantial differences between assays made it difficult to integrate vitamin D data from different studies. Our novel calibration approach enabled us to explore risk systematically over the broad range of vitamin D levels seen internationally.  (more…)
Author Interviews, Beth Israel Deaconess, HIV, Lancet, Vaccine Studies / 08.07.2018

MedicalResearch.com Interview with: Dan Barouch, M.D., Ph.D. Professor of Medicine Harvard Medical School Ragon Institute of MGH, MIT, and Harvard Director, Center for Virology and Vaccine Research Beth Israel Deaconess Medical Center Boston, MA 02215 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study demonstrates that the mosaic Ad26/Env HIV vaccine candidate induced robust and comparable immune responses in humans and monkeys. Moreover, the vaccine provided 67% protection against viral challenge in monkeys.    (more…)
Author Interviews, Brigham & Women's - Harvard, Electronic Records, JAMA / 07.07.2018

MedicalResearch.com Interview with: Li Zhou, MD, PhD, FACMI Associate Professor of Medicine Division of General Internal Medicine and Primary Care Brigham and Women’s Hospital, Harvard Medical School Somerville, MA 02145 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Documentation is one of the most time-consuming and costly aspects of electronic health record (EHR) use. Speech recognition (SR) technology, the automatic translation of voice to text, has been increasingly adopted to help clinicians complete their documentation in an efficient and cost-effective manner. One way in which SR can assist this process is commonly known as “back-end” SR, in which the clinician dictates into the telephone, the recorded audio is automatically transcribed to text by an speech recognition engine, and the text is edited by a professional medical transcriptionist and sent back to the EHR for the clinician to review and sign. In this study, we analyzed errors at different processing stages of clinical documents collected from 2 health care institutions using the same back-end SR vendor. We defined a comprehensive schema to systematically classify and analyze these errors, focusing particularly on clinically significant errors (errors that could plausibly affect a patient’s future care). We found an average of 7 errors per 100 words in raw  speech recognition transcriptions, and about 6% of those errors were clinically significant. 96.3% of the raw speech recognition transcriptions evaluated contained at least one error, and 63.6% had at least one clinically significant error. However, the rate of errors fell significantly after review by a medical transcriptionist, and it fell further still after the clinician reviewed the edited transcript. (more…)
Accidents & Violence, Author Interviews, JAMA, Pediatrics, University of Pittsburgh / 05.07.2018

MedicalResearch.com Interview with: Alison J. Culyba, MD, PhD, MPH Assistant Professor of Pediatrics UPMC Children’s Hospital of Pittsburgh University of Pittsburgh School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Homicide is the third leading cause of death among adolescents, and disproportionately affects minority youth in under-resourced urban communities. Most research on youth violence focuses on risk factors, such as weapon carrying and substance abuse. We know much less about factors that protect youth from violence. Future orientation, defined as hopes and plans for the future, is linked to many important positive outcomes for youth, including doing well in school and avoiding illicit substances. However, there has been very little research to examine whether future orientation may also protect youth from violence. To study links between future orientation and violence perpetration, we surveyed over 850 male youth in lower resource neighborhoods in Pittsburgh as part of a community-based sexual violence prevention study. We found that youth with positive future orientation were significantly less likely to report threatening someone with a weapon or injuring someone with a weapon in the past nine months. (more…)
Annals Internal Medicine, Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Heart Disease, OBGYNE / 03.07.2018

MedicalResearch.com Interview with: Jennifer J. Stuart, ScD Postdoctoral Research Fellow in Reproductive & Cardiovascular Epidemiology Department of Epidemiology Harvard T.H. Chan School of Public Health Division of Women's Health Brigham and Women's Hospital and Harvard Medical School  MedicalResearch.com: What is the background for this study? Response: Preeclampsia and gestational hypertension are common pregnancy complications involving high blood pressure that develops for the first time during pregnancy and returns to normal after delivery. Approximately 10 to 15% of all women who have given birth have a history of either preeclampsia or gestational hypertension. Previous studies have shown that women with a history of high blood pressure in pregnancy are more likely to develop cardiovascular disease events like heart attack and stroke later in life when compared to women with normal blood pressure in pregnancy. However, what is less clear is to what extent these women are more likely to develop chronic hypertension, diabetes, and high cholesterol and when these risk factors begin to emerge after pregnancy. We examined this question in a cohort of nearly 60,000 American women who we were able to follow for up to 50 years after their first pregnancy. Previous studies have been limited by small numbers, short follow-up, or a lack of information on shared risk factors, such as pre-pregnancy body mass index, smoking, and family history. This research was conducted within the Nurses’ Health Study II, which collected data on these pre-pregnancy factors in tens of thousands of women over several decades. (more…)
Author Interviews, Opiods, University of Pittsburgh / 27.06.2018

MedicalResearch.com Interview with: Jeanine M. Buchanich, Ph.D. Research associate Professor in the University of Pittsburgh Graduate School of Public Health’s Department of Biostatistics MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the U.S., cause of death codes are assigned by the National Center for Health Statistics (NCHS) using information reported by the coroner or medical examiner completing the death certificate. Drug-specific overdose deaths are identified by the contributory causes of death, which are categorized as “T codes” and are assigned based on the specific drugs recorded by the coroner or medical examiner completing the death certificate. A code of T50.9 means “other and unspecified drugs, medicaments and biological substances.” My colleagues and I extracted death data by state for 1999 through 2015 from the NCHS’s Mortality Multiple Cause Micro-data Files. We grouped overdose deaths into opioid-related, non-opioid-related and unspecified codes. In five states – Alabama, Indiana, Louisiana, Mississippi and Pennsylvania – more than 35 percent of the overdose deaths were coded as unspecified. We then calculated the change in percentage of overdose deaths that fell into each category from 1999 to 2015 by state. In those 17 years, opioid-related overdose deaths rose 401 percent, non-opioid-related overdose deaths rose 150 percent and unspecified overdose deaths rose 220 percent. This allowed us to extrapolate how many of the unspecified overdose deaths were likely opioid-related. By our calculations, potentially 70,000 opioid-related overdose deaths were not included in national opioid-related mortality estimates since 1999 because coroners and medical examiners did not specify the drug that contributed to the cause of death when completing the death certificates.  (more…)
Author Interviews, Dermatology, JAMA, Nutrition, UCLA / 27.06.2018

MedicalResearch.com Interview with: Adam Ford, BS Research fellow with Dr. April Armstrong Keck School of Medicine University of Southern California MedicalResearch.com: What is the background for this study? Response: Our psoriasis patients have long asked us about the role of diet on psoriasis. Previously, there was a lack of evidence synthesis on the relationship between psoriasis and diet. As such, providers were mostly unable to address their patients questions on the role of diet on psoriasis. This pivotal effort from the National Psoriasis Foundation has been a few years in the making. We looked at the role of diet on psoriasis and psoriatic arthritis based on a careful synthesis of the scientific studies available to us currently. (more…)