Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, End of Life Care / 14.12.2020

MedicalResearch.com Interview with: Isaac Chua, MD, MPH Division of General Internal Medicine and Primary Care Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Patient surveys have shown that most people prefer to die at home at the end-of-life. However, during the initial wave of the COVID-19 pandemic, anecdotal evidence from our colleagues and findings from a prior study published in the Journal of the American Geriatrics Society suggested that majority of COVID-19 decedents died in a medical facility. However, less is known about care intensity at the end-of-life according to place of death among patients who died of COVID-19. Therefore, we characterized end-of-life care by place of death among COVID-19 decedents at Mass General Brigham (MGB), the largest health system in Massachusetts.  (more…)
Author Interviews, COVID -19 Coronavirus, CT Scanning, Johns Hopkins, Nature / 12.12.2020

MedicalResearch.com Interview with: Nilanjan Chatterjee, PhD Bloomberg Distinguished Professor Departments of Biostatistics and Epidemiology Johns Hopkins Bloomberg School of Public Health  MedicalResearch.com: What is the background for this study? Response: Calculation of risks or severe COVID-19 disease and mortality for individuals in the general population can help to prioritize prevention efforts, such as early vaccination. We developed a model to estimate risks for COVID-19 mortality for currently uninflected individuals based on sociodemographic factors, pre-existing conditions and local pandemic intensity.  The model captures factors associated with both risk of infection and complications after infection. The model was developed using information from a large UK based cohort study called OpenSAFELY, and was adapted to the US population based on information on mortality rate associated with age and race/ethnicity available through CDC.  The model also utilizes information on state level projected death rates from pandemic forecasting models.  (more…)
Author Interviews, BMC, Breast Cancer, Brigham & Women's - Harvard, Cancer Research, Diabetes, Nutrition / 10.12.2020

MedicalResearch.com Interview with: Tengteng Wang, PhD, MSPH, MBBS Postdoctoral Research Fellow Department of Epidemiology Harvard T.H. Chan School of Public Health Channing Division of Network Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Type 2 diabetes (T2D) has been associated with poor progression of breast cancer. Moreover, having a breast cancer diagnosis may also increase the risk of developing T2D. Therefore, identifying strategies for T2D prevention among breast cancer survivors may play a key role in improving their survival outcomes. One approach may be through a diabetes risk reduction diet (DRRD), a dietary pattern comprised of 9 components that has been associated with 40% lower T2D risk in a previous Nurses’ Health Study publication.1 However, no studies to date have evaluated the association between adherence to the DRRD (as measured by the DRRD score) and survival outcomes following breast cancer. In this prospective cohort study among 8,320 breast cancer survivors, we found that greater adherence to the diabetes risk reduction diet after diagnosis was associated with a statistically significant 31% lower risk of overall mortality. Reduced breast cancer-specific mortality was also observed, which was more pronounced (20% lower risk) among those who improved adherence after diagnosis compared to women with consistently low DRRD adherence before and after diagnosis. (more…)
Author Interviews, COVID -19 Coronavirus, Infections, JAMA, NYU, Race/Ethnic Diversity / 04.12.2020

MedicalResearch.com Interview with: Gbenga Ogedegbe, MD, MPH Dr. Adolph & Margaret Berger Professor of Population Health Director, Division of Health & Behavior Director Center for Healthful Behavior Change Department of Population Health NYU Langone Health NYU School of Medicine MedicalResearch.com: What is the background for this study? Response: The background for the study is the disproportionately higher rates of COVID-19 hospitalizations and deaths in Blacks and Hispanics compared to Whites in major cities across the country. We asked two questions: 1) are there racial/ethnic differences in COVID-19 outcomes (likelihood of testing positive, hospitalizations, severe illness, and deaths) among patients who receive care at NYU Langone Health? If there are differences, are they explained by comorbidity and neighborhood characteristics (poverty, educational status, employment, housing, proportion of Blacks and Hispanics in communities)? (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Pediatrics, Smoking, Stanford, Tobacco, Tobacco Research / 03.12.2020

MedicalResearch.com Interview with: Bonnie Halpern-Felsher, PhD, FSAHM (pronouns: she/her) Professor of Pediatrics Taube Endowed Research Faculty Scholar Professor (by courtesy), Epidemiology and Population Health Professor (by courtesy), Psychiatry and Behavioral Sciences Director of Fellows’ Scholarship, Department of Pediatrics Director of Research, Division of Adolescent Medicine Co-leader, Scholarly Concentrations, Pediatrics Residency Program MedicalResearch.com: What is the background for this study? What are the main findings? Response: To examine adolescent and young adult e-cigarette use during the COVID-19 pandemic. There were 4 main findings:
  • About 2/3 of adolescent and young adult ever-e-cigarette users reported either quitting or cutting back on e-cigarette use since COVID-19 began.
  • Users least likely to quit or cut back e-cigarette use were those showing higher levels of nicotine dependence and those who had used e- cigarettes a large number of times.
  • Adolescent and young adult e-cigarette users found it harder to access e-cigarettes, but unlike studies before COVID-19, the dominant source of purchasing e-cigs was online instead of brick-and-mortar during COVID-19 pandemic.
  • Youth below 21 years were able to purchase e-cigarettes without any age verification, and those whose age was verified were asked to physically show ID or provided an email, which are less effective means to prevent underage youth use.
(more…)
Addiction, Author Interviews, COVID -19 Coronavirus, JAMA, Opiods, UCLA / 03.12.2020

MedicalResearch.com Interview with: Joseph Friedman, MD/PhD student David Geffen School of Medicine UCLA MedicalResearch.com: What is the background for this study? Response: Numerous researchers, clinicians, officials, harm reduction agencies, and people who use drugs have sounded the alarm that the COVID-19 pandemic is exacerbating the United States overdose crisis. However, data sources typically used to track overdoses in the US often have long lags that impede timely monitoring and response. For example, the CDC released preliminary overdose figures for 2019 in July 2020, and even these numbers may change. As they are available in near real-time, emergency medical services (EMS) data have increasingly been used as a source of up-to-date information to monitor epidemiological shifts during the COVID-19 pandemic. In this study, we used data from the National EMS Information System (NEMSIS), a large registry of over 10,000 EMS agencies in 47 states that represented over 80% of all EMS activations nationally in 2020. We used the data to track shifts in overdose-related cardiac arrests observed by EMS.   (more…)
Author Interviews, Breast Cancer, Cancer Research, Chemotherapy, JAMA, Yale / 26.11.2020

MedicalResearch.com Interview with: Lajos Pusztai, M.D, D.Phil. Professor of Medicine Director, Breast Cancer Translational Research Co-Director, Yale Cancer Center Genetics and Genomics Program Yale Cancer Center Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In HER2-positive early stage (stage I-II) breast cancer, several different preoperative (also called neoadjuvant) chemotherapy options exist, each of these is associated with a different rate of complete eradication of cancer from the breast and lymph nodes (called pathologic complete response or pCR). Patients who experience pCR have excellent long term survival. The complete response rates range from 20% to 80%, the rates are higher with regimens that include several different chemotherapy drugs and dual HER2 blockade. Unfortunately, these highly effective multi-drug treatment regimens are also more toxic and more expensive.  We also learned that patients who do not achieve pCR after preoperative therapy, have high rates of recurrence, but the recurrence rate can be improved by administering postoperative adjuvant therapy. These two observations together, (1) different regimens with different toxicities and costs resulting in different pCR rates, and (2) existence of effective postoperative therapies for patients with residual cancer after preoperative therapy, sets the stage for combining various pre- and post-operative treatment strategies. Starting with a shorter, less toxic and less expensive neoadjuvant regimen would allow a substantial minority (20-45%) of patients who archive pCR to be spared of longer and more toxic regimens, whereas those with residual disease could receive the remaining part of the currently most effective regimens post-operatively as adjuvant therapy. In this study we examined the cost effectiveness of different neoadjuvant followed by adjuvant treatment strategies from a healthcare payer perspective. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Genetic Research, Melanoma, Prostate Cancer / 23.11.2020

MedicalResearch.com Interview with: Saud H AlDubayan, M.D. Instructor in Medicine, Harvard Medical School Attending Physician, Division of Genetics, Brigham and Women's Hospital Computational Biologist, Department of Medical Oncology, Dana-Farber Cancer Institute Associate Scientist, The Broad Institute of MIT and Harvard  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The overall goal of this study was to assess the performance of the standard method currently used to detect germline (inhered) genetic variants in cancer patients and whether we could use recent advances in machine learning techniques to further improve the detection rate of clinically relevant genetic alterations. To investigate this possibility, we performed a head to head comparison between the current gold-standard method for germline analysis that has been universally used in clinical and research laboratories and a new deep learning analysis approach using germline genetic data of thousands of patients with prostate cancer or melanoma. This analysis showed that across all different gene sets that were tested, the deep learning-based framework was able to identify additional cancer patients with clinically relevant germline variants that went undetected by the standard method. For example, several patients in our study also had germline variants that are associated with an increased risk of ovarian cancer, for which the surgical removal of the ovaries (at a certain age) is highly recommended. However, these genetic alterations were only identified by the proposed deep learning framework.     (more…)
Aging, Author Interviews, Genetic Research, McGill / 22.11.2020

MedicalResearch.com Interview with: Richard C. Austin, PhD Professor and Career Investigator of the Heart and Stroke Foundation of Ontario Amgen Canada Research Chair in Nephrology McMaster University and St. Joseph’s Healthcare Hamilton, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: A previous study published in 2011 by my collaborator, Dr. Michel Chretien at the IRCM, identified a rare mutation in the PCSK9, termed Q152H. Individuals harboring this mutation demonstrated dramatic reductions in their LDL cholesterol levels and had a significantly lower risk of CVD. Furthermore, individuals harboring the Q152H mutation showed increases in longevity with no evidence of other diseases such as liver disease, cancer and chronic kidney disease. This Q152H mutation was unique with only 4 families in Quebec shown to harbor this genetic variant. In terms of its effect on PCSK9 expression/activity, the mutation at Q152H was precisely at the cleavage site in PCSK9 necessary for its activation. As a result, the Q152H mutation fails to be cleaved and activated, thereby blocking its secretion into the circulation. This is why the Q152H mutation is considered a loss-of-function PCSK9 mutant. Given our lab's interest in endoplasmic reticulum (ER) stress and ER storage diseases, we began to collaborate with Drs. Chretien and Seidah at the IRCM to investigate whether this Q152H mutant, when overexpressed in liver cells, would cause ER stress and liver cell injury. This was based on the findings that the Q152H mutant does not undergo autocatalytic cleavage and its subsequent secretion from liver cells. It is well known in the literature that the accumulation of misfolded or inactive proteins in the ER gives rise to ER stress and cell injury/dysfunction. As a result, we initially showed to our surprise that overexpression of the Q152H mutant in liver cells failed to cause ER stress BUT increased the protein levels of several important ER chaperones, GRP78 and GRP94, known to PROTECT against liver cell injury/dysfunction. As part of our JCI study, we furthered these studies to examine the effect of the Q152H mutant when overexpressed in the livers of mice. This is where we demonstrated that the Q152H mutation showed protection against ER stress-induced liver injury/dysfunction. (more…)
AHA Journals, Author Interviews, COVID -19 Coronavirus, Race/Ethnic Diversity, Stanford / 19.11.2020

MedicalResearch.com Interview with: Fatima Rodriguez, MD, MPH, FACC, FAHA Assistant Professor, Cardiovascular Medicine Stanford University School of Medicine Palo Alto, CA 94304 MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has magnified existing racial/ethnic disparities in the United States. The goal of this study was to leverage new data collected from the American Heart Association’s COVID-19 Cardiovascular Disease Registry to understand racial/ethnic differences in presentation and outcomes for hospitalized patients. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Fertility, OBGYNE / 19.11.2020

MedicalResearch.com Interview with: Jennifer Yland Doctoral Student in Epidemiology Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Worldwide, about 22% of reproductive-aged women used hormonal contraception last year. Long-acting reversible contraceptive (LARC) methods, which include intrauterine devices (IUDs), implants, patches, and injectable contraceptives, have become increasingly popular. However, little is known about the return to fertility after use of different contraceptives, particularly LARC methods. (more…)
Author Interviews, Orthopedics, Radiology, Rheumatology, UCSF, Weight Research / 18.11.2020

MedicalResearch.com Interview with: Silvia Schirò MD Department of Radiology and Biomedical Imaging University of California, San Francisco MedicalResearch.com: What is the background for this study?  Response: Knee osteoarthritis (OA) is worldwide the second most frequent cause of lower extremity disability, and it has a global incidence of 199 cases per 100.000, including over 14 million people with symptomatic knee OA in the US. Overweight and obese individuals have a higher incidence of knee OA due to excessive knee joint load. The association between physical activity and knee OA, has not been systematically addressed in overweight and/or obese subjects and its association seems to be controversial. On the one hand, mild to non-weight-bearing physical activities have been found to be beneficial in the management knee homeostasis, the physiologic knee joint load providing an optimized environment for the joint tissues. On the other hand, excessive fast-paced physical activity with high load-joint torsion such as racquet sports, ball sports and running have been found to have an increased incidence of knee injury compared to mild-moderate exercise such as swimming, bicycling and low-impact aerobics independent of body weight. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Prostate Cancer, Social Issues / 18.11.2020

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

MedicalResearch.com Interview with: Sara Saberi, MD, MS Assistant Professor Inherited Cardiomyopathy Program Frankel Cardiovascular Center University of Michigan Hospital Michigan Medicine MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by HCM? How common is it and whom does it affect? Response: HCM is short for hypertrophic cardiomyopathy, the most common genetic myocardial disorder. It occurs in 1:500 people worldwide and because it is inherited in an autosomal dominant fashion, it affects men and women equally. HCM is characterized by unexplained left ventricular (LV) hypertrophy, hypercontractility, myofibrillar disarray and myocardial fibrosis with associated abnormalities in LV compliance and diastolic function. In some patients, there is progressive adverse cardiac remodeling, associated with chronic heart failure and atrial fibrillation as a result of diastolic dysfunction, left ventricular outflow tract (LVOT) obstruction, or less commonly, LV systolic dysfunction. Current medical management of obstructive HCM (oHCM) is limited to the use of beta blockers and non-dihydropyridine calcium channel blockers, or disopyramide, none of which have been shown to modify disease expression or outcomes after onset. Mavacamten is a first-in-class, small molecule, selective inhibitor of cardiac myosin specifically developed to target the underlying pathophysiology of HCM by reducing actin–myosin cross-bridge formation. The phase 3 EXPLORER-HCM trial showed that mavacamten improved exercise capacity, LVOT gradients, symptoms, and health status compared with placebo in patients with symptomatic oHCM. At selected study sites, participants were enrolled in a cardiac magnetic resonance (CMR) imaging substudy. CMR is the gold standard for measurement of ventricular mass, volumes and noninvasive tissue characterization, making it an ideal imaging modality to assess the effect of mavacamten on cardiac structure and function in patients with HCM. (more…)
Author Interviews, Brigham & Women's - Harvard, Dermatology, JAMA, McGill, Mental Health Research / 17.11.2020

Editor's note: This piece discusses suicide. If you have experienced suicidal thoughts or have lost someone to suicide and want to seek help, you can contact the Crisis Text Line by texting "START" to 741-741 or call the Suicide Prevention Lifeline at 800-273-8255.  MedicalResearch.com Interview with: David-Dan Nguyen, MPH Research Fellow | Center for Surgery and Public Health, Brigham and Women's Hospital Medical Student | McGill University MedicalResearch.com: What is the background for this study? Response: There is ongoing concern about the side-effects of finasteride, a drug used for the management of alopecia and benign prostatic hyperplasia. These concerns have led to the coining of the “post-finasteride syndrome” which remains controversial. Indeed, there is conflicting evidence on the post-finasteride syndrome/adverse events associated with finasteride. We wanted to contribute to this conflicting body of evidence by examining suicidality, depression, and anxiety reports linked to finasteride use using the WHO’s pharmacovigilance database, VigiBase. Such pharmacovigilance databases are useful for the study of rare adverse events that are suspected to be associated with medication use. (more…)
Author Interviews, COVID -19 Coronavirus, Depression, Mental Health Research, Occupational Health, Pediatrics, UCSF / 11.11.2020

MedicalResearch.com Interview with: Kyle T. Ganson, PhD, MSW Assistant Professor, Factor-Inwentash Faculty of Social Work University of Toronto Toronto, Canada   Jason Nagata, MD, MSc Assistant Professor of Pediatrics University of California, San Francisco San Francisco, California, USA     MedicalResearch.com: What is the background for this study? Response: A quarter of young adults in the US have reported being unemployed during the COVID-19 pandemic. Young adults may be especially affected by employment loss as they often work in industries most adversely affected by social distancing. MedicalResearch.com: What are the main findings? Response: Among a sample of nearly 5,000 young adults age 18 to 26 in the US, we found that since March 2020, young adults who lost their job or were part of a household that experienced employment loss were more likely than those with secure employment to experience four common symptoms of anxiety and depression. This was also true of young adults who expected an employment loss in the next four weeks. The study also found that symptoms of anxiety and depression were common among the sample of young adults. In the seven days prior to the survey, 75% reported being nervous, anxious or on edge, 68% reported not being able to stop or control worrying, 67% reported having little interest or pleasure in doing things, and 64% reported feeling down, depressed, or hopeless. (more…)
Author Interviews, Baylor College of Medicine Houston, Smoking, Tobacco Research / 11.11.2020

MedicalResearch.com Interview with: Mahmoud Al Rifai, MD, MPH Cardiovascular Disease Fellow Baylor College of Medicine Houston, TX Salim S. Virani, MD, PhD, FACC, FAHA, FASPC Professor, Section of Cardiovascular Research Director, Cardiology Fellowship Training Program Baylor College of Medicine Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Co-Director, VA Advanced Fellowship in Health Services Research & Development at the Michael E. DeBakey VA Medical Center Investigator, Health Policy, Quality and Informatics Program Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Houston, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: E-cigarettes have gained popularity since their introduction in the U.S. market nearly 20 years ago and their use has increased especially among younger adults. On the other hand, public health efforts aimed at curbing tobacco use over the past few decades have resulted in a decrease in cigarette use. However, state-specific laws and regional cultural differences with regards to perception of these products may result in variability in tobacco use patterns. We therefore evaluate temporal changes in e-cigarette and cigarette use in each U.S. state between the years 2016 to 2018. (more…)
Author Interviews, COVID -19 Coronavirus, Nutrition, Pediatrics, UCSF / 11.11.2020

MedicalResearch.com Interview with: Jason M Nagata M.D., M.Sc Assistant Professor of Pediatrics Division of Adolescent and Young Adult Medicine Department of Pediatrics, University of California San Francisco, San Francisco, CA MedicalResearch.com: What is the background for this study? Response: During the COVID-19 pandemic, food insecurity is expected to rise given economic uncertainty and job losses. Vulnerable and marginalized populations are disproportionately affected by both COVID-19 and food insecurity.   (more…)
Author Interviews, COVID -19 Coronavirus, Race/Ethnic Diversity, Rheumatology, UCSF / 07.11.2020

MedicalResearch.com Interview with: Milena Gianfrancesco, PhD, MPH Assistant Professor. Education Division of Rheumatology, Department of Medicine University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: This study utilized data from the COVID-19 Global Rheumatology Alliance Provider Survey, which launched on March 25th. To date, it has collected information on over 6,000 patients with rheumatic disease diagnosed with COVID-19 from over 40 countries worldwide. As COVID-19 spread across the world in the spring, and especially within the United States, it became clear that the disease was impacting certain groups more than others. Growing attention and research began to illustrate the disproportionate burden of COVID-19 among racial/ethnic minorities in the United States. We know that racial and ethnic minorities experience a higher burden of rheumatic disease risk and severity; therefore, our group was interested in examining whether the disproportionate burden of COVID-19 also affected this susceptible population. (more…)
Author Interviews, Columbia, JAMA, OBGYNE, Weight Research / 05.11.2020

MedicalResearch.com Interview with: Marisa N. Spann, PhD, MPH Columbia University Irving Medical Center New York, New York MedicalResearch.com: What is the background for this study? Response: Prior research has demonstrated that higher maternal pre-pregnancy body mass index is associated with adverse long-term outcomes for offspring including obesity, poorer cognitive and social abilities, and increased risk of psychiatric disorders.  MedicalResearch.com: What are the main findings? Response: In this study, we investigated the association of maternal pre-pregnancy body mass index with fetal growth and neonatal functional connectivity and found that maternal pre-pregnancy BMI has a significant positive correlation with fetal weight and with greater thalamic connectivity of the brain.  (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus / 05.11.2020

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

MedicalResearch.com Interview with: Fan-Yun Lan, MD, MS PhD candidate in Population Health Sciences | Environmental Health Graduate School of Arts and Sciences & T.H. Chan School of Public Health Harvard University MedicalResearch.com: What is the background for this study? Response: Existing evidence has indicated that essential workers are heavily affected by the COVID-19 pandemic, as they are not able to benefit from mitigation policies. Their occupational exposures increase their own risk to SARS-CoV-2 infection, and increase the risk of secondary transmissions to their colleagues, families and communities. Research, however, has largely focused on healthcare workers with relatively limited literature investigating non-healthcare essential workers. (more…)
Author Interviews, Cancer Research, Journal Clinical Oncology, University of Pittsburgh / 03.11.2020

MedicalResearch.com Interview with: Kristine Gade, MD Hematology/Oncology Fellow UPMC Hillman Cancer Center MedicalResearch.com: What is the background for this study? Would you briefly describe the “surprise question”?  Response:  Via Oncology Pathways, a cancer care platform used by UPMC and other institutions across the country, asks physicians to answer the surprise question – “Would I be surprised if this patient died in the next 12 months?” – whenever a new treatment plan is implemented.   This question has been widely adopted by many oncology and palliative care frameworks and has been shown to be modestly predictive of mortality in multiple studies.  We know that advanced cancer patients have a high utilization of the emergency department, even near end of life.  Our group wanted to see if we could use the results of the surprise question to easily and quickly communicate to emergency department providers the expected prognosis for our advanced cancer patients.  First, we set out to assess the surprise question’s ability to predict survival among our UPMC Hillman Cancer Center patients with select stage IV cancer diagnoses.   (more…)
Author Interviews, Cleveland Clinic, Infections / 31.10.2020

MedicalResearch.com Interview with: MedicalResearch.com Interview with: Curtis J. Donskey, MD Professor of Medicine Case Western Reserve University Staff Physician, Infectious Diseases Section, Louis Stokes Cleveland VA Medical Center MedicalResearch.com: What is the background for this study? Response: The goal of the study was to obtain a better understanding of how healthcare-associated pathogens are transmitted.  Infection control efforts tend to emphasize hand hygiene and cleaning of high-touch surfaces in patient rooms.  However, there is evidence that portable equipment and floors could be underappreciated sources of transmission. We previously found that a nonpathogenic virus inoculated onto floors in patient rooms spread rapidly to the hands of patients and to surfaces in the room and throughout the ward.  This raised concern that pathogens could spread by the same route. (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Insomnia, Obstructive Sleep Apnea, Sleep Disorders / 29.10.2020

MedicalResearch.com Interview with: Salma Batool-Anwar, MBBS, MPH Instructor, Harvard Medical School Pulmonary and Critical Care, Sleep Medicine Brigham and Women's Faulkner Hospital MedicalResearch.com: What is the background for this study? Response: A well functioning sleep-wake cycle is vital to our health and prevention of chronic diseases. During previous disaters sleep disturbances have been reported. When Massachusetts governor declared a state of emergency in March’20, we hypothesized that sleep duration would be adversely affected by covid-19 related lockdown and stress. The study was approved by the institutional review board and information was collected retrospectively using the electronic medical records.  (more…)
Author Interviews, Cognitive Issues, Emory, Exercise - Fitness, Heart Disease / 27.10.2020

MedicalResearch.com Interview with: Henry Mahncke, PhD Chief Executive Officer Posit Science https://www.brainhq.com/?v4=true&fr=yDr. Mahncke earned his PhD at UCSF in the lab where lifelong brain plasticity was discovered. At the request of his academic mentor, he currently leads a global team of more than 400 brain scientists engaged in designing, testing, refining, and validating the computerized brain exercises found in the BrainHQ app from Posit Science, where he serves as CEO. MedicalResearch.com Tell us what’s important about this new study in people with heart failure? Response: Heart failure is a common condition that even when properly treated can have adverse long-term health outcomes and high medical costs. Heart failure commonly causes cognitive impairment, which can have devastating effect on patient abilities to engage in self-care, and which contributes to poor clinical outcomes, increased rehospitalizations, and higher mortality rates. What makes these results exciting is that the Emory University researchers discovered that a simple intervention – a fairly modest amount of walking and brain exercise – not only significantly improved a standard measure of cognition, but also significantly improved multiple measures that drive better health outcomes and lower costs. MedicalResearch.com: What is heart failure? Response: Heart failure – sometimes called congestive heart failure or congestive cardiac failure – is when the heart cannot pump sufficient blood flow to maintain the body’s needs. Common symptoms include excessive tiredness, shortness of breath and swelling particularly in legs. It’s treated with a combination of lifestyle changes, drugs, and devices. An estimated 6.5 million Americans are diagnosed with heart failure, with 960,000 new cases each year, leading some to describe it as reaching epidemic proportions. In older adults, it’s the most common cause of hospital readmissions within 30 days of discharge and among the most costly areas of Medicare expenditures. (more…)
Author Interviews, Nutrition, NYU, Pediatrics, Pediatrics, Technology / 26.10.2020

MedicalResearch.com Interview with: Marie Bragg, PhD Assistant Professor, Department of Population Health on Health Choice NYU College of Global Public Health MedicalResearch.com: What is the background for this study? Response: We know from previous research that children who see food advertisements eat significantly more calories than children who see non-food advertisements. Those studies led the World Health Organization and National Academy of Medicine to issue reports declaring that exposure to food advertising is a major driver of childhood obesity. What we don’t know is how frequently unhealthy food and beverage brands are appearing in YouTube videos posted by Kid Influencers. Kid influences are children whose parents film videos of the child playing with toys, unwrapping presents, eating food, or engaging in other family-friendly activities. The parents then post the videos to YouTube for other children and parents to view for entertainment.  (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lifestyle & Health, Nutrition / 26.10.2020

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

MedicalResearch.com Interview with: David E. Leaf, MD, MMSc, FASN Assistant Professor of Medicine, Harvard Medical School Director of Clinical and Translational Research in Acute Kidney Injury Division of Renal Medicine, Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: The data for this study were derived from a multicenter cohort study of over 4,000 critically ill patients with COVID-19 admitted to ICUs at 68 sites across the US, as part of the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID). STOP-COVID was initiated by David E. Leaf, MD, MMSc and Shruti Gupta, MD, MPH, from the Division of Renal Medicine at Brigham and Women’s Hospital and Harvard Medical School. It was initiated in March, 2020 as an unfunded, grassroots network, and now includes over 400 collaborators from 68 sites across the US. Using this data, we used a ‘target trial emulation’ approach to examine whether early administration of the monoclonal antibody, tocilizumab, reduces mortality in critically ill patients with COVID-19. Target trial emulation, a novel method of analyzing observational data, is the idea of simulating a randomized control trial to reduce bias.  (more…)
Author Interviews, Baylor College of Medicine Houston, Heart Disease, Social Issues, Tobacco Research / 19.10.2020

MedicalResearch.com Interview with: Mahmoud Al Rifai MD MPH Section of Cardiology, Department of Medicine Baylor College of Medicine Houston Salim S. Virani, MD, PhD Section of Cardiology Michael E. DeBakey Veterans Affairs Medical Center Section of Cardiology, Department of Medicine Baylor College of Medicine Houston    MedicalResearch.com: What is the background for this study? Response: E-cigarettes typically cost more than combustible cigarettes and there is more variability in cost due to a wide variety of flavors, e-cigarette liquid, and vaping device that are available in the market. Therefore, use of e-cigarettes may vary depending on income with potentially higher use among higher income individuals. (more…)