Author Interviews, Brain Injury, Erectile Dysfunction, JAMA / 26.08.2019

MedicalResearch.com Interview with: [caption id="attachment_51050" align="alignleft" width="200"]Rachel Grashow PhD Research Associate Department of Environmental Health Football Players Health Study at Harvard University Harvard T.H. Chan Dr. Grashow[/caption] Rachel Grashow PhD Research Associate Department of Environmental Health Football Players Health Study at Harvard University Harvard T.H. Chan  MedicalResearch.com: What is the background for this study? Response: It has been previously shown in small studies of boxers and military personnel that traumatic brain injuries can damage the pituitary gland, which serves as the "master controller" of hormone function in the brain. These studies on individuals at risk for repeated head injury found that hits on the head caused deficiencies in certain hormones, such as growth hormone and testosterone, which could have downstream effects on sexual function. Only one large study was conducted that used Taiwanese health insurance data and looked at single traumatic brain injuries and risk of erectile function (ED). In that study, men who experienced a single severe TBI were more than twice as like to report ED after their injury. In light of these findings, important questions remain regarding whether multiple head injuries are associated with pituitary or sexual dysfunction in a large population with other ED-related health issues. The Football Players Health Study at Harvard University asked former NFL players to fill out a questionnaire that interrogated demographic factors, football-related exposures and current health conditions. Specifically, we asked participants to self-report the frequency of ten different concussion symptoms experienced during professional play, as well as whether a clinician had ever recommended or prescribed medication for low testosterone or ED.  
Author Interviews, JAMA, Kidney Disease, Transplantation / 26.08.2019

MedicalResearch.com Interview with: [caption id="attachment_51066" align="alignleft" width="186"]Alexandre Loupy, MD PhD Necker Hospital Head of team at National institute of Medical research (Inserm) Prof. Loupy[/caption] Alexandre Loupy, MD PhD Nephrologist, Department of Nephrology & Kidney Transplantation Necker Hospital, Paris Head of the Paris Transplant Group (Inserm)  MedicalResearch.com: What is the background for this study? Response: The lack of organs for kidney transplantation is a major public health problem across the world, due to its attributable mortality and excess cost to healthcare systems while waitlisted patients are maintained on chronic dialysis. Nearly 5,000 people in the US and 3,500 people in Europe die each year while waiting for a kidney transplant. Yet in the US, over 3,500 donated kidneys are discarded annually, representing almost 18% of the available organs, while the discard rate in France is only 6,8%, though these countries have similar organ allocation systems and offer the same treatments to patients after transplant. We thus compared the use of donated kidneys in the US to France from 2004-2014 in much more depth, using a new approach based on validated analytic methods and computer simulation. 
Alzheimer's - Dementia, Author Interviews, JAMA, Mental Health Research, Sleep Disorders / 23.08.2019

MedicalResearch.com Interview with: Chenlu Gao, MA Graduate Student Department of Psychology and Neuroscience Baylor University Michael Scullin, PhD Assistant Professor Department of Psychology and Neuroscience Baylor University  MedicalResearch.com: What is the background for this study? Response: According to the World Alzheimer Report, dementia affects 50 million adults worldwide, and this number is expected to approach 131 million by 2050. Dementia patients often require assistance with daily activities from caregivers. The Alzheimer’s Association reported that, in the United States, 16 million caregivers spend on average 21.9 hours per week providing care for patients with dementia. Being a caregiver is stressful, which not only challenges emotional, cognitive, and physical health, but is also associated with shorter and poorer sleep at night. If a caregiver cannot obtain restorative sleep at night, their quality of life and their abilities to perform the caregiving role can be compromised. For example, sleep loss may jeopardize caregivers’ memory, causing them to forget medications or medical appointments for the patients. Sleep loss can also impair immune functions, causing the caregivers to suffer from illnesses. In the long-term, sleep loss is associated with cortical thinning and accumulation of beta-amyloid and tau, which increase the risks of dementia. Undoubtedly, there is a need to systematically study whether caregivers sleep less or worse during the night and whether we can improve their sleep quality through low-cost behavioral interventions. To answer these questions, we systematically reviewed and meta-analyzed 35 studies with data from 3,268 caregivers of dementia patients.    
Author Interviews, BMJ, Exercise - Fitness / 23.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50978" align="alignleft" width="133"]Prof. Ulf Ekelund PhD Professor in Physical Activity and Health Department of Sport Medicine Norwegian School of Sport Sciences Oslo, Norway Prof. Ekelund[/caption] Prof. Ulf Ekelund PhD Professor in Physical Activity and Health Department of Sport Medicine Norwegian School of Sport Sciences Oslo, Norway MedicalResearch.com: What is the background for this study? Response: We know that physical activity of a moderate or vigorous intensity (such as brisk walking) is good for your health. More recently, it has also been shown that prolonged sitting is also linked to an increased risk for many chronic diseases and premature death. Current physical activity recommendations suggest that all adults should participate in at least 150 minutes per week of moderate intensity physical activity and that prolonged sitting should be avoided. However, how much sitting is too much? This is not specified and is widely debated. In addition, are levels of physical activity below those recommended still beneficial for health and does light intensity physical activity still count? Answering these questions have huge relevance for health promotion. We therefore performed a study analysing data from eight studies in which physical activity was assessed precisely with an activity monitor in about 36000 individuals followed for about six years during which more than 2500 died. 
Author Interviews, BMJ, Diabetes, Lipids, Omega-3 Fatty Acids / 23.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50975" align="alignleft" width="133"]Lee Hooper PhD, RD Reader in Research Synthesis, Nutrition & Hydration Norwich Medical School University of East Anglia England, UK Dr. Hooper[/caption] Lee Hooper PhD, RD Reader in Research Synthesis, Nutrition & Hydration Norwich Medical School University of East Anglia England, UK MedicalResearch.com: What is the background for this study? Response: The World Health Organization asked us to carry out a set of studies (systematic reviews of randomised controlled trials) assessing health effects of omega-3 and omega-6, which are polyunsaturated fats. This is because the WHO are planning to update their dietary guidance on fats in the near future. Worries about effects of long chain omega-3 on control of diabetes have long existed, and some experimental studies have suggested that omega-3 supplementation and diets high in PUFA and omega-3 raise fasting glucose. Pollutants such as methylmercury and polychlorinated biphenyl levels exceeding recommended thresholds are rarer now, but have been reported in seafoods and fish oil supplements; elevated mercury levels interrupt insulin signalling, raising fasting glucose, in mouse models. Body concentrations of organic pollutants are correlated with prevalence of diabetes in the US, but other cross sectional studies have suggested either no association with or benefits of eating fish on glycaemic control. Systematic reviews of observational studies have suggested both positive and negative associations with glucose metabolism, but strong evidence shows that omega-3 supplements reduce raised triglycerides and have little or no effect on body weight. Theories suggest that omega-3 and omega-6 fats compete in some metabolic pathways so that the omega-3/omega-6 ratio is more important than absolute intakes of either. 
Author Interviews, Cancer Research, JAMA / 23.08.2019

MedicalResearch.com Interview with: [caption id="attachment_51041" align="alignleft" width="200"]Prof. Dr. Lukas Flatz MD Institute of Immunobiology Kantonsspital St Gallen, St Gallen Switzerland Prof. Flatz[/caption] Prof. Dr. Lukas Flatz MD Institute of Immunobiology Kantonsspital St Gallen, St Gallen Switzerland MedicalResearch.com: What is the background for this study? Response: Toxicity is an important limiting factor of treatment with checkpoint inhibitors. We aimed in investigating the relationship between immune-related adverse events during anti-PD-1 therapy and tumor mutational burden by comparing large scale surveillance data of irAEs with the median tumor mutational burden across multiple cancer types.
AHA Journals, Author Interviews, Brigham & Women's - Harvard, Heart Disease, Nutrition, Vegetarians / 22.08.2019

MedicalResearch.com Interview with: [caption id="attachment_51018" align="alignleft" width="173"]Megu Baden, MD, PhD Department of Nutrition Harvard T. H. Chan School of Public Health Boston, MA02115 Dr. Baden[/caption] Megu Baden, MD, PhD Department of Nutrition Harvard T. H. Chan School of Public Health Boston, MA02115  MedicalResearch.com: What is the background for this study? Would you give an example of healthful vs non-healthful plantbased diet? Response: Plant-based diets are recommended for health and recently also for their environmental benefits. However, most previous studies defined it as either vegetarian or non-vegetarian, and importantly, without differentiation for the quality of plant foods. As you know, not all plant foods are equally good to our health. Therefore, to capture the quality of plant-based diets, we established overall, healthful and unhealthful plant-based diet indices. A higher score on the overall plant based diet index indicates greater intake of all types of plant foods and less of animal foods. A higher score on the healthful plant based diet index indicates greater intake of only healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, tea/coffee), and less of less healthy plant foods (fruit juices, refined grains, potatoes, sugar-sweetened beverages, sweets/desserts) and animal foods. A higher score on the unhealthful plant based diet index indicates greater intake of only less healthy plant foods, and less of healthy plant foods and animal foods. In this study, we used these plant-based diet indices and investigated the associations between 12-year changes in plant-based diet quality and subsequent total and cause-specific mortality in two large US cohorts.
AHA Journals, Author Interviews, Lipids, Omega-3 Fatty Acids / 22.08.2019

MedicalResearch.com Interview with: [caption id="attachment_51022" align="alignleft" width="133"]Ann Skulas-Ray, PhD. Assistant Professor, Department of Nutritional Sciences University of Arizona Dr. Skulas-Ray[/caption] Ann Skulas-Ray, PhD. Assistant Professor, Department of Nutritional Sciences University of Arizona MedicalResearch.com: What is the background for this study? Response: The prior guidance from the AHA regarding omega-3 fatty acids and high triglycerides was published in 2002, prior to the availability of prescription omega-3 concentrates and results from many of the clinical studies we were able to review. Our advisory was able to address questions such as dose and concomitant use of statin therapy. Another unique feature of our advisory is that we evaluated studies of the effects of omega-3 fatty acids in people with triglycerides (TG)  > or = 500 mg/dL and 200-499 mg/dL separately, so we were able to see patterns relating to dose of omega-3 fatty acids and baseline triglyceride values. We came to separate conclusions for populations above and below TG of 500 mg/dL and concluded that 4 g/d was most effective. In contrast, the 2002 guidance recommended 2-4 g/d EPA + DHA under a physician's care for high triglycerides. 
Author Interviews, Brigham & Women's - Harvard, Global Health, Infections, Lancet, Pediatrics / 21.08.2019

MedicalResearch.com Interview with: [caption id="attachment_51012" align="alignleft" width="150"]Tori Cowger, MPH Ph.D Student | Population Health Sciences Department of Epidemiology Harvard T.H. Chan School of Public Health Tori Cowger[/caption] Tori Cowger, MPH Ph.D Student | Population Health Sciences Department of Epidemiology Harvard T.H. Chan School of Public Health  MedicalResearch.com: What is the background for this study? Response: Globally, approximately one million cases of tuberculosis disease (TB) and 233,000 TB-related deaths occurred among children aged younger than 15 years during 2018. TB in children and adolescents is clinically and epidemiologically heterogeneous, making diagnosis, care, and prevention challenging. Understanding this heterogeneity can inform TB care and prevention efforts, and efforts to eliminate disparities in TB incidence and mortality in these groups. In this study, we describe the epidemiology of TB among children and adolescents in the United States, and report TB incidence rates for US territories and freely associated states and by parental country of birth, which have not been previously described.
Author Interviews, Global Health, Pediatrics, PLoS, Social Issues / 21.08.2019

MedicalResearch.com Interview with: [caption id="attachment_51027" align="alignleft" width="149"]Jayanta Kumar Bora Guest Researcher IIASA|Laxenburg, Austria & Ph.D. Scholar Indian Institute of Dalit Studies New Delhi, India  Jayanta Bora[/caption] Jayanta Kumar Bora Guest Researcher IIASA|Laxenburg, Austria & Ph.D. Scholar Indian Institute of Dalit Studies New Delhi, India  MedicalResearch.com: What is the background for this study? Response: Although under-five mortality rate (U5MR) is declining in India, it is still high in a few selected states and among the scheduled caste (SC) and scheduled tribe (ST) population of the country. We examined the disparities in under-five mortality in high focus states of India. The high-focus states in India were designated as such by the Indian government because of their persistently high child mortality and relatively poor socio-economic and health indicators. This study re-examines the association between castes and under-five mortality in high focus Indian states using the most recent Indian Demographic Health Survey data conducted in 2015-16. The study also aims to quantify the relative contribution of socioeconomic determinants to under-five deaths by explaining the gap between socially disadvantaged (SC and ST) and non-disadvantaged castes in high focus states. Identifying disadvantaged groups in high focus states can help to reduce the absolute and relative burden of under-five deaths in India.
Author Interviews, BMJ, Environmental Risks, Ophthalmology / 21.08.2019

MedicalResearch.com Interview with: Professor Suh-Hang Hank Ju, PhD Kaohsiung Medical University Taiwan MedicalResearch.com: What is the background for this study? Response: Nitrogen dioxide (NO2) and carbon monoxide (CO) are 2 major traffic pollutants, which have been shown to increase a risk for respiratory and cardiovascular diseases. We previously showed that chronic exposure of NO2 is also associated with dementia. age-related macula degeneration (AMD) is a leading cause of blindness. Given the increase of traffic pollutants in many urbanized cities, we investigated whether these two traffic pollutants are associated with the development of age-related macula degeneration in Taiwan.
Author Interviews, Diabetes, JAMA, PTSD / 21.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50945" align="alignleft" width="174"]Jeff Scherrer, Ph.D. Associate professor; Research director Department of Family and Community Medicine Saint Louis University Center for Health Outcomes Research Dr. Jeff Scherrer[/caption] Jeff Scherrer, Ph.D. Associate professor; Research director Department of Family and Community Medicine Saint Louis University Center for Health Outcomes Research  MedicalResearch.com: What is the background for this study? Response: This study was part of a larger NIH grant to determine if PTSD is associated with poor health behaviors and subsequently whether PTSD remains an independent risk factor for diabetes and heart disease.  Our second focus of the grant was to measure if those patients who experience clinically meaningful PTSD improvement have improved health behaviors (e.g. seeking help to lose weight) and a lower risk for diabetes and heart disease. The rationale for this study of PTSD improvement and lower risk for diabetes is supported from other investigators' findings that PTSD treatment completion is often followed by improvement in sleep, depression, pain and general physical complaints and lower blood pressure.  Because we have found the association between PTSD and incident diabetes is largely explained by obesity, depression and other comorbid conditions that are more common in patients with vs. without PTSD, we hypothesized that improvements in PTSD would be associated with lower risk of diabetes either directly or due to improvements in these comorbid diabetes risk factors.
Author Interviews, Hospital Acquired, JAMA / 20.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50892" align="alignleft" width="176"]Todd Campbell Lee MD MPH FACP FIDSA Consultant in Internal Medicine and Infectious Diseases Director, MI4 Clinical Trials Platform Associate Professor of Medicine, McGill University Montreal, Quebec Dr. Todd Lee[/caption] Todd Campbell Lee MD MPH FACP FIDSA Consultant in Internal Medicine and Infectious Diseases Director, MI4 Clinical Trials Platform Associate Professor of Medicine, McGill University Montreal, Quebec  MedicalResearch.com: What is the background for this study? Response: For a number of years people have been advocating for a move towards single-patient rooms in hospital design.  This was articulately argued for in an opinion piece by Detsky and Etchells in 2008 (https://jamanetwork.com/journals/jama/article-abstract/182433) as being important for a move to safe and patient-centered design. One of the major selling points has always been a reduction in the risk of nosocomial, or hospital-associated, infections given reduced opportunities for contamination between patients; however, only a few studies have specifically looked at this issue.  Overall, despite some strong work, many of these studies were limited by only looking at specific units, over limited periods of time,  and using before-after comparisons which did not account for change over time either within or outside of the institution. We knew that in 2015 our old hospital would close and within the same day all patients would be moved to a brand new hospital with 100% single patient rooms -- most of which have a private bathroom for patients and a separate hand-washing sink for staff.  So in 2014, we designed this study, obtained ethics review, and then waited patiently for several years to pass after the move so that we could rigorously evaluate the impact.  We looked at monthly rates of vancomycin-resistant Enterococcus (VRE) colonizations and infections, methicillin-resistant Staphylococcus aureus (MRSA) colonization and infections, and Clostridium (now Clostrideroides) difficile infections (CDI). We chose these because we had good long term data on their rates and because we could compare the rates over time before and after the move and contrast them with the province of Quebec as a whole.
Author Interviews, Dental Research, JAMA, Mental Health Research, Mineral Metabolism, Pediatrics / 19.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50911" align="alignleft" width="200"]Rivka Green, MA Doctoral Candidate Clinical Developmental Neuropsychology York University Rivka Green[/caption] Rivka Green, MA Doctoral Candidate Clinical Developmental Neuropsychology York University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We conducted a study on 512 mother-child pairs from 6 major cities across Canada, about half of whom lived in a region that receives fluoridated water. We found that prenatal fluoride exposure was associated with lower IQ scores in 3-4 year old children.
Author Interviews, Cognitive Issues, End of Life Care, Gender Differences, JAMA / 16.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50851" align="alignleft" width="142"]Dr. Nathan Stall, MD Geriatrician and Research fellow Women’s College Research Institute Dr. Stall[/caption] Dr. Nathan Stall, MD Geriatrician and Research fellow Women’s College Research Institute   [caption id="attachment_50852" align="alignleft" width="133"]Dr. Paula Rochon, MD, MPH, FRCPC Periatrician and Vice-President of Research Women’s College Hospital Dr. Rochon[/caption]     Dr. Paula Rochon, MD, MPH, FRCPC Periatrician and Vice-President of Research Women’s College Hospital     MedicalResearch.com: What is the background for this study? Response: The advanced stages of the dementia are characterized by profound memory impairment, an inability to recognize family, minimal verbal communication, loss of ambulatory abilities, and an inability to perform basic activities of daily living. Nursing homes become a common site of care for people living with advanced dementia, who have a median survival of 1.3 years. In the advanced stages of the disease, the focus of care should generally be on maximizing quality of life. Our study examined the frequency and sex-based differences in burdensome interventions received by nursing home residents with advanced dementia at the very end of life. Burdensome interventions include a variety of treatment and procedures that are often avoidable, may not improve comfort, and are frequently distressing to residents and their families. We found that in the last 30 days of life, nearly one in 10 nursing home residents visited an emergency department, more than one in five were hospitalized, and one in seven died in an acute care setting. In addition, almost one in 10 residents received life-threatening critical care; more than one in four were physically restrained; and more than one in three received antibiotics.
Author Interviews, JAMA, Outcomes & Safety, Surgical Research, University of Michigan / 15.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50705" align="alignleft" width="160"]Kyle Sheetz, MD, MSc Research Fellow Center for Healthcare Outcomes and Policy University of Michigan Dr. Sheetz[/caption] Kyle Sheetz, MD, MSc Research Fellow Center for Healthcare Outcomes and Policy University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Various patient safety organizations and clinical societies continue to advocate for volume thresholds as a means to improve the short-term safety and overall effectiveness of high risk cancer surgeries in the United States. We asked two questions with this study: 1) What proportion of U.S. hospitals meet discretionary volume standards? 2) Do these standards differentiate hospitals based on short-term safety outcomes (mortality and complications)? We found that a relatively low proportion of hospitals meet even modest volume standards put forth by the Leapfrog Group. These standards did not differentiate hospitals based on outcomes for 3 of 4 high risk cancer operations reported by the Leapfrog Group. However, using higher thresholds, we were able to demonstrate a significant relationship between higher hospital volume and better outcomes, which has been reported numerous times.
Author Interviews, JAMA, Mayo Clinic, Pancreatic, USPSTF / 14.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50834" align="alignleft" width="138"]Dr. Chyke A. Doubeni, M.D., M.P.H. Dr. Doubeni is a family physician and The inaugural director of the Mayo Clinic Center for Health Equity and Community Engagement Research Dr. Doubeni[/caption] Dr. Chyke A. Doubeni, M.D., M.P.H. Dr. Doubeni is a family physician and The inaugural director of the Mayo Clinic Center for Health Equity and Community Engagement Research MedicalResearch.com: What is the background for this study? Response: The U.S. Preventive Services Task Force uses systematic review of existing research to make recommendations on clinical preventive services that are delivered in primary care, with the goal to promote and improve health for all Americans. Although pancreatic cancer is an uncommon condition in the general population, it is often deadly. Pancreatic cancer is now the third most common cause of cancer death in the United States, and could become the second leading cause if current trends continue. The vast majority of people with pancreatic cancer are diagnosed at a late stage and, unfortunately, even when caught early enough when surgery could be most effective, only a little over one-third of patients survive beyond five years.
Author Interviews, Blood Pressure - Hypertension, Duke, Heart Disease, JAMA, Race/Ethnic Diversity / 14.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50729" align="alignleft" width="200"]Yuichiro Yano MD Assistant Professor in Family Medicine and Community Health Duke University  Dr. Yano[/caption] Yuichiro Yano MD Assistant Professor in Family Medicine and Community Health Duke University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: African Americans are disproportionally affected by hypertension-related cardiovascular disease compared with other racial/ethnic groups in the United States and have higher blood pressure levels inside and outside the clinic than whites and Asians. However, little is known, among African Americans, regarding whether higher mean blood pressure measured outside of the clinic setting on 24-hour ambulatory blood pressure monitoring is associated with an increased risk for cardiovascular disease events, independent of blood pressure measured in the clinic setting.
Author Interviews, Heart Disease, JAMA, Pediatrics / 14.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50819" align="alignleft" width="177"]Dr Juan Pablo Kaski MD(Res) FRCP FESC Director of the GOSH Centre for Inherited Cardiovascular Diseases Great Ormond Street Hospital, University College London Institute of Cardiovascular Science, London, UK Dr. Kaski[/caption] Dr Juan Pablo Kaski MD(Res) FRCP FESC Director of the GOSH Centre for Inherited Cardiovascular Diseases Great Ormond Street Hospital, University College London Institute of Cardiovascular Science, London, UK  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Hypertrophic Cardiomyopathy?  Response: Hypertrophic cardiomyopathy (HCM) is a genetic condition characterised by abnormal thickening of the muscle of the heart and can affect people of all ages. It is associated with an increased risk of sudden cardiac death (SCD) and, in the last few years, a clinical risk tool that estimates the 5-year risk of SCD in adults with HCM has been developed. However, there are no similar risk models in children, where risk stratification has traditionally been based on clinical risk factors extrapolated from the adult population. We have recently shown that this approach does not discriminate risk well in children, and so the aim of this study was to develop a new risk tool to provide an individualised risk of SCD in children with HCM. 
Author Interviews, Environmental Risks, JAMA, NIH, Pulmonary Disease / 13.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50697" align="alignleft" width="150"]Joel Kaufman, MD, MPH, Professor   Environmental & Occupational Health Sciences, Medicine, and Epidemiology University of Washington Prof. Kaufman[/caption] Joel Kaufman, MD, MPH, Professor   Environmental & Occupational Health Sciences, Medicine, and Epidemiology University of Washington  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Increasingly, it is recognized that chronic lung diseases like emphysema occur in nonsmokers and rates of these diseases are continuing to increase.  We really need to understand what’s causing chronic lung disease. Air pollutants are known to make disease worse in people with prior lung disease, but little is known about whether long-term exposure to air pollutants can cause chronic lung disease. We found that higher residential concentrations of air pollutants—especially ozone and traffic-related air pollutants—are associated with changes in the lung—emphysema-like changes in the lung.  The associations were strong and suggest that air pollution may be an important contributor to chronic lung disease. 
Author Interviews, Heart Disease, Nature, Nutrition / 13.08.2019

MedicalResearch.com Interview with: apple-flavenoidsNicola Bondonno PhD National Health and Medical Research Council Early Career Research Fellow School of Medical and Health Sciences Edith Cowan University Joondalup  Perth WA   MedicalResearch.com: What is the background for this study? Response: In an aging society, there could be a huge importance in appropriate evidence-based diets to reduce mortality risk. Therefore, our main question was ‘do diets high in flavonoids reduce the risk of all-cause and cause-specific mortality and is this relationship affected by lifestyle risk factors for early mortality’? In brief, this is the largest study of flavonoid intake and mortality outcomes to date. This population based cohort study was conducted in 56,048 men and women of the Danish Diet, Cancer, and Health Cohort, followed for 23 years, with estimated intakes of 219 individual flavonoid compounds. The results provide a clarity not seen in previous smaller, often underpowered studies. 
Annals Internal Medicine, Author Interviews, Race/Ethnic Diversity, Weight Research / 13.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50610" align="alignleft" width="200"]Dr-Jonathan Emberson Dr. Emberson[/caption] Jonathan Emberson, PhD Associate Professor (Medical Statistics and Epidemiology) Deputy Director of Graduate Studies Medical Research Council Population Health Research Unit Clinical Trial Service Unit & Epidemiological Studies Unit Nuffield Department Population Health University of Oxford    MedicalResearch.com: What is the background for this study? Response: Some previous studies had claimed that being overweight is not strongly associated with mortality in Hispanic populations (the ‘Hispanic paradox’). However, these studies had not accounted for the fact that while obesity makes diabetes and several other chronic diseases more common, these diseases may then result in substantial weight loss, thereby hiding the reason why those diseases arose in the first place. 
Author Interviews, Breast Cancer, JAMA, UCLA / 12.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50709" align="alignleft" width="200"]Joann G. Elmore, MD, MPH Professor of Medicine, Director of the UCLA National Clinician Scholars Program David Geffen School of Medicine at UCLA Dr. Elmore[/caption] Joann G. Elmore, MD, MPH Professor of Medicine, Director of the UCLA National Clinician Scholars Program David Geffen School of Medicine at UCLA  MedicalResearch.com: What is the background for this study? What are the main findings?
  • A pathologist makes the diagnosis of breast cancer versus non-cancer after reviewing the biopsy specimen. Breast biopsies are performed on millions of women each year and It is critical to get a correct diagnosis so that we can guide patients to the most effective treatments.
  • Our prior work (Elmore et al. 2015 JAMA) found significant levels of disagreement among pathologists when they interpreted the same breast biopsy specimen. We also found that pathologists would disagree with their own interpretations of breast biopsies when they where shown the same biopsy specimen a year later.
  • In this study, 240 breast biopsy images were fed into a computer, training it to recognize patterns associated with several types of breast lesions, ranging from benign (noncancerous) to invasive breast cancer. We compared the computer readings to independent diagnoses made by 87 practicing U.S. pathologists and found that while our artificial intelligence program came close to performing as well as human doctors in differentiating cancer from non-cancer, the AI program outperformed doctors when differentiating ductal carcinoma in situ (DCIS) from atypia, which is considered the greatest diagnostic challenge.
Author Interviews, Diabetes, JAMA / 12.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50615" align="alignleft" width="180"]Pooyan Kazemian, Ph.D. Instructor in Medicine Massachusetts General Hospital Dr. Kazemian[/caption] Pooyan Kazemian, Ph.D. Instructor in Medicine Massachusetts General Hospital  MedicalResearch.com: What is the background for this study? Response: Advances in diabetes care can meaningfully improve outcomes only if they effectively reach the populations at risk. However, it is not known if recent innovations in diabetes treatment and care models have reached the United States population at risk.
Author Interviews, Orthopedics, PLoS / 12.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50683" align="alignleft" width="157"]Prof. Inger Mechlenburg, PhD, DMSc Orthopaedic Department, Aarhus University Hospital Department of Clinical Medicine Aarhus University Prof. Mechlenburg[/caption] Prof. Inger Mechlenburg, PhD, DMSc Orthopaedic Department, Aarhus University Hospital Department of Clinical Medicine Aarhus University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Traditionally, displaced 2-part humerus fractures have been operatively treated using a metal plate and screws. However, there are no studies showing a benefit of operation of those fractures. Therefore, we were interested in investigating, in a direct comparison between operation and non-operative treatment, whether there was a difference in patient-reported function, pain and health-related quality of life two years after the fracture. In this Nordic research collaboration http://nitep.eu/en/ between Finland, Sweden, Estonia and Denmark we showed that there is no difference in functional results between operative and non-operative treatment in persons aged 60 or more with displaced proximal humerus fractures. In the study, only fractures with a significant displacement between bone fragments were included. In the non-operative treatment group, patients used a collar and cuff sling for three weeks and underwent instructed physiotherapy.
Author Interviews, Brain Injury, Exercise - Fitness, Nature, Science / 11.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50651" align="alignleft" width="200"]Adnan Hirad, PhD MD Candidate, Medical Scientist Training Program University of Rochester School of Medicine and Dentistry Dr. Hirad[/caption] Adnan Hirad, PhD MD Candidate, Medical Scientist Training Program University of Rochester School of Medicine and Dentistry  MedicalResearch.com: What is the background for this study? Response: Concussion is defined based on the manifestation of observable signs and symptoms (e.g., dizziness, difficulty with concentration, loss of consciousness, inter alia). A non-concussive head injury is when someone hits their head but does not exhibit the signs and symptoms of concussion -- IE concussion is defined by observable signs, and sub-concussive is defined as sustaining  head impacts similar (in magnitude and mechanism) to those sustained with concussion without observable signs and/or symptoms. These hits are a problem not only in football, but also with IED/bomb blasts experienced during war and potentially rugby. 
Author Interviews, Circadian Rhythm, Heart Disease, JACC / 11.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50660" align="alignleft" width="200"]Dr. Alan Cheng, MD MBA Vice President at Medtronic Clinical Research and Therapy Development, Cardiac Rhythm Management Medtronic, Minnesota 55112. Dr. Cheng[/caption] Dr. Alan Cheng, MD MBA Vice President at Medtronic Clinical Research and Therapy Development, Cardiac Rhythm Management Medtronic, Minnesota 55112  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ventricular arrhythmias can be life threatening among patients with certain types of heart disease. While implantable cardioverter defibrillators (ICDs) have become the primary means in managing these events, we still don’t fully understand when ventricular arrhythmias occur and whether they are just random events that occur at any time of the day. We pooled patient-level data from 6 prospective studies of ICD recipients and leveraged the continuous monitoring features of the ICD to understand when ventricular arrhythmias occur. Across almost 4000 patients with almost 2 years average follow up from the time of implant, we saw that ventricular arrhythmias aren’t randomly distributed throughout the day. In fact, there is a predilection for these events to occur during normal waking hours as compared to the times of the day when most patients are asleep. Additionally, we found that across the year, the spring season had higher rates of arrhythmia occurrence when compared to summer. We didn’t observe any differences in arrhythmia occurrence by the days of the week or months of the year. This analysis is not the first to explore this question but it is the largest to date. 
Author Interviews, JAMA, Orthopedics, Pediatrics / 09.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50635" align="alignleft" width="200"]Dr Ahmed Elhakeem PhD Senior Research Associate in Epidemiology University of Bristol Dr. Elhakeem[/caption] Dr Ahmed Elhakeem PhD Senior Research Associate in Epidemiology University of Bristol MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that the denser (stronger) your bones are, the less likely they are to break (fracture). We also have reliable evidence that later maturing adolescents tend on average to have lower bone density than their earlier maturing peers. We wanted to find out how the timing of puberty might influence the development of bone density throughout adolescence and into early adult life. We did this by following up a large group of young people born in the early 90s around Bristol, UK that took part in a unique study (the Children of the 90s study) that included repeated density scans over a 15-year period from age ten to 25. We found that those later maturing adolescents that got their growth spurt at an older age tended to catch-up to some degree to their earlier maturing peers during puberty however, they continued on average to have lower bone density than average for several years into adulthood.
Author Interviews, Cancer Research, JAMA, MRI, Prostate Cancer / 07.08.2019

MedicalResearch.com Interview with: Dr Martha Elwenspoek PhD Research Associate in Epidemiology and Health Services Research NIHR CLAHRC West, Bristol MedicalResearch.com: What is the background for this study? Response: Prostate cancer is one of the most common cancers in men. Prostate cancer is usually diagnosed by taking 10 to 14 systematic samples from the prostate guided by ultrasound. However, these biopsies are unpleasant for patients, can miss cancer even when it’s present, can misclassify the severity of the cancer, and can cause side effects, such as bleeding and infection. If biopsies could be targeted better, men wouldn’t have to undergo so many and there would be less risk of getting a misleading result. Multiparametric MRI (mpMRI) scans are sometimes used before doing a biopsy to help diagnose prostate cancer, and while this approach is now being recommended by the UK National Institute for Clinical Excellence (NICE) their use isn’t widespread.