Author Interviews, Cost of Health Care, JAMA / 18.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50263" align="alignleft" width="140"]Jim Stimpson, PhD Professor, Associate Dean for Academic Affairs  Health Management and Policy Drexel Dornsife School of Public Health Dr. Stimpson[/caption] Jim Stimpson, PhD Professor, Associate Dean for Academic Affairs Health Management and Policy Drexel Dornsife School of Public Health  MedicalResearch.com: What is the background for this study? Response: We have limited information on the impact of the ACA on persons with a disability, even though nearly 1 in 5 persons in the US has a physical or mental disability. Prior to the ACA, persons with a disability had complications accessing health insurance for a variety of reasons including lower likelihood of employer-based coverage, reduced access to private insurance due to pre-existing conditions, and income-restrictions for Medicaid coverage that are on average below the poverty threshold across the country.
Author Interviews, Biomarkers, Heart Disease, JACC / 17.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50312" align="alignleft" width="100"]Dr. Fred Apple, PhD, DABCC Medical director,Clinical Laboratories, Clinical Chemistry, Clinical and Forensic Toxicology and Point of Care Testing, Hennepin HealthCare Principal investigator, Minneapolis Medical Research Foundation Professor, Department of Laboratory Medicine and Pathology University of Minnesota Dr. Apple[/caption] Dr. Fred Apple, PhD, DABCC Medical director,Clinical Laboratories, Clinical Chemistry, Clinical and Forensic Toxicology and Point of Care Testing, Hennepin HealthCare Principal investigator, Minneapolis Medical Research Foundation Professor, Department of Laboratory Medicine and Pathology University of Minnesota  MedicalResearch.com: What is the background for this study? Response: Few studies have addressed the role of high sensitivity cardiac troponin (hs-cTn) assays in ruling out myocardial infarction (MI) based on the measurement of a single baseline specimen in US patients presenting to the emergency department with symptoms suggestive of ischemia. Most studies have been published predicated on patients in Europe, Australia, and New Zealand. As US emergency departments have different ordering practices for using cTn in triaging patients, it is important to validate the role of hs-cTn assays in US practices to assure providers of appropriate utilization. We have published two papers using the Abbott ARCHITECT hs-cTnI assay, the same one used outside the US in clinical practice (as this assay is not yet FDA cleared) in a US cohort (clinicialtrials.gov trial: UTROPIA - Sandoval Y, Smith SW, Shah ASV, Anand A, Chapman AR, Love SA, Schulz K, Cao J, Mills NL, Apple FS. Rapid rule-out of acute myocardial injury using a single high-sensitivity cardiac troponin I measurement. Clin Chem 2017;63:369-76. Sandoval Y, Smith SW, Love SA,  Sexter A, Schulz K, Apple FS. Single high-sensitivity cardiac troponin I to rule out myocardial infarction. Am J Med 2017;130:1076-1083) that have shown similar rule out capacities predicated on clinical presentation, a normal ECG and the role of hs-cTnI testing.
Author Interviews, Global Health, HIV, NEJM / 17.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50304" align="alignleft" width="107"]Prof-Richard-Hayes.jpg Prof. Hayes[/caption] Dr. Richard J. Hayes, DSc, FMedSci Professor of Epidemiology and International Health London School of Hygiene and Tropical Medicine MedicalResearch.com: What is the background for this study? Response: HIV incidence rates remain at very high levels in many parts of southern Africa. Universal testing and treatment (i.e., ensuring that everyone in a community tests for HIV and that everyone diagnosed with HIV is started on treatment as soon as possible) has been proposed as a strategy to achieve steep reductions in HIV incidence in generalized epidemics. Prior trials have shown inconsistent results as to whether this strategy could be effective. HPTN 071 (PopART) was carried out in 21 urban communities in Zambia and South Africa, with individual communities randomly assigned into one of three arms: A, B or C. The 14 communities in Arms A and B received annual rounds of home-based HIV testing by community health workers who supported linkage to care, antiretroviral therapy (ART) adherence and other HIV services. The seven communities in Arm C received the local standard of care. We looked to see if the HIV incidence in the communities receiving universal testing and treatment would be lower (over time) compared to the incidence in the standard of care communities.
Author Interviews, JAMA, Opiods, Pediatrics, UCSD / 17.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50286" align="alignleft" width="200"]Lorraine Kelley-Quon, MD, MSHS, FAAP Assistant Professor | Division of Pediatric Surgery Children's Hospital Los Angeles Department of Surgery & Preventive Medicine Keck School of Medicine of USC Dr. Kelley-Quon[/caption] Lorraine Kelley-Quon, MD, MSHS, FAAP Assistant Professor | Division of Pediatric Surgery Children's Hospital Los Angeles Department of Surgery & Preventive Medicine Keck School of Medicine of USC  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Prescription opioids are pharmacologically similar to heroin, and previous research has shown an association between nonmedical opioid use and heroin use. This is the first study to follow a group of teenagers through all 4 years of high school and identify an association between nonmedical prescription opioid use and later heroin use.
Annals Internal Medicine, Author Interviews, OBGYNE, Rheumatology / 17.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50282" align="alignleft" width="155"]Bella Mehta, MBBS, MS  Assistant Attending Physician, Hospital for Special Surgery Instructor, Weill Cornell Medical College     Dr. Mehta[/caption] Bella Mehta, MBBS, MS Assistant Attending Physician, Hospital for Special Surgery Instructor, Weill Cornell Medical College MedicalResearch.com: What is the background for this study? What are the main findings? Response: For women with lupus, pregnancy has long been considered high-risk and associated with both medical and obstetric complications. In the 1960s and 1970s, pregnancy was thought to be contraindicated in lupus patients. Beginning in the 1980s, and especially in the 1990s, many studies identified specific risk factors for pregnancy complications and proposed best-practice management guidelines. We wished to see whether these advances improved pregnancy outcomes for lupus patients. Our study showed a decline in maternal mortality and other outcomes in lupus patients. The improvement in pregnancy outcomes was observed more so in lupus patients than those without lupus. 
Annals Internal Medicine, Author Interviews, Clots - Coagulation, Heart Disease, Kidney Stones / 16.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50193" align="alignleft" width="84"]Sunil Badve MBBS, MD, DNB, FRACP, PhD, FASN Senior Research Fellow, Renal & Metabolic Division Staff specialist nephrologist | St George Hospital University of New South Wales The George Institute for Global Health Australia Dr. Badve[/caption] Sunil Badve MBBS, MD, DNB, FRACP, PhD, FASN Senior Research Fellow, Renal & Metabolic Division Staff specialist nephrologist | St George Hospital University of New South Wales The George Institute for Global Health Australia MedicalResearch.com: What is the background for this study? Response: Despite the high prevalence of cardiovascular thrombotic events and venous thromboembolism (VTE) in chronic kidney disease (CKD), oral anticoagulant therapy is often underutilized in patients with advanced CKD and dialysis-dependent end-stage kidney disease (ESKD) due to uncertainty of benefit and potential bleeding complications. This comprehensive systematic review was performed to study the benefits and harms of oral anticoagulant therapy in patients with CKD.
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Mental Health Research, Outcomes & Safety / 16.07.2019

MedicalResearch.com Interview with: MedicalResearch.com Interview with: Regis Goulart Rosa, MD, PhD Responsabilidade Social - PROADI Hospital Moinhos de Vento MedicalResearch.com: What is the background for this study? Response: The debate about visiting policies in adult ICUs is of broad and current interest in critical care, with strong advocacy in favour of flexible family visitation models in order to promote patient- and family-centred care. However, the proportion of adult ICUs with unrestricted visiting hours is very low. Data from the literature show that 80% of hospitals in the United Kingdom and USA adopt restrictive ICU visiting policies. Among ICUs with restrictive visiting hours, published studies show that the daily visiting time ranges from a median of 1 hour in Italy to a mean of 4.7 hours in France. In agreement with this scenario, most adult ICUs in Brazil follow a restrictive visitation model, in which family members are allowed to visit the critically ill patient from 30 minutes to 1 hour, once or twice a day. These restrictive visitation models have been justified by the theoretical risks associated with unrestricted visiting hours, mainly infectious complications, disorganization of care, and burnout. Controversially, these risks have not been consistently confirmed by the scarce literature on the subject, and flexible ICU visiting hours have been proposed as a means to prevent delirium among patients and improve family satisfaction. MedicalResearch.com: What are the main findings? Response: Disappointingly, studies evaluating the effectiveness and safety of flexible ICU visiting hours are scarce. To date, no large randomized trials have assessed the impact of a flexible visiting model on patients, family members, and ICU staff, and this evidence gap may constitute a barrier to the understanding of the best way to implement and improve ICU visiting policies. In the present pragmatic cluster-randomized crossover trial (The ICU Visits Study), we engaged 1,685 patients, 1,295 family members, and 826 ICU professionals from 36 adult ICUs in Brazil to compare a flexible visitation model (12 hours/day plus family education) vs. the standard restricted visitation model (median 90 minutes per day). We found that the flexible visitation did not significantly reduce the incidence of delirium among patients, but was associated with fewer symptoms of anxiety and depression and higher satisfaction with care among family members in comparison to the usual restricted visitation. Also, the flexible visitation did not increase the incidence of ICU-acquired infections and ICU staff burnout, which are major concerns when adopting this intervention. MedicalResearch.com: What should readers take away from your report? Response: Considering the evidence suggesting that most adult ICUs restrict the presence of family members, our results provide useful and relevant information that may influence the debate about current ICU visitation policies around the world. First, a flexible visitation policy that permits flexible family visitation in ICU (up to 12 hour per day) is feasible, given the high adherence of participant ICUs to implementation in The ICU Visits Study. Second, the flexible family supported by family education is safe regarding the occurrence of infections, disorganization of care or staff burnout. Third, family members - a commonly missing piece of the critical care puzzle - seem to benefit from the flexible visitation model through higher satisfaction with care and less symptoms of anxiety and depression. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: Future research might focus on the following topics: 1) methods of implementation of flexible visiting models in ICUs; 2) Family support interventions in the context of flexible ICU visiting hours (e.g.: psychological and social support, support for shared decision making, peer support, and comfort); and 3) How flexible ICU visiting hours affects patient, family member and staff outcome at long-term. Disclosures: The ICU Visits study was funded by the Brazilian Ministry of Health through the Brazilian Unified Health System Institutional Development Program (PROADI-SUS). Citation: Effect of Flexible Family Visitation on Delirium Among Patients in the Intensive Care Unit [wysija_form id="3"] [last-modified] The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.Regis Goulart Rosa, MD, PhD Responsabilidade Social - PROADI Hospital Moinhos de Vento  MedicalResearch.com: What is the background for this study? Response: The debate about visiting policies in adult ICUs is of broad and current interest in critical care, with strong advocacy in favour of flexible family visitation models in order to promote patient- and family-centred care. However, the proportion of adult ICUs with unrestricted visiting hours is very low. Data from the literature show that 80% of hospitals in the United Kingdom and USA adopt restrictive ICU visiting policies. Among ICUs with restrictive visiting hours, published studies show that the daily visiting time ranges from a median of 1 hour in Italy to a mean of 4.7 hours in France. In agreement with this scenario, most adult ICUs in Brazil follow a restrictive visitation model, in which family members are allowed to visit the critically ill patient from 30 minutes to 1 hour, once or twice a day. These restrictive visitation models have been justified by the theoretical risks associated with unrestricted visiting hours, mainly infectious complications, disorganization of care, and burnout. Controversially, these risks have not been consistently confirmed by the scarce literature on the subject, and flexible ICU visiting hours have been proposed as a means to prevent delirium among patients and improve family satisfaction. 
Author Interviews, Cancer Research, Hormone Therapy, JAMA, Prostate Cancer, University of Pennsylvania / 15.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50254" align="alignleft" width="180"]Ravi Jayadevappa, PhD, MS Department of Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA 19104-2676  Dr. Jayadevappa[/caption] Ravi Jayadevappa, PhD, MS Department of Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA 19104-2676  MedicalResearch.com: What is the background for this study? Response: In the US, prostate cancer is the most commonly diagnosed non-skin cancer and the second leading cause of cancer death among men. Research shows that hormone therapy or ADT reduces the levels of male hormones in the body, called androgens, to stop them from stimulating cancer cells to grow., and thus is effective in reducing the spread and progression of prostate cancer. At the same time, some research has suggested that decreasing androgen levels may increase the risk factors for Alzheimer’s and dementia, including loss of lean body mass, diabetes, cardiovascular disease, and depression. The ADT therapy may lead to impaired neuron growth and the regeneration of axons, thus affecting the cognitive function. Thus there is growing interest in the possible association between exposure to ADT and cognitive dysfunction. Our study investigates the association between exposure to ADT and subsequent diagnosis of Alzheimer’s or dementia in elderly, fee-for-service Medicare enrollees using SEER-Medicare linked databases.
Author Interviews, JAMA, OBGYNE, Pediatrics, Social Issues / 15.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50215" align="alignleft" width="134"]Dr. Marina Mendonca PhD RECAP project (Research on European Children and Adults Born Preterm) Department of Psychology University of Warwick, UK Dr. Mendonca[/caption] Dr. Marina Mendonca PhD RECAP project (Research on European Children and Adults Born Preterm) Department of Psychology University of Warwick, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research on the social lives of adults born preterm (under 37 weeks gestation) was inconsistent. This meta-analysis brought together data from up to 4.4m adult participants and has shown that those who were born preterm are less likely to form romantic relationships, to have had sexual relations or experience parenthood than full terms. For example, those born preterm were 28% less likely to form romantic relationships and 22% less likely to become parents, when compared to those born full term. When looking at sexual relations, preterm born adults were 2.3 times (or 57%) less likely to ever have a sexual partner. These associations were found for both men and women, and were stronger the lower gestational age. This means that the chances of finding a romantic partner or having children were lower for those born very (<28 weeks gestation) or extremely preterm (<28 weeks gestation), with the extremely pre-term born adults being for example 3.2 times (78%) less likely to ever having had sexual relations when compared to their full term peers. Despite having fewer relationships, we found that when adults who were born preterm had friends or a partner, the quality of these relationships was at least as good as those born full term. 
Author Interviews, Genetic Research, Heart Disease, Imperial College, JAMA / 12.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50228" align="alignleft" width="112"]Ben Cordon, PhD NIHR Post-doctoral Academic Clinical Fellow Specialist Registrar training in cardiology Dr. Cordon[/caption] Ben Cordon, PhD NIHR Post-doctoral Academic Clinical Fellow Specialist Registrar training in cardiology  [caption id="attachment_50229" align="alignleft" width="112"]James S. Ware, PhD, MRCP  Reader in Genomic Medicine Group head within the Cardiovascular Genetics & Genomics Unit Imperial College London Dr. Ware[/caption] James S. Ware, PhD, MRCP  Reader in Genomic Medicine Group head within the Cardiovascular Genetics & Genomics Unit Imperial College London     MedicalResearch.com: What is the background for this study?   Response: Non-ischaemic dilated cardiomyopathy is a common cause of heart failure and carries the risk of life-threatening ventricular arrhythmia. An implantable cardioverter defibrillator (ICD) can be life-saving in this condition. However, the decision to implant an ICD is not one that can be taken lightly - ICD insertion carries its own risks, such as infection or inappropriate shocks, and our ability to predict who will benefit from a device is currently far from perfect. Genetic sequencing is affordable and widely available and for DCM, like many diseases, it is hoped that genetic stratification may one day help deliver personalised management. In DCM, variants in the Lamin A/C gene for example are known to cause a phenotype with early and severe arrhythmias and, as a result, international guidelines advocate a lower threshold for ICD insertion in these patients. However, Lamin A/C is an infrequent cause of DCM. The commonest known genetic cause of DCM are protein-truncating variants in the gene encoding Titin (TTNtv), accounting for ~15% of DCM cases. We wanted to know if this group had a higher risk of arrhythmia than the general DCM population. Earlier work from our group on this topic found that patients with TTNtv-associated DCM were more likely to have a clinical history of arrhythmia (composite of atrial and ventricular arrhythmia, including NSVT), at the time of their initial DCM diagnosis. But it was unclear if this was driven by ventricular arrhythmia, atrial arrhythmia, or both or if it would translate into a long-term risk of potentially dangerous ventricular arrhythmia of the sort for which an ICD can be life-saving. In another study we analysed a larger cohort of ambulant DCM patients but did not find an increased risk of ventricular arrhythmia – but this was a relatively low-risk group, with comparatively mild symptoms (NHYA I/II heart failure) and moderately impaired LV function. As a result, the overall arrhythmic event rate was low, meaning that the power to detect differences between the TTNtv and non-TTNtv groups was reduced.
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA / 12.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50160" align="alignleft" width="200"]Prof-Kazem Rahimi Prof. Rahimi[/caption] Dr Kazem Rahimi Deputy Director of the George Centre for Healthcare Innovation James Martin Senior Fellow in Essential Healthcare Honorary Consultant Cardiologist at the John Radcliffe Hospital Deputy Director of the George Institute for Global Health MedicalResearch.com: What is the background for this study? Response: In the last century, we have witnessed a dramatic change in the spectrum of valvular heart disease and the prevalence of this condition has been rapidly increasing, due to population ageing, with poor patient outcomes and high healthcare costs associated with the only effective treatment available, which is valve repair or replacement. However, modifiable risk factors for valvular heart disease remain largely unknown, which limits prevention and treatment. We used a state-of-the-art, gene-based method called Mendelian randomization to determine the causality of the association between systolic blood pressure and risk of valvular heart diseases. 
Anemia, Author Interviews, Heart Disease, JAMA, Karolinski Institute / 11.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50211" align="alignleft" width="200"]Dr. Niels Grote Beverborg, MD PhD Post-doctoral research fellow Department of experimental cardiology University Medical Center Groningen, Groningen, The Netherlands Integrated CardioMetabolic Center Karolinska Institutet, Stockholm Sweden Dr. Grote Beverborg[/caption] Dr. Niels Grote Beverborg, MD PhD Post-doctoral research fellow Department of experimental cardiology University Medical Center Groningen, Groningen, The Netherlands Integrated CardioMetabolic Center Karolinska Institutet, Stockholm Sweden  MedicalResearch.com: What is the background for this study?   Response: Iron deficiency is very prevalent worldwide and a significant cause of morbidity and mortality, especially in vulnerable populations such as patients with heart failure. It is well known that iron deficiency can be a consequence of an insufficient iron uptake or increased iron loss (termed low iron storage), or of a chronic low inflammatory state (defective iron utilization). However, so far, we had no tools to distinguish these causes from each other in patients and have not been able to assess their potential consequences.
Author Interviews, JAMA, Nutrition, Weight Research / 11.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50185" align="alignleft" width="135"]Anne Thorndike, MD, MPH Massachusetts General Hospital General Internal Medicine Division Boston, MA 02114 Dr. Thorndike[/caption] Anne Thorndike, MD, MPH Massachusetts General Hospital General Internal Medicine Division Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response: Nearly one-third of the 150 million US adults who are employed are obese. Employees frequently eat meals acquired at work, and workplace food is often high in calories. Effective strategies for reducing non-nutritive energy intake during the workday could help address the rising prevalence of obesity. Simplified labeling, such as traffic-light labels, provide understandable information about the relative healthfulness of food and can be placed on menu boards, shelf labels, and individual packages to help employees make healthier choices. Choice architecture (e.g., product placement) interventions make it easier and more convenient for employees to choose a healthy item. It is unknown if labeling interventions are associated with sustained reductions in calorie intake, or if there are only temporary effects after which most people revert to higher-calorie choices. A previous study demonstrated that a hospital cafeteria traffic-light labeling and choice architecture program resulted in a higher proportion of healthy green-labeled purchases and lower proportion of unhealthy red-labeled purchases over two years. The current study analyzed calories purchased by a longitudinal cohort of 5,695 hospital employees who used the cafeteria regularly. The study examined changes in calories purchased over time and hypothesized the effect of the change in calorie intake on employees’ weight.
Addiction, Author Interviews, JAMA, Technology / 11.07.2019

MedicalResearch.com Interview with: video-gamesDr. Klaus Wölfling Psychologische Leitung - Ambulanz für Spielsucht Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie Universitätsmedizin der Johannes Gutenberg-Universität Mainz Mainz MedicalResearch.com: What is the background for this study? What are the main findings?  Response:  Our institution, the outpatient clinic of Behavioral Addictions at the Department of Psychosomatic Medicine, University Medical Center Mainz started as a pilot project, which was funded by Rhineland-Palatine, our federal state in Germany. We rapidly noticed the need for treatment in the population. We revealed insights of the disease during the last decade. During this time, we developed and refined therapeutic processes addressing Internet Addiction and Gaming Disorder. We conducted a pilot study, which tested the feasibility of a CBT-treatment approach for Internet Addiction in an RCT. We learned a lot from therapy research and noticed that it was important to conduct a study, which indicates an effective treatment for this disease. STICA found a strong remission rate for Internet and Computer game Addiction of treatment group vs. WLC (OR=10.10; 94% CI 3.69 to 27.65).
Author Interviews, Dermatology, Gastrointestinal Disease, JAMA / 11.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50197" align="alignleft" width="200"]Hidradenitis suppurativa- DermNetNZ Hidradenitis suppurativa- DermNetNZ[/caption] Prof Ching-Chi Chi, MD, MMS, DPhil (Oxford) Department of Dermatology Chang Gung Memorial Hospital, Linkou Guishan Dist, Taoyuan 33305 Taiwan MedicalResearch.com: What is the background for this study? Response: Hidradenitis suppurativa (HS) and inflammatory bowel disease (IBD) are inflammatory diseases that share common clinical manifestations, genetic susceptibility, and immunologic features. For example, both diseases have similar clinical manifestations in the skin and gut, characterized by sterile abscesses in perineal and inguinal areas, scarring, and sinus tract formation. Both diseases have been associated with an increased prevalence of spondyloarthropathy, have common risk factors (smoking and obesity), and respond well to tumor necrosis factor-inhibitors. Some studies have suggested a link between HS and IBD, but data on the association of HS and IBD remain inconsistent and unclear. Therefore, we conducted a meta-analysis to investigate the association of hidradenitis suppurativ with IBD.
Author Interviews, Biomarkers, NEJM, Pulmonary Disease / 11.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50147" align="alignleft" width="200"]Dr. Chris Butler,, BA MBChB DCH CCH MD FRCGP (Hon)FFPH FMedSci Professor of Primary Care Nuffield Department of Primary Care Health Sciences, Professorial Fellow at Trinity College Clinical Director Primary Care Clinical Trials Unit University of Oxford Dr. Butler[/caption] Dr. Chris Butler,, BA MBChB DCH CCH MD FRCGP (Hon)FFPH FMedSci Professor of Primary Care Nuffield Department of Primary Care Health Sciences, Professorial Fellow at Trinity College Clinical Director Primary Care Clinical Trials Unit University of Oxford  MedicalResearch.com: What is the background for this study? Response: More than a million people in the UK have COPD, which is a lung condition associated with smoking and other environmental pollutants. People living with the condition often experience exacerbations, or flare-ups, and when this happens, three out of four are prescribed antibiotics. However, two-thirds of these flare-ups are not caused by bacterial infections and antibiotics often do not benefit patients. A simple finger-prick blood test could help prevent unnecessary prescribing of antibiotics for people with the lung condition chronic obstructive pulmonary disease (COPD).  The finger-prick test measures the amount of C- reactive protein (CRP) - a marker of inflammation that rises rapidly in the blood in response to serious infections. People with a COPD flare-up who have a low CRP level in the blood appear to receive little benefit from antibiotic treatment. The General Practitioner (GP) use of a C-Reactive Protein (CRP) Point of Care Test (POCT) to help target antibiotic prescribing to patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) who are most likely to benefit (The PACE Study) determined whether the using a POCT CRP to guide antibiotic treatment decisions for acute exacerbations of COPD reduced antibiotic use without harming patients.
Annals Internal Medicine, Author Interviews, Supplements, Vitamin C, Vitamin D / 09.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50150" align="alignleft" width="128"]Safi U. Khan, MD Department of Internal Medicine Robert Packer Hospital Sayre, PA 18840  Dr. Khan[/caption] Safi U. Khan, MD Department of Internal Medicine Robert Packer Hospital Sayre, PA 18840  MedicalResearch.com: What is the background for this study? Response: There is substantial body of observational data favoring use of vitamins, supplements and special diets for improving cardiovascular health. However, such type of data is limited by various biases. Randomized controlled trial (RCT) is considered gold standard to evaluate effects of a therapy. 
Annals Internal Medicine, Author Interviews, Infections, University of Michigan / 09.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50132" align="alignleft" width="125"]Valerie M. Vaughn, MD MSc Assistant Professor of Medicine and Research Scientist, Division of Hospital Medicine The Patient Safety Enhancement Program and Center for Clinical Management Research Michigan Medicine and the Ann Arbor VA Medical Center Dr. Vaughn[/caption] Valerie M. Vaughn, MD MSc Assistant Professor of Medicine and Research Scientist, Division of Hospital Medicine The Patient Safety Enhancement Program and Center for Clinical Management Research Michigan Medicine and the Ann Arbor VA Medical Center  MedicalResearch.com: What is the background for this study? Response: Pneumonia is one of the top causes for hospitalization and one of the main reasons for antibiotic use in US hospitals. In the past decade, studies have suggested that patients can be safely treated with short course antibiotic therapy instead of the prolonged courses we used to prescribe. Our study looked at prescribing practices in 43 hospitals across the state of Michigan to see if we were appropriately prescribing short course therapy, and if so, how that affected patients.
Author Interviews, Cannabis, JAMA, Pediatrics / 09.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50165" align="alignleft" width="200"]D. Mark Anderson, Ph.D. Associate Professor Department of Agricultural Economics and Economics Montana State University, IZA, and NBER Dr. Anderson[/caption] D. Mark Anderson, Ph.D. Associate Professor Department of Agricultural Economics and Economics Montana State University, IZA, and NBER MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Using data from the Youth Risk Behavior Surveys for the period 1993-2017, we explore the effect medical and recreational marijuana laws have on teen use. We find that medical marijuana laws (MMLs) are not associated with teen marijuana consumption, but recreational marijuana laws (RMLs) are actually negatively associated with teen use. 
Author Interviews, End of Life Care, JAMA, Kidney Disease / 08.07.2019

MedicalResearch.com Interview with: [caption id="attachment_43001" align="alignleft" width="133"]Dr. Ann M. O’Hare, MD Professor,Division of Nephrology University of Washington Investigator, VA HSR&D Center of Excellence Affiliate Investigator, Group Health Research Institute Seattle, WA  Prof. O'Hare[/caption] Dr. Ann M. O’Hare, MD Professor,Division of Nephrology University of Washington Investigator, VA HSR&D Center of Excellence Affiliate Investigator, Group Health Research Institute Seattle, WA  MedicalResearch.com: What is the background for this study? Response: We know that survival for people undergoing dialysis is generally quite limited.  Only a few studies have attempted to elicit how patients undergoing dialysis understand prognosis and how their prognostic awareness might be related to their interest in planning for the future, their preferences for resuscitation and the kind of care they would want if they were seriously ill or dying.
Aging, Author Interviews, Cognitive Issues, Gender Differences, Hormone Therapy, JAMA, Menopause, Weight Research / 05.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50128" align="alignleft" width="144"]Rachel Zsido PhD student Department of Neurology  International Max Planck  Rachel Zsido[/caption] Rachel Zsido PhD student Department of Neurology International Max Planck MedicalResearch.com: What is the background for this study? Response: We integrated measures of brain network structure, visceral adipose tissue (VAT), serum estradiol levels, and cognitive performance from 974 participants in order to shed light on potential mechanisms underlying cognitive health. We believe it is imperative to assess sex-specific risk trajectories in brain aging and cognitive decline, especially given the known sex differences in both VAT accumulation patterns and estradiol fluctuations across the lifespan. Thus, we aimed to answer three questions in men and in women: 1) Does visceral adipose tissue exacerbate the association between age and brain network structure, 2) Does estradiol mitigate the negative association between VAT and brain network structure, and 3) What does this imply for healthy cognitive aging in men and women? 
Author Interviews, Lancet, Neurology, Surgical Research / 05.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50105" align="alignleft" width="158"]Natasha van Zyl, MBChB (Cape Town), FRACS FRACS Plastic and Reconstructive Surgeon Melbourne, Australia  Dr Natasha van Zy[/caption] Dr. Natasha van Zyl, MBChB (Cape Town), FRACS FRACS Plastic and Reconstructive Surgeon Melbourne, Australia  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The estimated global incidence of spinal cord injury (SCI) from all causes is 40 to 80 new cases per million population per year which means that every year between 250 000 to 500 000 people worldwide suffer SCI (1)(chap 2 p 17). In Australia the age standardised, annual incident rate of persisting traumatic SCI for Australian residents aged 15 years and above is 11.8 cases per million.(2) Just over 50% of all spinal cord injuries  in Australia occur at the cervical level resulting in tetraplegia. (2) Cervical spinal cord injury is a devastating, life-changing injury impacting almost every aspect of a person’s work, family and social life. Although compared to many other health conditions it has a relatively low incidence, it is certainly a high cost health condition, with the lifetime cost per tetraplegia incident case estimated to be AU$9.5 million.(3) For those living with tetraplegia improvement in hand function is their highest ranked goal.(4) As such, reconstruction of upper extremity function in cervical spinal cord injury is a crucial component of the surgical rehabilitation of people with mid/low cervical spinal cord injury as it has the capacity to restore critical functions such as elbow extension, wrist extension, grasp, key pinch and release. Traditionally these functions have been reconstructed using tendon transfers, which move a functioning muscle to a new insertion site to recreate the function of a paralysed muscle.(5)
Author Interviews, JAMA / 04.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50098" align="alignleft" width="200"]Lucy Schulson, MD MPH Section of General Internal Medicine Boston University School of Medicine Boston, Massachusetts Dr. Schulson[/caption] Lucy Schulson, MD MPH Section of General Internal Medicine Boston University School of Medicine Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: Research in the early 2000s in California demonstrated that racial and ethnic minorities, immigrants, and those with limited English proficiency (LEP) experienced high rates of discrimination in healthcare. Since those studies were published, California has made concerted efforts at the state and local level to address health equity; these efforts may have impacted perceptions of discrimination in health care. However, it is not known how perceptions of discrimination in healthcare have changed over the last ten years overall and for specific groups. This study sought to compare perceptions of discrimination in health care in 2003-2005 compared to 2015-2017 overall, for racial and ethnic minorities, among immigrants, and among those with Limited English Proficiency (LEP). 
Author Interviews, Cancer Research, JAMA / 03.07.2019

MedicalResearch.com Interview with: [caption id="attachment_46733" align="alignleft" width="120"]Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303 Dr. Islami[/caption] Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc MedicalResearch.com: What is the background for this study?   Response: In the United States, cancer is the second leading cause of death, and premature cancer deaths impose significant economic burden. Contemporary information on the economic burden of cancer mortality can inform policies and help prioritize resources for cancer prevention and control, but this information is lacking. In our study, we provide contemporary estimates for the loss of future earnings (lost earnings) due to cancer death at national and state levels for all cancers combined and for major cancers.
Author Interviews, Biomarkers, Geriatrics, Heart Disease, JACC / 02.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50008" align="alignleft" width="149"]Martin Bødtker Mortensen, læge PhD Afdelingen for Hjertesygdomme Aarhus Universitetshospital Danmark Dr. Mortensen[/caption] Martin Bødtker Mortensen, læge PhD Afdelingen for Hjertesygdomme Aarhus Universitetshospital Danmark  MedicalResearch.com: What is the background for this study?   Response: The background for the study is a combination of two things: First, the proportion and number of elderly people 65 years of age or older are increasing fast worldwide. Second, given the dominant impact of age on estimated risk for cardiovascular disease, nearly all elderly individuals eventually become statin eligible under current guidelines – just because of aging alone. Thus, to limit overtreatment of elderly individuals, we wanted to find “negative” risk markers that can be used to identify elderly individuals at truly low cardiovascular risk who are less likely to benefit from statin therapy despite advancing age.
Author Interviews, CDC, Emory, Infections, JAMA, Pediatrics, Vaccine Studies / 02.07.2019

MedicalResearch.com Interview with: Ms. Cassandra Pingali Ms. Pingali worked on this paper while a a graduate student at Emory University, and completed it post-graduation. She is currently an ORISE fellow at Centers for Disease Control and Prevention Immunization Services Division MedicalResearch.com: What is the background for this study? Response: Despite high overall immunization coverage in the United States, we are currently experiencing the largest measles outbreak since measles was declared eliminated in 2000. In 2014, California grappled with a very large measles outbreak known as the “Disneyland” outbreak. Later investigation revealed that most of the affected children were unvaccinated against measles despite the availability of a safe and effective vaccine. In order to prevent future outbreaks, California officials wanted to improve their declining childhood vaccination coverage. California passed two laws and implemented an educational program for school staff to increase vaccination rates in the state. We felt it was important to take a systematic look at these interventions and examine if public health initiatives such as these are working to improve vaccination rates.
Addiction, Author Interviews, JAMA, Opiods, University of Michigan / 30.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49992" align="alignleft" width="135"]Rebecca L. Haffajee, J.D., Ph.D., M.P.H. Assistant Professor Department of Health Management & Policy University of Michigan School of Public Health Dr. Haffajee[/caption] Rebecca L. Haffajee, J.D., Ph.D., M.P.H. Assistant Professor Department of Health Management & Policy umichsphumichsph MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Evidence suggests that the availability of medications to treat opioid use disorder (OUD) has been slow to expand, particularly in rural areas, despite the efficacy and effectiveness of these medications in reducing overdose deaths and other adverse life outcomes. We were interested in understanding the characteristics of counties both with high need (as measured by above-national rates in opioid overdose deaths) AND low provider capacity to deliver medications to treat OUD in 2017. We found that such "opioid high-risk" counties were likely to be in the East North Central (e.g., Michigan, Ohio, Illinois, Indiana), South Atlantic (e.g., North Carolina, South Carolina, Virginia, West Virginia), and Mountain (e.g., New Mexico, Arizona, Nevada) regions. We also found that these opioid high-risk counties were more likely to have higher rates of unemployment and less likely to have fewer primary care clinicians or be micropolitan
Author Interviews, Columbia, JAMA, Pulmonary Disease / 28.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49933" align="alignleft" width="198"]Elizabeth C. Oelsner, MD, MPH Irving Assistant Professor of Medicine Division of General Medicine New York Presbyterian Columbia University Dr. Oelsner[/caption] Elizabeth C. Oelsner, MD, MPH Irving Assistant Professor of Medicine Division of General Medicine New York Presbyterian Columbia University MedicalResearch.com: What is the background for this study? Response: Uncertainty regarding how to diagnose chronic obstructive pulmonary disease (COPD) has posed significant problems for early detection and treatment of this common disease. Simplifying and standardizing the diagnosis of COPD has the potential to improve diagnosis, clinical care, and clinical research for this common and under-diagnosed chronic lung disease. We therefore aimed to provide robust evidence for the best threshold to diagnose COPD by comparing how well various thresholds predict hospitalizations and deaths from COPD.