Author Interviews, Cancer Research, Cost of Health Care, JAMA / 19.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49162" align="alignleft" width="191"]Nina Niu Sanford, M.D. Assistant ProfessorUT Southwestern Department of Radiation OncologyDallas TX 75390 Dr. Sanford[/caption] Nina Niu Sanford, M.D.  Assistant Professor UT Southwestern Department of Radiation Oncology Dallas TX 75390  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is that we know cancer survivors are at risk for uninsurance or underinsurance and the most commonly cited reason for this is cost of insurance.  However, there have been no prior studies assessing from the patient perspective the reasons for not having insurance. In addition, there has been further recent controversy over the Affordable Care Act, including threats from the current administration to dismantle it.  Thus assessing the impact of the ACA among at risk populations including cancer survivors is timely.
Author Interviews, Brigham & Women's - Harvard, JAMA, Orthopedics, Osteoporosis, Surgical Research / 15.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49152" align="alignleft" width="135"]Elaine W. Yu, MD, MMSc Assistant Professor,  Harvard Medical School Director, Bone Density CenterEndocrine Unit, Massachusetts General Hospital  Dr. Elaine Yu[/caption] Elaine W. Yu, MD, MMSc Assistant Professor,  Harvard Medical School Director, Bone Density Center Endocrine Unit, Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Roux-en-Y gastric bypass (RYGB) is a popular surgical weight loss procedure.  We have previously shown that gastric bypass leads to rapid high-turnover bone loss. Bariatric procedures are being increasingly performed in older adults, and the clinical consequences of gastric bypass-associated skeletal changes in this vulnerable population have been unclear to date.  Thus, we used Medicare claims data to investigate fracture risk among older adults after gastric bypass, and in comparison to adults who received another bariatric procedure called adjustable gastric banding (AGB), which is thought to have fewer negative bone effects. In our analysis, we found that patients undergoing Roux-en-Y gastric bypass were 73% more likely to fracture than those undergoing AGB. Importantly, we found that hip fracture risk increased nearly 180% after RYGB, and that fracture rates in patients aged 65 or older were similar to the overall group. 
Annals Internal Medicine, Author Interviews, Critical Care - Intensive Care - ICUs, Infections, University of Pittsburgh / 15.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49126" align="alignleft" width="160"]Minh-Hong Nguyen, MDInfectious DiseasesProfessor of MedicineDirector, Transplant Infectious DiseasesDirector, Antimicrobial Management ProgramDepartment of Medicine University of Pittsburgh School of Medicine Dr, Minh-Hong Nguyen[/caption] Minh-Hong Nguyen, MD Infectious Diseases Professor of Medicine Director, Transplant Infectious Diseases Director, Antimicrobial Management Program Department of Medicine University of Pittsburgh School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Blood cultures, the gold standard for diagnosing blood stream infections, are insensitive and limited by prolonged time to results. Early institution of appropriate antibiotics is a crucial determinant of improved outcomes in patients with sepsis and blood stream infections (BSI). For these reasons, development of rapid non-culture diagnostic tests for blood stream infections is a top priority. The T2Bacteria panel is the first direct from blood, non-culture test cleared by FDA for diagnosis of blood stream infections .  It detects within 4-6 hours the 5 most common ESKAPE bacteria that are frequent causes of hospital infection, and which are often multi-drug resistant.  This study shows that the T2Bacteria panel rapidly and accurately diagnosed and identified ESKAPE bacterial BSIs, and identified probable and possible BSIs that were missed by blood cultures (in particular among patients who were already receiving antibiotics).
Author Interviews, Hip Fractures, JAMA, Supplements / 13.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49114" align="alignleft" width="149"]Prof. Haakon E Meyer, PhDDepartment of Public Health and Global HealthNorwegian Institute of Public HealthOslo, Norway Prof. Meyer[/caption] Prof. Haakon E Meyer, PhD Department of Public Health and Global Health Norwegian Institute of Public Health Oslo, Norway MedicalResearch.com: What is the background for this study? What are the main findings? Response: The use of high dose vitamin supplementation is popular in parts of the population, often without any clear indication and in the absence of clear evidence of benefit. However, side effects can occur, and in a previous published secondary analysis of double blinded randomized controlled trials, we found to our surprise an increased risk of hip fracture in those supplemented with high doses of vitamin B6 in combination with vitamin B12. This finding was re-assessed in the current study employing data from the large observational Nurses' Health Study. As in the previous study, we found that a combined high intake of vitamin B6 and B12 was associated with increased risk of hip fracture.
Author Interviews, Biomarkers, Cancer Research, Colon Cancer, JAMA, Karolinski Institute / 13.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49076" align="alignleft" width="150"]Louise OlssonSenior researcherDepartment of Molecular Medicine and SurgeryColorectal SurgeryKarolinski InstituteStockholm, Sweden Dr. Olsson[/caption] Louise Olsson MD PhD Senior researcher Department of Molecular Medicine and Surgery Colorectal Surgery Karolinski Institute Stockholm, Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: I read a very interesting paper back in 2006 “Detection and quantification of mutation in the plasma of patients with colorectal cancer”. Only some 60 % of patients with early colorectal cancer were detectable in this way whereas patients with stage IV disease all had a high concentration of APC mutations in their plasma. So the prospects of using the method for example, screening of primary colorectal cancer seemed limited but I thought wow, this is the test to detect recurrences and generalized disease during follow-up after surgery for colorectal cancer. After some discussion we started to collect plasma samples from patients at the hospital where I worked and that´s how my research began.
Author Interviews, JAMA, Opiods, Primary Care, University of Michigan / 11.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49122" align="alignleft" width="140"]Kao-Ping Chua, M.D., Ph.D.Department of PediatricsSusan B. Meister Child Health Evaluation and Research CenterUniversity of Michigan, Ann Arbor Dr. Kao-Ping Chua[/caption] Kao-Ping Chua, M.D., Ph.D. Department of Pediatrics Susan B. Meister Child Health Evaluation and Research Center University of Michigan, Ann Arbor MedicalResearch.com: What is the background for this study?   Response: Doctor and pharmacy shopping is a high-risk behavior in which patients obtain opioid prescriptions from multiple prescribers and fill them at multiple pharmacies. Because this behavior is associated with a high risk of overdose death, there have been many efforts to help clinicians detect doctor and pharmacy shopping among patients prescribed opioids. For example, 49 states have a prescription drug monitoring program that provides information on patients’ prior controlled substance prescriptions. In contrast, there has been little attention to the possibility that patients prescribed opioids may have family members who are engaged in opioid doctor and pharmacy shopping. Such family members may divert opioids prescribed to patients because of their access to these opioids.
Author Interviews, JAMA, OBGYNE, Weight Research / 09.05.2019

MedicalResearch.com Interview with: Dr-Romy GaillardRomy Gaillard MD PhD LifeCycle Project-Maternal Obesity and Childhood Outcomes Study Group Erasmus MC MedicalResearch.com: What is the background for this study?   Response: Obesity among women of reproductive age is a major problem for society. Scientists have long known that maternal weight before and during pregnancy are associated with pregnancy outcomes. Gestational weight gain is necessary to ensure healthy development of the fetus, but too much weight gain is associated with a higher risk of pregnancy complications. The magnitude of the associations of maternal weight before and during pregnancy with the risks of pregnancy complications, as well as the optimal amount of weight that especially obese women should gain during pregnancy were not well-known.
Author Interviews, Clots - Coagulation, NEJM, Neurology / 09.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49060" align="alignleft" width="165"]Geoffrey A Donnan AOMBBS, MD, FRCP, FRACP, FAAHMSProfessor of NeurologyUniversity of Melbourne, Melbourne Brain Centre,Royal Melbourne and Austin Hospitals Prof. Donnan[/caption] Geoffrey A Donnan AO MBBS, MD, FRCP, FRACP, FAAHMS Professor of Neurology University of Melbourne, Melbourne Brain Centre Royal Melbourne and Austin Hospital MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Currently the thrombolysis time window for acute ischemic stroke is restricted to less than 4.5 hours from stroke onset and patients with wake-up stroke are not eligible. EXTEND is a multi-centre randomised placebo-controlled trial involving patient with acute ischemic stroke who presented between 4.5 to 9 hours of stroke onset or with wake-up-stroke and had penumbral tissue demonstrated on automated perfusion imaging. Patients were randomised to receive either alteplase or placebo. In total there were 225 patients recruited and the patients who received alteplase had higher rate of excellent functional outcome at 3 months (35.4% vs 29.5% adjusted odd ration 1.44 with 95% confidence interval 1.01 – 2.06 p=0.04). Patients who received alteplase achieved higher rate of early neurological improvement at day 3, reperfusion and recanalization at 24 hours. There was numerically more haemorrhage in the alteplase group but this not negate the functional benefit and there was no difference in the rate of mortality between the two groups. 
Author Interviews, Cannabis, PLoS / 09.05.2019

MedicalResearch.com Interview with: Kyle Gardiner B.Pharm(Hons)PhD candidateDiscipline of PharmacyQueensland University of Technology | QUT · Brisbane, Australia Kyle Gardiner B.Pharm(Hons) PhD candidate Discipline of Pharmacy Queensland University of Technology | QUT · Brisbane, Australia MedicalResearch.com: What is the background for this study?   Response: The background to this study was a personal interest in behavioural science. I am often intrigued as to why health professional behave the way they do. Studies exploring health professional behaviour are seldom complete or comprehensive, however. Medicinal cannabis presents an interesting case point to explore health professional behaviours due to its topical nature. The socio-political discussion surrounding medicinal cannabis is often quite different from the medical discussion, yet for legal and regulated access to be achieved across most jurisdictions, a health professional is required to be involved in that process. Simply, if health professionals are not willing to behave, the delivery of medicinal cannabis does not occur. For purposes of transparency, I neither support or reject the use of medicinal cannabis and this paper has nothing to do improving or reducing access. This paper is about beginning to understand health professional behaviours within the context of medicinal cannabis. Yet, if we hope to change practice in the future, by definition, we need to change behaviour. We cannot change behaviour without first understanding the behaviour in context.
Author Interviews, Global Health, Infections, NEJM / 08.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49046" align="alignleft" width="133"]Birgit Nikolay PhDMATHEMATICAL MODELLING OF INFECTIOUS DISEASESInstitut Pasteur Dr. Nikolay[/caption] Birgit Nikolay PhD MATHEMATICAL MODELLING OF INFECTIOUS DISEASES Institut Pasteur  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nipah virus was identified by the World Health Organization as an emerging infectious disease that may cause major epidemics if the pathogen evolves to become more transmissible, leading the organization to prioritize it for research to prevent future health emergencies. In the absence of efficient treatments or vaccines, the only way to control Nipah virus outbreaks is through targeted interventions that limit opportunities of spread. Designing such interventions is challenging in a context where transmission mechanisms remain poorly understood. The study provides important insights to better understand these mechanisms.
Author Interviews, Electronic Records, JAMA, Pediatrics, Primary Care / 07.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49055" align="alignleft" width="173"]Cari McCarty, PhDResearch Professor, UWInvestigator, Seattle Children’s Research Institute Dr. McCarty[/caption] Cari McCarty, PhD Research Professor, UW Investigator, Seattle Children’s Research Institute  MedicalResearch.com: What is the background for this study? Response: Adolescence is a time when teens begin to take charge of their health, but it is also a time when they can be prone to health risk behaviors, such as insufficient physical activity, poor sleep, and substance use. We were interested in whether using an electronic health risk screening tool in primary care settings could improve healthcare and health for adolescents.  The tool was designed to provide screening as well as motivational feedback directly to adolescents, in addition to clinical decision support for the healthcare clinician.  We conducted a trial with 300 adolescent patients where one group received the screening tool prior to their health checkup, and the other group received usual care.
Author Interviews, Heart Disease, JAMA, Johns Hopkins, Pulmonary Disease / 07.05.2019

MedicalResearch.com Interview with: [caption id="attachment_48985" align="alignleft" width="80"]Robert A. Wise, M.D.Professor of MedicinePulmonary and Critical CareJohns Hopkins University School of MedicineBaltimore, MD  Dr. Wise[/caption] Robert A. Wise, M.D. Professor of Medicine Pulmonary and Critical Care Johns Hopkins University School of Medicine Baltimore, MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a lingering controversy about the safety of long-acting anti-muscarinic agents (LAMA) as maintenance treatment for COPD in patients who have increased cardiovascular risk.  This study enrolled participants with COPD who also had increased cardiovascular risk or known cardiovascular disease.  Participants were randomly treated with either aclidinium bromide (Tudorza Pressair) or placebo. Over 3 years of follow up there was no increased risk of adverse cardiovascular events.  Moreover, the medication had a significant benefit in terms of reducing exacerbations and COPD hospitalizations.
Alcohol, Author Interviews, Hepatitis - Liver Disease, JAMA / 07.05.2019

MedicalResearch.com Interview with: [caption id="attachment_48981" align="alignleft" width="140"]Robert Wong, MD, MS, FACGAssistant Clinical Professor of MedicineDirector, GI Education & ResearchHighland Hospital   I A member of Alameda Health SystemOakland, CA 94602 Dr. Wong[/caption] Robert Wong, MD, MS, FACG Assistant Clinical Professor of Medicine Director, GI Education & Research Highland Hospital   I A member of Alameda Health System Oakland, CA 94602  MedicalResearch.com: What is the background for this study?   Response: Alcoholic liver disease is a major cause of chronic liver disease in the United States and has become the leading indication for liver transplantation in the U.S.  However, accurate estimates of the true burden among U.S. adults is not well studies due to challenges in accurately identifying alcoholic liver disease or lack of awareness is screening individuals for alcohol use disorder.  Given the gaps in knowledge regarding the epidemiology of alcoholic liver disease in the U.S., our current study attempts to further contribute to the understanding of alcoholic liver disease epidemiology in the U.S We utilized a U.S. national cross sectional database and focused on the specific subset of alcoholic fatty liver disease, which is the earlier stage of disease along the spectrum of alcoholic liver disease.  Focusing on alcoholic fatty liver disease allowed us to more accurately define and capture the prevalence of this disease.  Furthermore, given that alcoholic fatty liver disease is early on the overall spectrum of alcoholic liver disease, it is a disease state that early identification provides opportunities to implement therapy and counseling for alcohol abstinence that can prevent further liver damage and disease progression.
Author Interviews, Cancer Research, Colon Cancer, JAMA / 07.05.2019

MedicalResearch.com Interview with: Prof. Dr. med. Hermann Brenner Clinical Epidemiology and Aging Research Division Head German Cancer Research Center Foundation under Public Law Germany  MedicalResearch.com: What is the background for this study? Response: Colorectal cancer is the third most common cancer globally, accounting for almost 900.000 deaths every year. Most of these deaths could be prevented by screening colonoscopy with early detection and removal of precursors of the cancer. However, capacities and use of screening colonoscopy are limited in most parts of the world, and low-cost but reliable noninvasive screening tests are important alternative primary screening tests. The currently best established noninvasive tests are fecal immunochemical tests for hemoglobin (FITs) which are offered for colorectal cancer screening in an increasing number of countries. Although FITs detect the majority of colorectal cancers they detect approximately one out of four advanced adenomas only, the precursors of most colorectal cancers. We hypothesized that this proportion could be increased by taking a single pill of aspirin two days prior to collecting the stool sample for FIT, because the well-established antithrombotic effects of aspirin might favor detecting occult bleeding from colorectal cancer or its precursors.
Author Interviews, Critical Care - Intensive Care - ICUs, Outcomes & Safety, Pediatrics, Pediatrics / 06.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49020" align="alignleft" width="99"]John P. Galiote, M.D.Neonatologist at Children’s National-Virginia Hospital Center NICU Dr. Galiote[/caption] John P. Galiote, M.D. Neonatologist at Children’s National-Virginia Hospital Center NICU [caption id="attachment_49021" align="alignleft" width="100"]Michelande Ridoré, MS, NICUQuality improvement lead at Children’s National  Ms. Ridoré[/caption] Michelande Ridoré, MS, NICU Quality improvement lead at Children’s National [caption id="attachment_49022" align="alignleft" width="99"]Lamia Soghier, M.D., MEd, Children’s National NICU medical director Dr. Soghier[/caption]   Lamia Soghier, M.D., MEd, Children’s National NICU Medical Director MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study emphasizes the importance of team work and real-time communication in a quality-improvement project within the neonatal intensive care unit (NICU) setting. Through bedside huddles, weekly reviews of apparent cause analysis reports reducing the frequency of X-rays and the creation of an Airway Safety Protection Team, we were able to focus not only on  reducing unintended extubations, but also on the quality-improvement project’s effect on our staff. Adhering to simple quality principles enabled us to ensure that all members of our staff were heard and had a positive effect on the progress of our project. This allowed us to implement and sustain a series of simple changes that standardized steps associated with securing and maintaining an endotracheal tube (ET). Unintended extubations are the fourth-most common adverse event in the nation’s NICUs. Continual monitoring via this quality-improvement project allowed us to intervene when our rates increased and further pushed our unintended extubation rate downward.
Author Interviews, Dermatology, Environmental Risks, FDA, JAMA / 06.05.2019

MedicalResearch.com Interview with: [caption id="attachment_48994" align="alignleft" width="191"]David Strauss, MD, PhDDirector, Division of Applied Regulatory ScienceU.S. Food and Drug AdministrationCenter for Drug Evaluation and Research Dr. Strauss[/caption] David Strauss, MD, PhD Director, Division of Applied Regulatory Science U.S. Food and Drug Administration Center for Drug Evaluation and Research MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is unknown whether most active ingredients in sunscreens are absorbed. FDA has provided guidance that sunscreen active ingredients with systemic absorption greater than 0.5 ng/mL or with safety concerns should undergo nonclinical toxicology assessment including systemic carcinogenicity and additional developmental and reproductive studies. This randomized clinical trial demonstrated systemic exposure of 4 commonly used sunscreen active ingredients on application of sunscreen products under maximal use conditions consistent with current sunscreen labeling. All 4 sunscreen active ingredients tested resulted in exposures exceeding 0.5 ng/mL. 
Allergies, Author Interviews, Immunotherapy, JAMA / 06.05.2019

MedicalResearch.com Interview with: [caption id="attachment_48976" align="alignleft" width="129"]Dr. Marcus Shaker Dr. Shaker[/caption] Marcus S. Shaker, MD Associate Professor of Pediatrics Associate Professor of Community and Family Medicine Dartmouth-Hitchcock Medical Center MedicalResearch.com: What is the background for this study? Response: There are two peanut allergy treatments that are being evaluated for potential FDA approval—an orally administered treatment and an epicutaneous (skin based) treatment.  Both have tremendous potential benefit.  The focus of our study was to explore the range of health and economic benefits in terms of establishing pathways for how each therapy could be cost effective. We want to be clear that our purpose was not to suggest one therapy is or is not cost effective at present.  That would be a ridiculous statement to make regarding two treatments that not only lack FDA approval, but do not have established pricing.  Rather, we used preliminary inputs that are presently available to create as robust a model as we could to better determine the individual paths that would make them more or less cost-effective.
Author Interviews, Brigham & Women's - Harvard, Education, JAMA / 06.05.2019

MedicalResearch.com Interview with: [caption id="attachment_48973" align="alignleft" width="169"]Arabella L. Simpkin,  MD, MMScAssociate Director, Center for Educational Innovation and Scholarship, MGHAssociate Program Director, Education and Curriculum, Internal Medicine Residency, MGHInstructor in Medicine, Harvard Medical SchoolBoston, MA 02114 Dr. Simpkin[/caption] Arabella L. Simpkin,  MD, MMSc Associate Director, Center for Educational Innovation and Scholarship, MGH Associate Program Director, Education and Curriculum, Internal Medicine Residency, MGH Instructor in Medicine, Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response: The academic health care environment has changed in unprecedented ways over several decades, with mounting evidence that faculty are becoming increasingly more unhappy, dissatisfied, and burnt out in their work. Concern for faculty wellbeing is high, with much speculation about causes of burnout. Comprehending what affects satisfaction at work in academic health care centers is critically important to stem this epidemic of discontent. For physicians, satisfaction has been reported to be associated with quality of care delivered, particularly as measured by patient satisfaction; faculty retention and job satisfaction are intricately linked, with dissatisfied physicians more likely to leave the profession and to discourage others from entering. Other industries that have suffered similar rises in employee discontent have found that demonstration of respect is the most important leadership behavior in improving employees satisfaction. To our knowledge this factor has not been looked at in healthcare professionals. To address this gap, we sought to determine key variables influencing satisfaction at work for faculty in a large academic medical center in the United States.
Author Interviews, JAMA, Pediatrics, Smoking / 06.05.2019

"E-Cigarette/Electronic Cigarette/E-Cigs/E-Liquid/Vaping/Cloud Chasing" by Vaping360 is licensed under CC BY 2.0 CC BY 2.0MedicalResearch.com Interview with:Jenny L. Carwile, ScD, MPH Department of Medicine Maine Medical Center Portland   MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Although e-cigarette aerosols are commonly perceived to be "harmless water vapors" they contain numerous potentially harmful chemicals including volatile organic compounds like formaldehyde, nicotine, heavy metals, and ultrafine particulates. Non-users can be exposed to these chemicals through secondhand exposure. We found that in the US 4.9% of adults who lived in a household with children were current e-cigarette users.
Author Interviews, Genetic Research, PNAS / 02.05.2019

MedicalResearch.com Interview with: [caption id="attachment_48961" align="alignleft" width="200"]Dr. Casey Trimmer, PhDGeneticist, was a post-doctoral fellow at the Monell Center when the research was conducted Dr. Trimmer[/caption] Dr. Casey Trimmer, PhD Geneticist, was a post-doctoral fellow at the Monell Center when the research was conducted MedicalResearch.com: What is the background for this study?   Response: We detect odors using 400 different types of sensor proteins, called olfactory receptors, in our noses. An odor molecule activates a specific combination of these receptors, and this pattern of activation gives us information on what we're smelling--whether its floral or smoky, intense or weak, and how much we like it. However, how the system translates receptor activation to these perceptual features is largely unknown. Here, we take advantage of the extensive genetic variation in the OR gene family to understand the contribution of individual ORs to odor perception. By studying cases where the function of a particular OR is lost, we can examine what kinds of perceptual alterations occur, allowing us to link receptor to odor and understand what kind of information the receptor is encoding. Data linking genetic variation to perceptual changes exist for only 5 ORs. Here, we examined the perceived intensity and pleasantness of 68 odors in 332 participants. We used next-generation genome sequencing to identify variants in 418 OR genes and conducted a genetic association analysis to relate this variation to differences in odor perception. We then use a cell-based assay to examine receptor function and investigate the mechanisms underlying our associations. Finally, we examined the contribution of single OR genotype, genetic ancestry, age, and gender to variations in odor perception.
Author Interviews, Infections, JAMA / 01.05.2019

MedicalResearch.com Interview with: [caption id="attachment_48954" align="alignleft" width="130"]Nicholas B. DeFelice, PhDDepartment of Environmental Medicine & Public HealthIcahn School of Medicine at Mount SinaiNew York, New York Dr. DeFelice[/caption] Nicholas B. DeFelice, PhD Department of Environmental Medicine & Public Health Icahn School of Medicine at Mount Sinai New York, New York MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Effective allocation of public health resources during an outbreak is complicated and often reactive. Thus, it is important that we develop quantitative tools that can accurately and rapidly forecast the progression of an outbreak and provide decision support. Recently, several advancements have been made in the realm of infectious disease forecasting: it is a field that is growing in exciting directions. However, for these forecasting tools to work in real time, we must understand how the forecasting apparatus and observational network work in real time to ensure they are sufficient to support accurate operational predictions. We previously showed that accurate and reliable forecasts of West Nile virus outbreaks can be made using surveillance data and a mathematical model representing the interactions between birds, mosquitoes and risk of human spillover. This model system was able to retrospectively forecast mosquito infection rates prior to the week of peak mosquito infection, and to forecast accurately the seasonal total number of human West Nile virus cases prior to when the majority of cases were reported. For this study, we were interested in the data flow process and the question of whether appropriate infrastructure is in place to support real time forecasting. If this forecast system were made operational in real time, public health officials would have an evidence-based decision-support tool to help 1) actively target control of infected mosquito populations (i.e., larviciding and adulticiding), 2) alert the public to future periods of elevated West Nile virus spillover transmission risk, and 3) identify when to intensify blood donor screening.
Alzheimer's - Dementia, Author Interviews, End of Life Care, JAMA, University of Pennsylvania / 30.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48887" align="alignleft" width="180"]Emily Largent, PhD, JD, RNAssistant Professor, Medical Ethics and Health PolicyPerelman School of MedicineLeonard Davis Institute of Health EconomicsUniversity of Pennsylvania Dr. Largent[/caption] Emily Largent, PhD, JD, RN Assistant Professor, Medical Ethics and Health Policy Perelman School of Medicine Leonard Davis Institute of Health Economics University of Pennsylvania  MedicalResearch.com: What is the background for this study? What are the main findings?  Response:  Public support for aid in dying in the United States is rapidly growing.  As a result, we’re now seeing debates about whether to expand access to aid-in-dying to new populations – such as people with Alzheimer’s disease – who wouldn’t be eligible under current laws. With those debates in mind, we asked currently healthy people who recently learned about their risk for developing Alzheimer’s disease dementia (i.e., due to the presence of amyloid, an Alzheimer’s disease biomarker) whether they would be interested in aid-in-dying. Our findings suggest that about 20% of individuals with elevated amyloid may be interested in aid-in-dying if they become cognitively impaired.  
Author Interviews, Cancer Research, Genetic Research, JAMA, Technology / 30.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48863" align="alignleft" width="132"]Steven J.M. Jones, Professor, FRSC, FCAHSCo-Director & Head, BioinformaticsGenome Sciences CentreBritish Columbia Cancer Research CentreVancouver, British Columbia, Canada Dr. Jones[/caption] Steven J.M. Jones, Professor, FRSC, FCAHS Co-Director & Head, Bioinformatics Genome Sciences Centre British Columbia Cancer Research Centre Vancouver, British Columbia, Canada and Jasleen Grewal, BSc.Genome Sciences CentreBritish Columbia Cancer Research CentreVancouver, British Columbia, CanadaJasleen Grewal, BSc. Genome Sciences Centre British Columbia Cancer Research Centre Vancouver, British Columbia, Canada MedicalResearch.com: What is the background for this study? Response: Cancer diagnosis requires manual analysis of tissue appearance, histology, and protein expression. However, there are certain types of cancers, known as cancers of unknown primary, that are difficult to diagnose based purely on their appearance and a small set of proteins. In our precision medicine oncogenomics program, we needed an accurate approach to confirm diagnosis of biopsied samples and determine candidate tumour types for where the primary site of the cancer was uncertain.  We developed a machine learning approach, trained on the gene expression data of over 10,688 individual tumours and healthy tissues, that has been able to achieve this task with high accuracy. Genome sequencing offers a high-resolution view of the biological landscape of cancers. RNA-Seq in particular quantifies how much each gene is expressed in a given sample. In this study, we used the entire transcriptome, spanning 17,688 genes in the human genome, to train a machine learning method for cancer diagnosis. The resultant method, SCOPE, takes in the entire transcriptome and outputs an interpretable confidence score from across a set of 40 different cancer types and 26 healthy tissues. 
Author Interviews, Cancer Research, JAMA, MD Anderson, Radiation Therapy / 30.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48932" align="alignleft" width="140"]Quynh-Nhu Nguyen, MDDepartment of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHouston Dr. Quynh-Nhu[/caption] Quynh-Nhu Nguyen, MD Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This is the first non-spine bone metastases trial comparing higher dose single fraction radiotherapy vs multifraction standard fractionated radiotherapy for patients with painful bone metastases. The results of this trial demonstrated more durable pain relief and superior local control for patients treated in the higher dose(12 Gy-16 Gy)  single fraction RT compared to standard 30 Gy/10 fractions multifractionated regimen.  This trial supports the previous multiple randomized trials which recommend single fraction should be standard palliative radiotherapy regimen for bone metastases.  This trial is unique in that it addressed previous criticism that single fraction does not provide durable palliation with lower 8 gy single fraction and result in higher re-irradiation rates.  This trial on the contrary with the utilization of modern radiotherapy techniques, demonstrated we can safely and more effectively deliver a higher single fraction radiotherapy regimen for improvement in the quality of life for patients.  This higher dose should be the new standard single fraction regimen for patients who are functional and have a longer life expectancy. 
Author Interviews, Global Health, JAMA / 29.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48876" align="alignleft" width="180"]Dr Barbara Mintzes PhDAssociate Professor The University of Sydney Charles Perkins Centre and School of PharmacyFaculty of Medicine and HealthThe University of Sydney Dr. Mintzes[/caption] Dr Barbara Mintzes PhD Associate Professor The University of Sydney Charles Perkins Centre and School of Pharmacy Faculty of Medicine and Health The University of Sydney MedicalResearch.com: What is the background for this study?   Response: When medicines are approved for marketing, the information available on rare serious harmful effects, longer-term effects, and outcomes in vulnerable populations is often limited. New serious safety concerns often arise when a medicine is already on the market. In many cases these can be  managed for example through dose reductions or avoiding prescribing to at-risk patients. Drug regulatory agencies such as the US FDA often issue safety warnings to let health professionals and the public know  about new evidence of potential harm and often to provide advice on how to avoid this. We were interested to know how consistent these warnings are between different countries. This is a research project funded by Australia’s National Health and Medical Research Council and the Canadian Institutes of Health Research. We examined warnings for medicines in Australia, Canada the US and the UK over a 10-year period, from 2007 to 2016 inclusive. We were looking at how often regulators issue the same warning if the drug is approved for marketing at the time. 
Author Interviews, Cancer Research, CMAJ, Emergency Care / 29.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48843" align="alignleft" width="200"]Keerat Grewal, MD, MSc, FRCPC Schwartz/Reisman Emergency Medicine Institute Mount Sinai Hospital Toronto, ON Dr. Grewal[/caption] Keerat Grewal, MD, MSc, FRCPC Schwartz/Reisman Emergency Medicine Institute Mount Sinai Hospital Toronto, ON  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Patients with cancer have complex care requirements and often use the emergency department. The purpose of our study was to determine whether continuity of care, cancer expertise, or both, impact outcomes among cancer patients in the emergency setting. Using administrative data we looked at adult patients with cancer who received chemotherapy or radiation therapy in the 30 days prior to an emergency department visit. 
Author Interviews, Environmental Risks, Heart Disease, JAMA, Toxin Research / 29.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48834" align="alignleft" width="200"]Monica Lind, PhD, Professor, Environmental toxicologistOccupational and Environmental MedicineUppsala University HospitalVisiting adress: Dag Hammarskjölds väg 60Uppsala Sweden  Dr. Lind[/caption] Monica Lind, PhD, Professor, Environmental toxicologist Occupational and Environmental Medicine Uppsala University Hospital Visiting adress: Dag Hammarskjölds väg 60 Uppsala Sweden MedicalResearch.com: What is the background for this study? Response: Previous studies in workers exposed to very high levels of polychlorinated biphenyls (PCBs) have suggested hazardous health effects. However, circulating PCB levels are detected in almost all indivuduals in industrialized countries, but the health effects of moderately elevated levels as seen in the general population are not well established. We investigated levels of PCBs in around 1,000 individuals, all aged 70 years, randomly chosen from the City of Uppsala, Sweden.
Author Interviews, JAMA, Opiods / 28.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48846" align="alignleft" width="200"]Leah LaRue, PharmD, PMPAssociate Director, Clinical AffairsMillennium Health Dr. LaRue[/caption] Leah LaRue, PharmD, PMP Associate Director, Clinical Affairs Millennium Health MedicalResearch.com: What is the background for this study? Response: Drug overdose deaths continue to increase, despite the leveling off of prescription opioid use and policy changes limiting opioid prescribing. While fentanyl has garnered most of the attention, overdose deaths involving cocaine and methamphetamine also have increased markedly over the past few years. It is possible that those increases are due not just to those drugs, but to concomitant use with fentanyl. To better understand what is causing this rapid increase in overdose deaths, it is important to characterize the emerging combination of other illicit drugs with fentanyl, which increases the risk of overdose. The purpose of this study was to determine whether rates of the combination of nonprescribed fentanyl with cocaine or methamphetamine have changed in urine drug test (UDT) results through time.
Author Interviews, Brigham & Women's - Harvard, JAMA, Pediatrics, Weight Research / 26.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48883" align="alignleft" width="200"]Vincent W. V. Jaddoe, MD, PhDAdjunct Professor of EpidemiologyDepartment of Epidemiology Dr. Jaddoe[/caption] Vincent W. V. Jaddoe, MD, PhD Adjunct Professor of Epidemiology Department of Epidemiology MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Childhood body fat may be affected by patterns of fetal and infant weight change. Children born small for gestational age (SGA) tend to have infant growth acceleration, whereas those born large for gestational age (LGA) tend to have infant growth deceleration. Little is known about fetal and infant growth patterns affecting visceral, liver, and pericardial fat, which are strongly associated with cardiometabolic disease in later life. We assessed in a large population cohort study whether fetal and infant weight change was associated with not only general, but also organ fat at school age. We observed that fetal and infant weight change patterns were both associated with childhood body fat, but weight change patterns in infancy tended to have larger effects. Fetal growth restriction followed by infant growth acceleration was associated with increased visceral and liver fat.