Author Interviews, ENT, Hearing Loss, JAMA, University of Michigan / 17.06.2017

MedicalResearch.com Interview with: Aileen Wertz, MD Otolaryngology - Head and Neck Surgery University of Michigan  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The key finding of this study is: free, comprehensive audiologic care, including hearing aids and fitting, is feasible within a well-established free clinic model. We found that donated hearing aids and volunteer health care providers were able to run the clinic and that 20 patients have thus far been fit with hearing aids.
Author Interviews, Heart Disease, JAMA, Stroke / 15.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35355" align="alignleft" width="110"]Gregory Y. H. Lip, MD Professor of Cardiovascular Medicine University of Birmingham, UK; Adjunct Professor of Cardiovascular Sciences, Thrombosis Research Unit, Aalborg University, Denmark National Institute for Health Research (NIHR) Senior Investigator. Visiting Professor of Haemostasis Thrombosis & Vascular Sciences, Aston University, Birmingham, UK Visiting Professor of Cardiology, University of Belgrade, Serbia; Visiting Professor, University of Leeds, UK Honorary Professor, Chinese PLA Medical School, Beijing, China; Honorary Professor, Nanjing Medical University, Nanjing, China; Visiting Professor, National Yang-Ming University, Taipei, Taiwan Institute of Cardiovascular Sciences City Hospital Birmingham England UK Dr. Lip[/caption] Gregory Y. H. Lip, MD Professor of Cardiovascular Medicine University of Birmingham Adjunct Professor of Cardiovascular Sciences, Thrombosis Research Unit, Aalborg University, Denmark National Institute for Health Research (NIHR) Senior Investigator. Visiting Professor of Haemostasis Thrombosis & Vascular Sciences, Aston University, Birmingham, UK Institute of Cardiovascular Sciences City Hospital Birmingham England UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: The randomized clinical trials comparing non-Vitamin K antagonist oral anticoagulants (NOACs) vs warfarin largely focused on recruitment of high risk atrial fibrillation(AF) patients with >2 stroke risk factors, with only the trials testing dabigatran or apixaban including a minority of patients with 1 stroke risk factor. Despite this, regulatory approvals of all NOACs have been for stroke prevention in AF patients with ≥1 stroke risk factors. No difference between NOACs compared to warfarin in risk of ischemic stroke/systemic embolism, was seen but for ‘any bleeding’, this was lower for apixaban and dabigatran compared to warfarin.
Author Interviews, JAMA, Parkinson's / 15.06.2017

MedicalResearch.com Interview with: Rajesh Pahwa MD Department of Neurology University of Kansas Medical Center, Kansas City, KS, MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dyskinesia are one of the major unmet needs in Parkinson Disease patients. At the present time there are no approved medication for dyskinesia, however immediate release amantadine is used in PD patients with dyskinesia. ADS-5102 is a long acting, extended release capsule formulation of amantadine HCl administered once daily at bedtime. This study investigated the safety, efficacy and tolerability of ADS-5102 in Parkinson’s disease (PD) patients with levodopa-induced dyskinesia. This was a randomized, double-blind, placebo-controlled study of Parkinson’s disease patients with levodopa-induced dyskinesia. In total, 126 patients were randomized to placebo or 274 mg ADS-5102 administered orally at bedtime. ADS-5102 was associated with a significant reduction in dyskinesia at 12 weeks compared with placebo, as measured by the mean change in Unified Dyskinesia Rating Scale (treatment difference, –7.9; P =.0009). OFF time was significantly reduced in ADS-5102 patients compared to placebo (treatment difference -0.9 hours, p=.017).
Author Interviews, BMJ, Heart Disease / 14.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35317" align="alignleft" width="200"]Dr Nicola Adderley BA, MSci (Cantab), MA, MPhil, PhD Institute of Applied Health Research Research Fellow University of Birmingham Dr. Adderley[/caption] Dr Nicola Adderley BA, MSci (Cantab), MA, MPhil, PhD Institute of Applied Health Research Research Fellow University of Birmingham MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a major global public health problem. It is associated with a five-fold increase in risk of stroke. There are three types of AF – paroxysmal, persistent or permanent. In paroxysmal AF, episodes come and go, and usually stop without any treatment. With persistent AF episodes can last for periods of more than seven days and are treated with medication or a medical procedure called cardioversion. In permanent AF, the irregular heartbeat is present all the time and cardioversion has failed to restore a normal heart rhythm. All patients with AF, including paroxysmal AF, are at an increased risk of stroke. UK guidelines recommend anticoagulant treatment, such as the blood-thinning drug warfarin, for patients with all types of AF in order to reduce the risk of stroke. Our study aimed to determine whether patients with paroxysmal AF are less likely to be treated with anticoagulants than patients with persistent or permanent AF and to investigate trends in treatment between 2000 and 2015.
Author Interviews, JAMA, Johns Hopkins, Outcomes & Safety / 14.06.2017

MedicalResearch.com Interview with: Pranita Tamma, MD Assistant Professor Director, Pediatric Antimicrobial Stewardship Program Assistant Professor of Pediatrics Johns Hopkins Bloomberg School of Public Health Dr. Pranita D. Tamma Assistant Professor of Pediatrics Director, Pediatric Antimicrobial Stewardship Program The Johns Hopkins University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A study examining the impact of antibiotics prescribed for nearly 1500 adult patients admitted to The Johns Hopkins Hospital found that adverse side effects occurred in a fifth of them, and that nearly a fifth of those side effects occurred in patients who didn’t need antibiotics in the first place. In the study, the researchers evaluated the electronic medical records of 1488 adults admitted to the general medicine services at The Johns Hopkins Hospital between September 2013 and June 2014. The patients were admitted for reasons ranging from trauma to chronic disease, but all received at least 24 hours of antibiotic treatment. The researchers followed patients for 30 days after hospital discharge to evaluate for the development of antibiotic-associated adverse events. To determine the likelihood that an adverse reaction was most likely due to antibiotics and to identify how many adverse reactions could be avoided by eliminating unnecessary antibiotic use, two infectious disease clinicians reviewed all of the data.
Author Interviews, Education, Heart Disease, JAMA, Social Issues / 14.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35213" align="alignleft" width="133"]Yasuhiko Kubota, MD, MPH Visiting Scholar Division of Epidemiology and Community Health School of Public Health University of Minnesota, Minneapolis, MN Dr. Kubota[/caption] Yasuhiko Kubota, MD, MPH Visiting Scholar Division of Epidemiology and Community Health School of Public Health University of Minnesota, Minneapolis, MN MedicalResearch.com: What is the background for this study? Response: Educational inequality is one of the most important socioeconomic factors contributing to cardiovascular disease. Since education is usually completed by young adulthood, educational inequality may affect risk of cardiovascular disease early in the life course. We thought it would be useful to calculate the lifetime risk of cardiovascular disease according to educational levels in order to increase public awareness of the importance of education. Thus, our aim was to evaluate the association of educational attainment with cardiovascular disease risk by estimating the lifetime risks of cardiovascular disease using a US. biracial cohort. Furthermore, we also assessed how other important socioeconomic factors were related to the association of educational attainment with lifetime risk of cardiovascular disease.
Author Interviews, Exercise - Fitness, Gender Differences, JAMA, Pediatrics, Surgical Research / 13.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35287" align="alignleft" width="200"]Mackenzie M. Herzog, MPH PhD Candidate, Injury Epidemiology The University of North Carolina at Chapel Hill  Mackenzie Herzog[/caption] Mackenzie M. Herzog, MPH PhD Candidate, Injury Epidemiology The University of North Carolina at Chapel Hill  MedicalResearch.com: What is the background for this study? Response: In 1999, a study by Arendt et al. reported that women were more likely to tear their ACL than men while playing the same sport. Since then, numerous studies have investigated this sex difference in ACL injury, and many prevention programs targeting youth athletes have been developed and tested. Although randomized trials have demonstrated the value of injury prevention programs in reducing the risk of ACL injury, the overall impact of these programs has not been examined in the general population. Our study investigated the net impact of research and prevention efforts over nearly 20 years in reducing ACL injuries by assessing time trends of ACL reconstruction, a consequence of ACL injury, among commercially-insured individuals in the United States.
Author Interviews, Cancer, Cancer Research, Hepatitis - Liver Disease, Race/Ethnic Diversity / 12.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35272" align="alignleft" width="120"]Farhad Islami, MD PhD Strategic Director, Cancer Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303 Dr. Islami[/caption] Farhad Islami, MD PhD Strategic Director, Cancer Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Liver cancer is one of the leading causes of cancer death in the United States, accounting for nearly 29,000 deaths per year, with variations in occurrence by race/ethnicity and state. We examined trends in liver cancer incidence, survival, and mortality in the United States and provided liver cancer mortality rates by race/ethnicity at the national and state level. State-level statistics are particularly important as they can inform state cancer control and prevention planning. We also provided detailed information on prevalence and trends in major risk factors for liver cancer and interventions to prevent or reduce their burden, to make our article a comprehensive yet concise source of information on liver cancer statistics, risk factors, and interventions in the United States.
Author Interviews, BMJ, Cannabis, Pediatrics / 12.06.2017

MedicalResearch.com Interview with: Dr Michelle Taylor PhD Senior Research Associate in Epidemiology MRC Integrative Epidemiology Unit (IEU) School of Social and Community Medicine University of Bristol Bristol UK MedicalResearch.com: What is the background for this study? Response: Many previous studies have looked at adolescent cannabis use, however most of these look at use at a single time point, for example whether an individual has ever used cannabis at age 16 years, or how regularly a person uses cannabis at age 18. However, as young people do not initiate use at the same time or follow the same pattern of use, using measures at a single time point does not always tell the whole story. We used a form of statistical modelling using data taken over the course of adolescence to try and characterise underlying patterns of cannabis use across adolescence. We used data from the Avon Longitudinal Study of Parents and Children which had information on cannabis use at six time points between the ages of 13 and 18 years.
Author Interviews, Cancer Research, Geriatrics, JAMA, Johns Hopkins / 12.06.2017

MedicalResearch.com Interview with: Nancy Schoenborn, MD Assistant Professor Division of Geriatric Medicine and Gerontology Johns Hopkins University School of Medicine Nancy Schoenborn, MD Assistant Professor Division of Geriatric Medicine and Gerontology Johns Hopkins University School of Medicine MedicalResearch.com: What are the main findings? Response: A lot of cancer screenings are not expected to save lives until up to 10 years later; however, the side effects of the test happen right away. Because of this, clinical guidelines have recommended against routine screening for those patients who will not live long enough to benefit but may experience the potential harm of the test in the short term. However, many patients with limited life expectancy still receive screening and clinicians are worried about how patients would react if they recommended that patients stop screening. This research is important because it is the first study that explores how patients think about the decision of stopping cancer screening and how patients want to talk to their doctors about this issue. Understanding patient perspectives would help improve screening practices and better align recommendations and patient preference.
Author Interviews, JAMA, Nutrition, Stanford / 12.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35210" align="alignleft" width="140"]Bradley P. Turnwald Bradley Turnwald[/caption] Bradley P. Turnwald MS Stanford University, Department of Psychology Stanford, California MedicalResearch.com: What is the background for this study? Response: This study tested an intervention to encourage people to consume healthier foods. Encouraging healthy eating is difficult because many people think that healthy foods do not taste good, and most people prioritize taste over health when choosing what to eat. In fact, lab studies suggest that people rate foods as less tasty, less enjoyable, and less filling when they are labeled as healthy compared to when the same foods are not labeled as healthy. A recent study from the Stanford Mind & Body Lab published last month in Health Psychology showed that healthy foods are even described with less tasty, exciting, and indulgent descriptions compared to standard items on the menus of top-selling chain restaurants in America. This led us to ask the question, what if healthy foods were described with the tasty and indulgent descriptions that are typically reserved for the more classic, unhealthy foods?
Author Interviews, JAMA, Surgical Research / 12.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35128" align="alignleft" width="200"]Virginia Sun, RN, PhD Assistant Professor Division of Nursing Research and Education Department of Population Sciences Cancer Control and Population Sciences Program City of Hope Duarte, CA 91010 Dr. Sun[/caption] Virginia Sun, RN, PhD Assistant Professor Division of Nursing Research and Education Department of Population Sciences Cancer Control and Population Sciences Program City of Hope Duarte, CA 91010  MedicalResearch.com: What is the background for this study? Response: Surgery is one of the most effective and important treatment strategies for cancer. Surgical procedures are by definition invasive, and patients are at risk for unpleasant symptoms, impaired functional status, and poor quality of life. Traditionally, mortality has been the sole measure to assess the risk of most surgical procedures. However, as surgical mortality has sharply declined, focus has shifted toward other endpoints, including patient-centered outcomes. There are critical gaps to assessing and integrating patient-centered outcomes into the surgical oncology workflow. We conducted this proof-of-concept study to assess the feasibility and acceptability of a wireless monitoring approach for patient-centered outcomes before and after a major abdominal cancer surgery.
Addiction, Author Interviews, Cost of Health Care, Opiods, PLoS / 10.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35195" align="alignleft" width="200"]A. Simon Pickard, PhD Dr. Pickard[/caption] A. Simon Pickard, PhD Professor, Dept of Pharmacy Systems, Outcomes and Policy University of Ilinois at Chicago College of Pharmacy MedicalResearch.com: What is the background for this study? What are the main findings? Response: The heroin epidemic, which has left virtually no part of American society unscathed, can be viewed as an illness.  Unlike some illnesses, however, it was largely manufactured by stakeholders in the healthcare system, wittingly or unwittingly. The main finding, that heroin addiction costs us just over $50 billion per year, is likely a conservative estimate.
Author Interviews, Breast Cancer, JAMA, Surgical Research / 10.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35180" align="alignleft" width="200"]Monica Morrow, MD, FACS Chief, Breast Service Department of Surgery Anne Burnett Windfohr Chair of Clinical Oncology Memorial Sloan Kettering Dr. Morrow[/caption] Monica Morrow, MD, FACS Chief, Breast Service Department of Surgery Anne Burnett Windfohr Chair of Clinical Oncology Memorial Sloan Kettering MedicalResearch.com: What is the background for this study? Response: Although we know that bigger surgery does not result in better patient outcomes in breast cancer, since 2005 rates of lumpectomy have been decreasing accompanied by an increase in bilateral mastectomy for unilateral cancer. High rates of second surgery after initial lumpectomy are one deterrent for patients. In 2013 the SSO and ASTRO developed an evidence based consensus guideline endorsing no ink on tumor as the standard negative margin width for women with stage 1 and 2 cancer having breast conserving surgery with whole breast irradiation. The purpose of our study was to examine time trends in the use of additional surgery after lumpectomy before and after guideline dissemination and to determine the impact of these trends on final rates of breast conservation.
Author Interviews, JAMA, Karolinski Institute, Pharmacology, Schizophrenia / 09.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35117" align="alignleft" width="200"]Jari Tiihonen, MD, PhD Professor, Department of Clinical Neuroscience Karolinska Institutet Stockholm, Sweden Prof. Tiihonen[/caption] Jari Tiihonen, MD, PhD Professor, Department of Clinical Neuroscience Karolinska Institutet Stockholm, Sweden  MedicalResearch.com: What are the limitations of existing analyses of the comparative effectiveness of antipsychotics? Response: It has remained unclear if there are clinically meaningful differences between antipsychotic treatments in relapse prevention of schizophrenia, due to the impossibility of including large unselected patient populations in randomized controlled trials, and due to residual confounding from selection biases in observational studies.
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity, Social Issues / 09.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35105" align="alignleft" width="200"]Dr. Ayodele Odutayo MD MSc DPhil(pending) Centre For Statistics in Medicine, University of Oxford Resident Physician (PGY1), Post-Doctoral Fellow, Applied Health Research Centre St. Michael’s Hospital, University of Toronto Dr. Odutayo[/caption] Dr. Ayodele Odutayo MD MSc DPhil(pending) Centre For Statistics in Medicine, University of Oxford Resident Physician (PGY1), Post-Doctoral Fellow, Applied Health Research Centre St. Michael’s Hospital, University of Toronto   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previously published studies have reported increasing gaps in life expectancy among adults belonging to different socioeconomic strata and suggested that much of this gap was mediated through behavioural and metabolic risk factors. In this study, we found that from 1999-2014, there was an increasing gap in the control of cardiovascular risk factors between high income adults compared to adults with incomes at or below the poverty line. The proportion of adults at high cardiovascular risk (predicted risk of a cardiovascular event ≥20%), the mean systolic blood pressure and the percentage of current smokers decreased for high income adults but did not change for adults with incomes at or below the poverty line. Notably, the income disparity in these cardiovascular risk factors was not wholly explained by access to health insurance or educational attainment. Trends in the percentage of adults with diabetes and the average total cholesterol level did not vary by income.
Author Interviews, Brigham & Women's - Harvard, NEJM, Ophthalmology / 08.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35083" align="alignleft" width="142"]Elisabetta Patorno, MD, DrPH Assistant Professor of Medicine, Harvard Medical School Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital Dr. Patorno[/caption] Elisabetta Patorno, MD, DrPH Assistant Professor of Medicine, Harvard Medical School Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Lithium, a widely used medicine to treat bipolar disorder, has been associated with a 400 fold increased risk of Ebstein’s anomaly, a congenital malformation of the heart, and a 5 fold increased risk of cardiac defects overall in infants when taken early in pregnancy, based on the results from the International Register of Lithium Babies in the 1970’s. Beyond this data, most of the information on the safety of lithium during pregnancy accumulated in the last 40 years is based on case reports and small studies with conflicting results. Despite these concerns and the limited information, lithium remains a first-line treatment for the 1% of women of reproductive age with bipolar disorder in the U.S. population, due to its recognized efficacy during pregnancy and the postpartum period, and due to the presence of a larger body of evidence showing increased risk of congenital malformations for other mood stabilizers, such as valproate.
Author Interviews, JAMA, Pediatrics, Weight Research / 07.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35001" align="alignleft" width="135"]Elsie M. Taveras, MD, MPH Ofer and Shelly Nemirovsky MGH Research Scholar Chief, Division of General Academic Pediatrics, Department of Pediatrics Mass General Hospital for Children Professor of Pediatrics, Harvard Medical School Professor in the Department of Nutrition, Harvard T.H. Chan School of Public Health Boston, MA Dr. Taveras[/caption] Elsie M. Taveras, MD, MPH Ofer and Shelly Nemirovsky MGH Research Scholar Chief, Division of General Academic Pediatrics, Department of Pediatrics Mass General Hospital for Children Professor of Pediatrics, Harvard Medical School Professor in the Department of Nutrition, Harvard T.H. Chan School of Public Health Boston, MA MedicalResearch.com: What is the background for this study? Response: We designed this study to test the effectiveness of two interventions that linked clinical and community approaches in improving childhood body mass index (BMI) and obesity prevalence. Another important question we set out to understand was whether there were outcomes aside from BMI and obesity that mattered most to families of children with obesity.
Author Interviews, JAMA, Lifestyle & Health, OBGYNE, Weight Research / 07.06.2017

MedicalResearch.com Interview with:   [caption id="attachment_35023" align="alignleft" width="133"]Professor Helena Teede MBBS, FRACP, PhD Executive Director Monash Partners Academic Health Research Translation Centre Director Monash Centre for Health Research and Implementation Monash University Prof. Teede[/caption] Professor Helena Teede MBBS, FRACP, PhD Executive Director Monash Partners Academic Health Research Translation Centre Director Monash Centre for Health Research and Implementation Monash University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Reproductive aged women are gaining weight rapidly both before and during pregnancy. Here in 1.3 million pregnancies internationally we show that almost 3 in 4 have unhealthy weight gain (half with excess weight gain and one quarter with inadequate gain) MedicalResearch.com: What should readers take away from your report? Response: For women establish your healthy weight for your height and try to stay within this for better fertility, pregnancy and for your and your child's health. Regardless of your starting weigh,  aim to gain within targets in pregnancy. Seek help to do so. For health professionals: unhealthy weight gain in pregnancy is now the norm, we must monitor women in pregnancy wand support them to gain healthy weight for better health outcomes. Weighing is not enough with health professionals needing skills in healthy conversations and support strategies for women. For governments and policy makers this life stage around pregnancy is an optimal time to tackle obesity prevention and is targeted by WHO.
Author Interviews, Cost of Health Care, JAMA, Nursing, University of Pittsburgh / 06.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35059" align="alignleft" width="130"]Kristin Ray, MD, MS</strong> Assistant Professor Health Policy Institute University of Pittsburgh School of Medicine Dr. Ray[/caption] Kristin Ray, MD, MS Assistant Professor Health Policy Institute University of Pittsburgh School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: We were interested in understanding how nurse practitioners and physician assistants are working with specialist physicians to provide specialty care. Much has been described and studied about nurse practitioners and physician assistants providing primary care, but the literature about their role in specialty care is more sparse. There have been many concerns over time about the supply of specialist physicians, heightening our interest in the role of nurse practitioners and physician assistants in working with specialist physicians. We focused on examining whether care to physician specialist's patients by nurse practitioners and physician assistants has increased over time as well as examining characteristics of patients seen by nurse practitioners and physician assistants. We found that visits with NPs and PAs for specialty care have increased over time, but remains a small fraction of specialty care overall.
AHA Journals, Author Interviews, Hepatitis - Liver Disease, Stroke / 05.06.2017

MedicalResearch.com Interview with: Neal S. Parikh, M.D. Administrative Chief Resident Department of Neurology Weill Cornell Medicine & NewYork-Presbyterian Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: In contrast to the gastrointestinal and systemic hemorrhagic and thrombotic complications of cirrhosis, little was known about the risk of cerebrovascular complications. In this analysis of Medicare beneficiaries' claims data, we found cirrhosis to be associated with stroke, with associations appearing to be stronger for hemorrhagic stroke than for ischemic stroke. We controlled for demographic variables and stroke risk factors and relevant comorbidities, and our results were essentially unchanged in multiple sensitivity analyses.
Author Interviews, CMAJ, OBGYNE / 05.06.2017

MedicalResearch.com Interview with: [caption id="attachment_34973" align="alignleft" width="200"]Giulia Muraca, MPH, PhD(c) Vanier Canada Graduate Scholar School of Population and Public Health Child & Family Research Institute Faculty of Medicine University of British Columbia Dr. Muraca[/caption] Giulia Muraca, MPH, PhD(c) Vanier Canada Graduate Scholar School of Population and Public Health Child & Family Research Institute Faculty of Medicine University of British Columbia  MedicalResearch.com: What is the background for this study? Response: The rate of cesarean delivery has increased dramatically over the last 30 years. And in an effort to curb the rising trend in caesarean delivery, The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine have recently advocated for increased use of operative vaginal delivery (forceps/vacuum delivery) as a strategy to reduce the cesarean delivery rate. The evaluation of approaches to achieve this end are underway and the current discourse surrounding operative vaginal delivery centers on methods to promote these important skills. But, the truth is, we don’t yet fully understand the balance of risks and benefits to mothers and their babies following operative vaginal delivery compared with caesarean delivery. The preferred choice given these two options relies heavily on how far the baby’s head has descended in the birth canal. If the baby’s head has descended far enough that it is visible and on the perineum, then the use of an instrument has clear advantage. However, when the fetal head is engaged in the maternal pelvis, but has not descended so far down the birth canal, the decision between these modes of delivery becomes much less clear. These deliveries are called midpelvic deliveries. And it’s an increase in these midpelvic deliveries that would have the most potential as a strategy to reduce the cesarean delivery rate, and as a result, it is these deliveries that we were interested in studying. Operative vaginal deliveries are carried out in approximately 14% of all term births in Canada and those that occur when the baby is at midpelvic station account for over 20% of all operative vaginal deliveries. This translates to about 2-3% of all term, singleton deliveries in Canada or about 10,000 deliveries per year overall. The literature on perinatal and maternal outcomes contrasting midpelvic operative vaginal delivery and caesarean delivery is based on studies undertaken 25 to 30 years ago that are no longer reflective of the current obstetric practice.  This was the impetus for our study. We reasoned that before we decide to encourage increased OVD we should first get a sense of the safety of such procedures compared to cesarean delivery as provided by contemporary maternity care providers.
Author Interviews, Brigham & Women's - Harvard, Gender Differences, JAMA, Mental Health Research / 05.06.2017

MedicalResearch.com Interview with: [caption id="attachment_34884" align="alignleft" width="160"]Carl G Streed Jr. M.D. Pronouns: he, him, his, himself Fellow, Division General Internal Medicine & Primary Care Brigham & Women’s Hospital Dr. Streed[/caption] Carl G Streed Jr. M.D. Pronouns: he, him, his, himself Fellow, Division General Internal Medicine & Primary Care  Brigham & Women’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: The National Institutes of Health (NIH) has underscored the need to better understand the health of gender minorities, including transgender and gender non-conforming individuals. Prior investigations of gender minorities are limited by the lack of national gender identity data. In 2013, the Centers for Disease Control and Prevention (CDC) developed a gender identity question for the Behavioral Risk Factors Surveillance System (BRFSS); states had the option to administer this module beginning 2014. Our study aims to examine the health status of gender minorities in the US compared to cisgender peers. Compared to cisgender adults, gender minority adults are younger, less likely to be non-Hispanic white, married or living with a partner, have a minor child in the household, or be English speaking; but are more likely to have lower income, be unemployed, be uninsured, have unmet medical care due to cost, be overweight, and report depression. Gender minority adults, compared to cisgender adults, are more likely to report: poor or fair health; difficulty concentrating, remembering, or making decisions; and being limited in any way. These outcomes remained significant after adjustment.
Author Interviews, JAMA, Salt-Sodium / 05.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35054" align="alignleft" width="200"]Jennifer Poti, PhD Research Assistant Professor Nutritional Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill Dr. Poti[/caption] Jennifer Poti, PhD Research Assistant Professor Nutritional Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill MedicalResearch.com: What is the background for this study? Response: Although strong evidence links excessive sodium intake to hypertension, a leading risk factor for cardiovascular disease, the majority of American children and adults have sodium intake that exceeds the recommended upper limit for daily sodium intake. To lower sodium intake at the population-level, the Institute of Medicine has recommended that reducing sodium in packaged foods will be essential and has emphasized the need to monitor sodium in the US food supply. However, little is known about whether sodium in packaged foods has changed during the past 15 years.
Author Interviews, Autism, Mineral Metabolism, Nature, Pediatrics / 05.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35028" align="alignleft" width="130"]Manish Arora, PhD Associate Professor Environmental Medicine & Public Health Icahn School of Medicine at Mount Sinai Dr. Arora[/caption] Manish Arora, PhD Associate Professor Environmental Medicine & Public Health Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: Autism has both genetic and environmental risk factors. Our aim was to study if exposure to toxic metals, such as lead, or disruptions in the uptake of essential nutrient elements such as manganese or zinc would be related to autism risk. Furthermore, we were interested in not only understanding how much exposure had taken place but also which developmental periods were associated with increased susceptibility to autism risk. Researchers suspect that the risk factors for autism start early in life, even prenatally, but measuring in utero exposures is technically very challenging. We used a newly developed technique that uses lasers to map growth rings in baby teeth (like growth rings in trees) to reconstruct the history of toxic metal and essential nutrient uptake. We applied this technology in samples collected from twins, including twins who were discordant for autism. This allowed us to have some control over genetic factors. We found that twins with autism had higher levels of lead in their teeth compared to their unaffected twin siblings. They also had lower levels of zinc and manganese. The lower uptake of zinc was restricted to approximately 10 weeks before birth to a few weeks after birth, indicating that as a critical developmental period.
AHA Journals, Author Interviews, Depression, Stroke / 04.06.2017

MedicalResearch.com Interview with: Chung-Yen Lu, MD, PhD Assistant Professor Department of Sport and Health Management, Da-Yeh University, Changhua, Taiwan; Department of Chinese Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei, Taiwan  MedicalResearch.com: What is the background for this study? Response: Post-stroke depression is a common mood complication of patients with stroke and may deteriorate motor function and cognitive function. Acupuncture therapy is an alternative and supplementary medical care often used worldwide. Previous studies have reported that acupuncture therapy for post-stroke depression may involve multiple therapeuticeffects including treating neurological disorders and physical disabilities following stroke, which are predictors of post-stroke depression. However, population-based evaluations on the association between acupuncture treatment and prevention of post-stroke depression are rare. 
Author Interviews, Hepatitis - Liver Disease, Kidney Disease, Lancet, Merck / 01.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35005" align="alignleft" width="112"]Annette Bruchfeld MD, PhD Senior Consultant Associate Professor Karolinska Institute Dept of Renal Medicine, M99 Karolinska University Hospital Huddinge Stockholm, Sweden Dr. Bruchfeld[/caption] Annette Bruchfeld MD, PhD Senior Consultant Associate Professor Karolinska Institute Dept of Renal Medicine, M99 Karolinska University Hospital Huddinge Stockholm, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: In patients with stage 4–5 chronic kidney disease(CKD), hepatitis C virus (HCV) infection can accelerate the decline in kidney function, impair health-related quality of life (HRQOL), and decrease survival chances of both patients and grafts in transplantation recipients. In this study additional data from patients with stage 4–5 chronic kidney disease undergoing treatment for HCV infection in the C-SURFER study, including HRQOL and resistance analyses was presented not previously reported for this patient population with gwnotype 1 infection. The final virological analysis of this study indicated a high cure rate with sustained virological response at 12 weeks after the end of treatment (SVR12) in more than 98% of all treated patients. Even in patients with resistance-associated substitutions (RASs) the SVR was high in 11 (84·6%) of 13 patients genotype 1a infection.
Author Interviews, Brain Cancer - Brain Tumors, JAMA, Radiation Therapy / 01.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35007" align="alignleft" width="200"]Professor Rakesh Jalali, MD Professor of Radiation Oncology President, Indian Society of Neuro-Oncology Tata Memorial Parel, Mumbai India Dr. Jalali[/caption] Professor Rakesh Jalali, MD Professor of Radiation Oncology President, Indian Society of Neuro-Oncology Tata Memorial Parel, Mumbai India  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Randomized controlled trials to test the efficacy of radiotherapy techniques are challenging to perform. High-precision conformal techniques such as stereotactic radiosurgery/radiotherapy, intensity modulated radiotherapy (IMRT) and particle therapy, etc have been incorporated into routine clinical practice including for brain tumors without always being supported by level-1 evidence. We therefore conducted a prospective, randomized, controlled trial of stereotactic conformal radiotherapy compared to conventional radiotherapy in young patients with residual/progressive bening and low grade brain tumors requiring radiotherapy for optimal disease control.