Author Interviews, Cost of Health Care, Health Care Systems, Hospital Readmissions, Technology / 25.02.2016 Interview with: Andrey Ostrovsky, MD CEO | Co-Founder Care at Hand  Medical Research: What is the background for this study? Dr. Ostrovsky: Hospital readmissions are a large source of wasteful healthcare spending, and current care transition models are too expensive to be sustainable. One way to circumvent cost-prohibitive care transition programs is complement nurse-staffed care transition programs with those staffed by less expensive nonmedical workers. A major barrier to utilizing nonmedical workers is determining the appropriate time to escalate care to a clinician with a wider scope of practice. The objective of this study is to show how mobile technology can use the observations of nonmedical workers to stratify patients on the basis of their hospital readmission risk. (more…)
Author Interviews, Compliance, Electronic Records, Kaiser Permanente, Technology / 12.02.2016 Interview with: Shayna L. Henry, PhD Postdoctoral Research Fellow Department of Research & Evaluation Kaiser Permanente Southern California Medical Research: What is the background for this study? What are the main findings? Dr. Henry: In this study, we analyzed the electronic health records of 838,638 Kaiser Permanente members in Southern California. We decided to conduct this study because Kaiser Permanente always strives to advance standards of excellence for care, and even with all the outreach resources available to health care providers and staff, gaps in preventive care still arise. It can be hard to get patients engaged in managing their preventive care, because there are so many tasks for them to keep track of – many of which don’t happen on a very regular basis. Online patient portals have been very useful at helping patients get more engaged in their care, but patients still have to make the first move, and put all the pieces together. Our tool, the Online Personal Action Plan (oPAP), puts our members’ health status and preventive and chronic care tasks in a single dashboard, and alerts them via email to their upcoming care needs, prompting them to log in, view their upcoming health care tasks such as annual vaccinations, tests and blood draws for chronic conditions, and routine cancer screenings, and make the necessary medical appointments to close those gaps in care. We wanted to better understand if having access to the oPAP tools was associated with a higher likelihood of taking care of those outstanding health care tasks in a timely manner. We found that members who used oPAP were more likely to get a mammogram, Pap smear, receive colorectal cancer screenings, and more likely to complete HbA1c testing for diabetes within 90 days of their coming due compared to members who were not registered on our patient portal.   (more…)
Author Interviews, BMJ, Karolinski Institute, Mental Health Research, Psychological Science, Technology / 06.02.2016 Interview with: Dr. Jesper Enander Department of Clinical Neuroscience Karolinska Institutet MedicalResearch: What is the background for this study? Dr. Enander: Body dysmorphic disorder (BDD) is a common anxiety disorder affecting about 2% of the general population, and is associated with hospitalization, substance dependence and suicidality. The disorder is characterized by a intense preoccupation with perceived defects in physical appearance, despite looking perfectly normal. It is common for people with BDD to seek non-psychiatric care, such as dermatological treatment or plastic surgery, however, such treatments rarely work, and can even lead to a deterioration of symptoms. The National Institute for Health and Clinical Excellence (NICE) in the UK recommends that patients with Body dysmorphic disorder should be offered cognitive behavior therapy (CBT), however, there is a gap between supply and demand of CBT. One way of increasing access to CBT is to deliver it using the Internet. In this randomized clinical trial we tested the efficacy of a Internet based CBT program for Body dysmorphic disorder called BDD-NET and compared it to supportive therapy. MedicalResearch: What are the main findings? Dr. Enander: Our study shows that BDD-NET was associated with large and significant improvements in  Body dysmorphic disorder symptom severity. 56% of those receiving BDD-NET were responders (defined as at least a 30% reduction in symptoms), compared to 13% of those receiving supportive therapy. At the six months follow-up, 39% of those who received BDD-NET no longer met diagnostic criteria for Body dysmorphic disorder. No serious adverse events were reported, and most participants were satisfied with BDD-NET, despite no face-to-face contact with a therapist, and deemed the treatment as highly acceptable. (more…)
Author Interviews, Technology, Zika / 03.02.2016 Interview with: Christopher Bibbs Anastasia Mosquito Control District Florida Medical Research: What is the background for this report? Mr. Bibbs: In vector management, the uphill battle is always against the mosquito. And of those, the anthropophilic Yellow Fever mosquito, Aedes aegypti, has become established world-wide as a vector of several emergent diseases. Historically, these mosquitoes carried Yellow Fever and to this day still carry Dengue. Chikungunya, a newly established virus in the Caribbean, has joined the western hemisphere since 2014. And most recently, Zika virus made its way to Brazil and others in South America during 2015. This mosquito thrives in the United States as well, and should a traveler visit a country suffering from these disease and return home sick they risk passing it along to the representative mosquito in your home country. In order to manage these risks, vector management programs employ an integrated approach using multiple techniques and surveillance tools. But oft-neglected are what is available over-the-counter to consumers wanting relief. One such tool is called "spatial repellents." By vaporizing a minute amount of chemical into the air, it creates a flight barrier to the mosquito. The mosquito, upon encountering this vapor, will become disoriented and leave the area, thusly reducing bite contact. But as yet these tools are exclusively considered as repellent. But is that all they do?   (more…)
Author Interviews, Compliance, JAMA, Technology / 01.02.2016 Interview with: Dr. Clara Chow PhD Director of the Cardiovascular division The George Institute, Westmead Hospital Sydney, Australia Medical Research: What is the background for this study? What are the main findings? Dr. Chow: Text messaging has immense potential in healthcare. Not only for supporting medication adherence, but we have shown in the “TEXT ME” study its ability to simultaneously influence multiple lifestyle domains like increasing physical activity, embarking on healthier diets and reducing smoking rates. With increasing penetration of mobile phone use in developed as well as developing countries, there is a potential for wider reach, however there remains a need to evaluate the value of text messaging programs in various patient populations to establish the generalizability of these research findings. (more…)
Author Interviews, Dermatology, Technology / 18.01.2016

More on Dermatology on Interview with: Jung Min Bae, MD, PhD Department of Dermatology, St. Vincent's Hospital, College of Medicine The Catholic University of Korea, Suwon Korea Medical Research: What is the background for this study? Response: Vitiligo is one of the major challenging skin diseases. Although a number of interventions have been done in the treatment of vitiligo, no definitive curative treatment exists. Narrowband ultraviolet B phototherapy is considered the mainstay of vitiligo treatment, and 308-nm excimer laser/light therapy has gained popularity for localized vitiligo. However, they are not effective in all patients with vitiligo, and the combination therapies with topical agents are widely applied to increase the response rates of these treatment modalities in clinical practice. We sought to compare the efficacy of excimer laser/light and topical agent combination therapy versus excimer laser/light  monotherapy for vitiligo. We performed a systematic review and meta-analyses of randomized controlled trials in this subject.  Medical Research: What are the main findings? Response: According to our study, the combination therapy of excimer laser/light and topical calcineurin inhibitors showed almost a two-fold increase in treatment success rate (≥75% repigmentation) compared to excimer laser/light monotherapy (relative risk 1.93). The combination therapy also reduced the treatment failure rate (<25% repigmentation) by almost half (relative risk 0.43). Addition of topical vitamin-D3 analogs or topical corticosteroids on excimer laser/light showed insufficient evidence to support their use in combination therapies yet. Considering the difficulites in complete recovery of vitiligo, the combination therapies enhancing the treatment response are promising. (more…)
Author Interviews, Cancer Research, Technology / 15.01.2016

More on Cancer Research on Interview with: Elena V. Batrakova, Ph.D. Associate Professor Center for Nanotechnology in Drug Delivery Division of Molecular Pharmaceutics Eshelman School of Pharmacy University of North Carolina at Chapel Hill Chapel Hill, NC  Medical Research: What is the background for this study? What are the main findings? Dr. Batrakova: Deep down I was always was fascinated by the ability of biological systems to deliver various compounds to the disease sites. I believe, we have a lot to learn from living things. For example, immune cells, macrophages can feel inflammation and travel to this sited to deal with the problem, for example, kill bacteria, virus, or regenerate and support dying cells. So, when I realized that specific and targeted transport of therapeutics to cancer cells is very difficult task, I turned to nature. Exosomes are naturally occurring vesicles (bubbles) that offer distinct advantages that uniquely position them as highly effective drug carriers. They consist of cellular membranes with multiple sticky proteins on their surface. Exosomes by nature specialize in cell-cell communication and provide an approach for the delivery drugs to target disease sites. Plus, exosomes released by patient’s white blood cells are not immunogenic, because they are part of the immune system, so these tiny bubbles can be used for very precise and effective delivery of anticancer drugs to treat metastases, as well as primary tumors. (more…)
Author Interviews, Dermatology, JAMA, Melanoma, Technology / 08.01.2016 Interview with: Marc Haspeslagh, MD Dermpat, Ardooie, Belgium Department of Dermatology University Hospital, Ghent, Belgium Medical Research: What is the background for this study? Dr. Haspeslagh: In daily practice, most pathology laboratories process skin biopsy specimens without access to the clinical and /or dermoscopic images. In pigmented skin tumors, this information can be crucial to process and diagnose the lesion correctly. With increasingly smaller diameter lesions undergoing biopsy, these focal changes are only visible with dermoscopy; therefore, communication of this dermoscopic information to the pathologist is important. In many dermatopathology laboratories, this communication is often insufficient or totally absent, and one can presume that these suspicious areas are often missed with the standard random sectioning technique that examines less than 2% of the tissue. To overcome this diagnostic limitation we developed in 2013 a new method for processing skin biopsies, were we routinely take an ex vivo dermoscopic image of most tumoral skin lesions. In combination with marking specific and suspected areas seen on the ex vivo dermoscopy (EVD) with nail varnish, EVD with derm dotting is a simple and easy method that brings this crucial information to the pathologist and in the slides to be examined (Am J Dermatopathol 2013; 35(8),867-869). (more…)
Author Interviews, Cancer Research, Genetic Research, Personalized Medicine, Technology / 06.01.2016 Interview with: Dr Bissan Al-Lazikani Team leader in computational biology The Institute of Cancer Research London Medical Research: What is the background for the canSAR database? What are the main uses for the tool? Dr. Al-Lazikani: Drug discovery is a difficult, time consuming and expensive venture that frequently ends in late stage drug failures - especially in oncology. As with any complex venture, decisions throughout the drug discovery pipeline can be empowered by having access to the right information at the right time. But for drug discovery this means bringing together billions of experimental data from very diverse areas of science spanning genomics, proteomics, chemistry and more. We developed canSAR to help guide our own drug discovery efforts by integrating these huge, diverse data and by analysing the data and deriving hidden links and knowledge from them. This means that we can answer questions in minutes that would have taken weeks using previously available public resources. But, more importantly, canSAR analyses and links these data in a way that allows us  to derive knowledge that was hidden before. For example, one of the main ways canSAR is used is to help select the best druggable targets for drug discovery. Using canSAR we were able to uncover many druggable cancer proteins that were previously overlooked, and we are delighted to see that several of these proteins are now the subjects of drug discovery and development projects both by us and by others. We took the decision to make canSAR publicly and freely available because we believe that cancer drug discovery is a vast challenge that requires openness and data sharing worldwide. It has been embraced by the community is being used by tens of thousands of cancer scientists worldwide, both in academia and industry, to generate hypotheses for experiments and select targets for drug discovery. (more…)
Author Interviews, Pediatrics, Technology / 27.12.2015 Interview with: Dr. Deirdre Murray Senior Lecturer/Consultant Paediatrician Dept of Paediatrics and Child Health University College Cork Clinical Investigations Unit Cork University Hospital Principal Investigator Irish Centre for Fetal and Neonatal Translational Research  Medical Research: What is the background for this study? What are the main findings? Dr. Murray: Everyday in clinic, and in waiting rooms and in restaurants we see parents are handing over their smart phones and iPads to occupy young children. The nature of childhood play is changing rapidly. The exact frequency and the effect of this change in unknown. We wanted to first measure how young children 12-36 months are using touchscreen devices. We asked parents who attended our paediatric unit, both outpatients and short stay inpatients to answer a study specific questionnaire. We found that of the 82 parents surveyed, 82% of parents owned a touchscreen device, and of these 87% gave their device to their toddler to play with. Thus 71% of toddlers had access to a touchscreen device. This rate was similar across the age range studied (12-36 months). By parental report, 24 months was the median age of ability to swipe (IQR: 19.5–30.5), unlock (IQR: 20.5–31.5) and active looking for touch-screen features (IQR: 22–30.5), while 25 months (IQR: 21–31.25) was the median age of ability to identify and use specific touch-screen features. Overall, 32.8% of toddlers could perform all four skills. Touchscreen usage was common at a very young age and from 2 years of age toddlers have the ability to interact purposefully with touch-screen technology.  (more…)
Author Interviews, Dermatology, Technology / 21.12.2015 Interview with: Christie Riemer MD Candidate-Class of 2016 Michigan State University College of Human Medicine Medical Research: What is the background for this study? What are the main findings? Response: Online physician rating sites allow patients to recommend, grade, and publicly comment on physician performance. Despite increases in physician rating website popularity, little information exists regarding the online footprint of dermatologists. Many physicians also remain wary of these websites for fear of malicious reviews. Our study aimed to investigate the patterns of dermatologist online ratings. We found the average ratings for dermatologists were high, >3.5 stars, on the top 5 websites (ZocDoc, Healthgrades, Yelp, RateMDs, and, we also searched for more specific geographic criteria such as including a location in our search for example a dermatologist in columbia sc, by doing this we found that the online ratings were not only national and but state wide too allowing us to look for local and national patterns of ratings. Most importantly, these ratings were consistently high across the 3 sites with the most dermatologist profiles. There were no differences in rating based on gender or subspecialty training. Four of the sites offer the option to write comments. ZocDoc had significantly fewer negative comments, and also had the most comments per dermatologist, there are also dermatologists in different areas of the United States, for example, there is a dermatologist in nyc that those who live in that area can look into. (more…)
Author Interviews, Epilepsy, Technology / 11.12.2015 Interview with: Dr. Frances Hutchings Interdisciplinary Computing and Complex BioSystems School of Computing Science, Newcastle University Newcastle upon Tyne, United Kingdom Medical Research: What is the background for this study? Response: Temporal lobe epilepsy is a prevalent and disruptive disorder, which is often treated with surgical removal of epileptic tissue when medication fails to repress seizures. In around a third of cases surgery is unsuccessful at preventing seizures. The aim of this study is to seek ways to improve surgery success rates by giving a better prediction of where seizures are starting and spreading on an individual patient basis, using an individual’s brain imaging data. Surgery is simulated in the model to provide a prediction of a procedures effectiveness at reducing seizures. Medical Research: What are the main findings? Response: Using patient Diffusion Tensor Imaging data to reconstruct the brain as a network, locations commonly implicated in temporal lobe epilepsy were found by the model to be most vulnerable to seizures. Simulations of surgery (following a commonly used surgery procedure) in patient models predicted a surgery success rate close to 70%, matching clinical observations. Subject specific surgery simulations were also tried, following individual predictions from the model of which regions to remove for which person. These showed far greater improvements in seizure likelihood than regular surgery. This is a preliminary study and there is much to be done to improve the predictive success, and also to ensure that model predicted subject specific surgery regions are safe to remove. Nonetheless it is a significant move towards computer aided patient specific surgery planning to improve outcomes. (more…)
Author Interviews, Biomarkers, Infections, PLoS, Technology / 10.12.2015 Interview with: Leo McHugh, Ph.D. Director, Bioinformatics Immunexpress Seattle, Washington  Medical Research: What is the background for this study? What are the main findings? Dr. McHugh: Sepsis is the leading cause of child mortality in the world, and in developing countries kills more adults than breast cancer, prostate cancer and HIV combined. Approximately 30% of people admitted to ICU have sepsis, and up to 50% of these patients die. It’s a major cost burden also, costing the US health system $17 billion per year. The best way to reduce costs and improve patient outcomes is to detect sepsis early and with confidence, so that appropriate treatments can be applied. Each hour delay in the detection of sepsis has been reported to correspond to an 8% increase in mortality. So the need for a rapid and accurate diagnostic is recognized. Traditional methods rely on detection of the specific pathogen causing the infection, and these methods often take more than 24 hours, and find a pathogen in only 30% of clinically confirmed cases because they’re trying to detect a minuscule amount of pathogen or pathogenic product in the blood. Our approach was to use the host’s own immune system, which is highly tuned to respond to the presence of pathogens. Around 30% of all genes are dysregulated in sepsis, so there is a huge signal base to draw from. The trick with using multi marker host response is to pick out the specific combination of gene expression patterns that cover the broad range of patients that present with sepsis and who may present either early or late in the episode, thus with different gene activation patterns. This paper describes a simple combination of such genes that can be used to detect sepsis and performs over the full range of patients irrespective of stage of infection or severity of infection. In it’s current format, the test is manual and takes 4-6 hours, and is a great advance on the current tools, however the methods we’ve used are specifically designed to meet requirements to port this assay onto a fully automated Point of Care platform that could deliver a result in under 90 minutes. (more…)
Annals Thoracic Surgery, Author Interviews, Heart Disease, Technology / 24.11.2015 Interview with: Neeraj Shah, MD, MPH Cardiology Fellow Department of Cardiology Lehigh Valley Health Network Allentown, PA. Medical Research: What is the background for this study? What are the main findings? Dr. Shah:  Congestive heart failure (CHF) affects 5.8 million Americans, with prevalence as high as 10% in individuals aged 65 years or more. There are long wait times for heart transplants. Left ventricular assist devices (LVADs) have been shown to significantly improve outcomes in end stage CHF patients. In the current situation of limited donor hearts, the utilization of LVAD technology is likely to increase over time. Moreover, the LVAD technology has improved considerably over time. The first generation devices were bulky and pulsatile in nature and of limited durability, whereas the second and third generation devices are smaller, longer lasting and exhibit “continuous flow”. The United States Food and Drug Administration (FDA) approved continuous flow devices in 2008. Presently, continuous flow devices account for over 95% of LVAD implants. Our aim was to examine the trends in utilization, in-hospital mortality, procedure related complications and cost of care after LVAD implantation from 2005 to 2011, and to study any differences in the pulsatile flow era from 2005-2007, compared to continuous flow era from 2008-2011. We used the Nationwide Inpatient Sample (NIS), which the largest all-payer US national hospitalization database, for our study. We identified LVAD implants using International Classification of Disease, 9th edition (ICD-9) procedure code 37.66. NIS data showed that there were 2,038 LVAD implantations from 2005 to 2011. LVAD utilization increased from 127 procedures in 2005 to 506 procedures in 2011, with a sharp increase after the year 2008 (from 149 procedures in 2007 to 257 procedures in 2008). In-hospital mortality associated with LVAD implantation decreased considerably from 47.2% in 2005 to 12.7% in 2011 (p<0.001), with a sharp decline in mortality after the year 2008 (from 38.9% in 2007 to 19.5% in 2008). Average length of stay (LOS) decreased from 44 days in the pulsatile-flow era to 36 days in the continuous-flow era. Cost of hospitalization increased from $194,380 in 2005 to $234,808 in 2011 but remained steady from 2008 to 2011. There was a trend of increased incidence of major bleeding and thromboembolism and decreased incidence of infectious and iatrogenic cardiac complications in the continuous-flow era. Thus, there has been a considerable increase in utilization of LVADs and decline in in-hospital mortality and LOS after LVAD implantation. These changes strongly coincide with US FDA approval of continuous flow devices in 2008. (more…)
Author Interviews, Cancer Research, Fertility, OBGYNE, Technology / 19.11.2015 Interview with: Kutluk Oktay, MD, PhD. Professor of Obstetrics & Gynecology, Medicine, and Cell Biology & Anatomy Director, Division of Reproductive Medicine & Institute for Fertility Preservation Innovation Institute for Fertility and In Vitro Fertilization New York Medical College, Valhalla, NY Medical Research: What is the background for this study? What are the main findings? Dr. Oktay: Cancer treatments cause infertility and early menopause in a growing number of young women around the world and US. One of the strategies to preserve fertility, which was developed by our team, is to cryopreserve ovarian tissue before chemotherapy and later transplant it back to the patient when they are cured of the cancer and ready to have children. However, success of ovarian transplantation has been limited due to limitation in blood flow to grafts. In this study we described a new approach which seems to improve graft function. The utility of an extracellular tissue matrix and robotic surgery seems to enhance graft function. With this approach both patients conceived with frozen embryos to spare and one has already delivered. (more…)
Annals Internal Medicine, Author Interviews, Critical Care - Intensive Care - ICUs, Technology / 18.11.2015 Interview with: Daniel Niven MD, MSc, FRCPC Department of Critical Care Medicine Department of Community Health Sciences O'Brien Institute for Public Health Cumming School of Medicine, University of Calgary  Medical Research: What is the background for this study? Dr. Niven: Fever (temperature 38.0 degrees Celsius or higher) and hypothermia (temperature less than 36.0 degrees Celsius) are commonly included in diagnostic criteria for certain disorders, influence clinical decision making, and are associated with an increased risk for death in select patient populations. Therefore, accurately measuring body temperature is important. Unfortunately, the accuracy of many commonly employed thermometers is not well defined.  Medical Research: What are the main findings? Dr. Niven: This systematic review and meta-analysis examined the accuracy of thermometers measuring temperature from peripheral sites (for example, forehead measurement devices) relative to central sites (for example, the bladder) in adults and children. From 75 studies and 8,682 patients, this meta-analysis found that the majority of commonly used peripheral thermometers do not have clinically acceptable accuracy among adults and children. This was especially the case for patients with fever and hypothermia, where peripheral temperature measurements may be as much as 1 to 2 degrees higher or lower than actual body temperature. Sensitivity for detection of fever was low (64%), whereas specificity was high (96%). (more…)
Author Interviews, Ovarian Cancer, Technology / 18.11.2015 Interview with: Professor John McDonald PhD Director of its Integrated Cancer Research Center School of Biology at the Georgia Institute of Technology Medical Research: What is the background for this study? What are the main findings? Response: Ovarian cancer is a deadly disease because it cannot be diagnosed at early stages when it can be most effectively effectively treated. It has long been recognized that there is a great need for an accurate diagnostic test for early stage ovarian cancer. Until now, efforts to develop a highly accurate way to detect early stage ovarian cancer have been unsuccessful. We have used a novel approach that integrates advanced methods in analytical chemistry with advanced machine learning algorithms to identify 16 metabolites that collectively can detect ovarian cancer with extremely high accuracy (100% in the samples tested in our study) (more…)
Author Interviews, NYU, Technology / 05.11.2015 Interview with: Dustin T. DuncanScD Assistant Professor Department of Population Health and Dr. Paul Krebs PhD Assistant Professor in the Department of Population Health New York University School of Medicine  Medical Research: What is the background for this study? What are the main findings? Dr.  Krebs: Everyone seems to be talking about health apps, but there was no quality research on what was actually happening in the US with regard to these apps. Knowing why people use and don’t use health-related apps is critical for advancing this area of healthcare. In terms of main findings, we found that a little over half of Americans are using a health-related app, primarily in the domains of fitness and nutrition. We also found greater use among minority populations, younger persons, among people who were obese, and those with higher incomes. Surprisingly we found that about 40% of people would not pay anything for a health app. Hidden costs and difficulty of data entry were main reasons people stopped using them. Dr. Duncan: Little is know about health app use, which was surprising to us—especially because many people have smartphones so downloading a health app can easy. We wanted to understand the landscape of health app use and patterns in the US to ultimately improve the population’s health. (more…)
Author Interviews, Breast Cancer, Technology / 31.10.2015 Interview with: Anuradha Godavarty PhD and Dr. Sarah J Erickson-Bhatt PhD Dept of Biomedical Engineering, Florida International University Miami, FL Medical Research: What is the background for this study? What are the main findings? Response: It is well known that early detection and staging of breast cancer is crucial in order to save lives. While the current gold standard for breast cancer screening is x-ray mammography, this method still misses many cancers especially in younger women with denser tissue. Our group and others have explored diffuse optical tomography using near-infrared light to image breast tumors. We have developed a unique optical imager with a hand-held probe that can contour to breast curvature in order to image the tissue without painful compression and without ionizing radiation (like x-rays). This study demonstrated the ability of the device to detect lesions in breast cancer patients due to elevated levels of total hemoglobin concentration in tumor vasculature. The hand-held has a potential to not only image the breast contours, but the probe was flexible to image the surrounding chest wall regions, thus expanding its application to image lymphatic spread as well. (more…)
Author Interviews, Surgical Research, Technology / 28.10.2015 Interview with: Dr. Carmine Simone MD, FRCSC  Chief, Department of Surgery, Toronto East General Hospital Co-Program Medical Director, Surgery HealthService, Toronto East General Hospital Lecturer, University of Toronto, Division of Thoracic Surgery Courtesy Staff, Sunnybrook Health Sciences Centre & Royal Victoria Hospital, Barrie Medical Research: What is the background for this study? What are the main findings? Dr. Simone: Patients preparing for surgery are often overwhelmed with information. Most of the time patients are given written instructions regarding preoperative preparation as well as written information at discharge. Our own institutional experience is that only 2/3 of patients read the information we provide and less than half of these patients can understand or retain the information they read. We have found that providing patients SMS alerts or reminders leading up to their surgery increases the likelihood that they will follow instructions and keep their appointments. Furthermore having patients log their progress after discharged from hospital allows patients to track their progress and report complications earlier and avoid coming to the ER. Educational modules enable patients to better gauge their symptoms and make more informed decisions about calling the surgeon’s office or proceeding to the emergency department. We found a significant reduction in the number of ER visits and cancelled procedures after implementing the mobile device reminders and post-discharge daily log. (more…)
Author Interviews, Surgical Research, Technology / 23.10.2015

[wysija_form id="5"] Interview with: Professor Philip Breedon Professor of smart technologies Nottingham Trent University Design for Health and Wellbeing Research Group  Medical Research: What is the background for this study? Prof. Breedon: This report presented an innovative approach of enhancing the efficiency of spinal surgery by utilizing the technological capabilities and design functionalities of wearable headsets, in this case Google Glass. The overall aim was to improve the efficiency of the Selective Dorsal Rhizotomy ( SDR) neurosurgical procedure through the use of Google Glass via an innovative approach to information design for the intraoperative monitoring display. (more…)
Author Interviews, JAMA, Melanoma, Technology / 15.10.2015

Ashley K. Day, Ph.D., M. Psych (Hlth) Post-Doctoral Associate Rutgers Cancer Institute of New Interview with: Ashley K. Day, Ph.D., M. Psych (Hlth) Post-Doctoral Associate Rutgers Cancer Institute of New Jersey Medical Research: What is the background for this study? What are the main findings? Dr. Day: Skin cancer is one of the most common cancers in the US, and it is estimated that more than 9,000 Americans will die of melanoma this year. Melanoma patients have a 9-times greater risk for a diagnosis of another melanoma compared to the general population. Because of this, it is important that melanoma patients practice regular sun protection and skin self-examination behaviors. There is potential opportunity to use the Internet to deliver information and interventions to help melanoma patients engage in these behaviors. However, it is important to understand patients’ preferences. Our research explored factors associated with the receptivity of patients with melanoma to such Internet-delivered behavioral interventions. We found that, in a sample of 176 melanoma patients, the vast majority (84.1%) had Internet access and had previously sought melanoma information online (77.7%). More than two-thirds of patients (68.4%) reported being at least moderately interested in participating in an Internet-based intervention to promote engagement in sun protection and skin self-examination behaviors. Receptivity to such an intervention was higher among patients who were younger, had greater knowledge of the ABCDE signs of melanoma (looking at the asymmetry, border irregularity, color, diameter, and evolution of the mole or affected area), and were more comfortable using the Internet. (more…)
Author Interviews, Pediatrics, Technology / 05.10.2015

Ichiro Morioka, M.D. Professor of Pediatrics, Kobe University Graduate School of Medicine Chuo-ku, Kobe, Interview with: Ichiro Morioka, M.D. Professor of Pediatrics, Kobe University Graduate School of Medicine Chuo-ku, Kobe, Japan  Medical Research: What is the background for this study? What are the main findings? Dr. Morioka: Japan has the highest survival rate for preterm infants due to recent advanced medical treatment and the availability of Neonatal Intensive Care Units (NICU). Despite this, cases of cerebral palsy and hearing loss caused by neonatal jaundice continue (kernicterus) to occur, with cases reported for at least 2 in every 1000 infants born before the 30th week of gestation. It has also been established that cases of jaundice can worsen even two weeks after birth and thereafter, meaning that there is a need for continuous long-term jaundice monitoring of infants in the NICU. However, jaundice in preterm infants is difficult to detect through physical observations, and monitoring through a daily blood test is not a realistic option. We focused on transcutaneous jaundice monitoring used in daily health tests for full term infants. The bilirubin levels of 85 infants with a birth weight of under 1500 grams were monitored in NICUs at Kobe University, Kakogawa City Hospital, Hyogo Prefectural Kobe Children’s Hospital, Japanese Red Cross Society Himeji Hospital, and Takatsuki General Hospital, and were taken a total of 383 transcutaneous and blood bilirubin measurements at the same time. Through our results we were able to ascertain that the chest and back areas of preterm infants have the highest levels of sensitivity, and transcutaneous bilirubin levels in those areas were close to bilirubin levels in the blood. In addition to expanding the possibilities for transcutaneous monitoring of jaundice in preterm infants, we discovered the optimum area of skin to monitor it. (more…)
Author Interviews, Neurological Disorders, Technology / 24.09.2015

An Do, MD Assistant Professor Department of Neurology University of California, Interview with: An Do, MD Assistant Professor Department of Neurology University of California, Irvine Medical Research: What is the background for this study? What are the main findings? Dr. An Do: In this study, we demonstrated that it is possible for a person with paraplegia due to spinal cord injury to regain brain-controlled walking through the use of a brain-computer interface. This system records EEG signals as a person is thinking about walking. While the person is thinking about walking, EEG signals change in a manner which can be detected by a computer algorithm. Upon detecting that a person is thinking about walking from the EEG signals, the computer sends a command signal to an electrical stimulation system to stimulate the nerves in the legs to continuously generate alternating right and left stepping movements. This stepping stimulation stops when he stops thinking about walking. (more…)
Author Interviews, Diabetes, Outcomes & Safety, Technology / 21.09.2015

Wencui Han PhD Assistant Professor Business Administration University of Illinois at Urbana Interview with: Wencui Han PhD Assistant Professor Business Administration University of Illinois at Urbana Champaign Medical Research: What is the background for this study? What are the main findings? Dr. Han: Well-designed disease registries integrate a variety of information, including patient demographics, laboratory results, pharmacy data, and comorbidity data, to serve a variety of functions outside the clinical encounter. However, the adoption of disease registries by healthcare organizations is associated with significant direct and indirect costs. The impacts of using disease registries that meet meaningful use (MU) requirements in improving health outcomes and creating cost savings are understudied. This study examines the impact of using a registry for patient reminders and for improvement of the quality of care, hospital utilization, and cost saving. The results suggest that the use of diabetes registries meeting Meaningful Use core objectives is associated with higher completion or recommended lab tests and a lower hospital utilization rate for patients with type 2 diabetes. (more…)
Accidents & Violence, Technology / 18.09.2015

Dr. Xiaohu Xia Ph.D. Assistant Professor Department of Chemistry Michigan Technological University Houghton, MI Interview with: Dr. Xiaohu Xia Ph.D. Assistant Professor Department of Chemistry Michigan Technological University Houghton, MI 49931 Medical Research: What is the background for this study? What are the main findings? Xiaohu Xia, Jingtuo Zhang, Ning Lu, Moon J. Kim, Kushal Ghale, Ye Xu, Erin McKenzie, Jiabin Liu, Haihang Ye. Pd–Ir Core–Shell Nanocubes: A Type of Highly Efficient and Versatile Peroxidase Mimic. ACS Nano, 2015; 150910154147007 DOI: 10.1021/acsnano.5b03525Dr. Xia: Peroxidases, a family of enzymes that catalyze the oxidation of certain compounds with peroxides, have found widespread use in areas such as biomedicine and environmental protection. Over the past several years, researchers have found that certain inorganic nanomaterials (such as nanoparticles made of metal, metal oxides, and carbon) possess intrinsic peroxidase-like activities. As the major advantage over their natural counterparts, these peroxidase mimics are much more stable because they are less vulnerable to denaturation and protease digestion. In spite of the superior stability of the mimics, improvement in their catalytic efficiency has been met with limited success. The catalytic efficiencies for most of the previously reported peroxidase mimics with sizes 1-100 nm are limited to the range of 101-104 s-1 in terms of catalytic constant (Kcat, which measures the maximum number of chemical conversions of substrate molecules per second per enzyme/mimic). Our research team have recently developed a new type of peroxidase mimic with a record high efficiency that was engineered by coating ~18 nm palladium (Pd) nanocubes with ultrathin iridium (Ir) skins of a few atomic layers (i.e., Pd-Ir core-shell cubes, see Figure). The catalytic efficiency of our Pd-Ir cubes could reach a level of Kcat = 106 s-1. In view of the substantially enhanced efficiency, we applied our Pd-Ir cubes to the colorimetric enzyme-linked immunosorbent assay (ELISA) of human prostate surface antigen (PSA) by functionalizing their surface with antibodies. The detection limit of the Pd-Ir cubes-based ELISA of PSA was determined to be 0.67 pg/mL, which is over 100-fold lower than that of the conventional horseradish peroxidase(HRP)-based ELISA using the same set of antibodies and the same procedure (see Figure). (more…)
Author Interviews, Pediatrics, Sleep Disorders, Technology / 27.08.2015

Stephanie J. Crowley, Ph.D. Assistant Professor Biological Rhythms Research Laboratory Department of Behavioral Sciences Rush University Medical Center Chicago, IL Interview with: Stephanie J. Crowley, Ph.D. Assistant Professor Biological Rhythms Research Laboratory Department of Behavioral Sciences Rush University Medical Center Chicago, IL 60612 Medical Research: What is the background for this study? Dr. Crowley: Your readers may have seen recent reports by the American Academy of Pediatrics and the CDC about problems with early morning school bells for teens and the need to push school start times later.  These recent calls for later school start times come from data showing that biological processes make it challenging for a teen to get enough sleep and be rested for school when they have to wake up very early for school.  One of these biological processes is the circadian timing system, which is the approximate 24-hour brain clock that regulates the timing of sleep and wake.  During the teen years, the brain clock is shifted later making it more difficult for many teens to fall asleep early enough to get sufficient sleep on school nights. Medical Research: What are the main findings? Dr. Crowley: Melatonin suppression, as tested in this new study, is a good indication of how light affects the circadian system.  Our findings show that even a very small amount of light (similar to “romantic mood lighting”) in the evening suppressed melatonin levels in the middle-school-aged adolescents.  Because evening light “seen” by the brain clock shifts the clock later in time, the message is that biologically-driven later sleep times starts at this early age and needs to be considered when managing school and sleep schedules. (more…)
Author Interviews, Brigham & Women's - Harvard, Gastrointestinal Disease, Technology / 16.08.2015 Interview with: Dr. Jeff Karp Ph.D Associate Professor of Medicine Brigham and Women's Hospital Harvard Medical School Cambridge, MA  02139 Dr. Jeff Karp Ph.D Associate Professor of Medicine Brigham and Women's Hospital Harvard Medical School Cambridge, MA  02139 and Giovanni Traverso M.B., B.Ch., Ph.DDr-Giovanni-Traverso The David H. Koch Institute for Integrative Cancer Research Massachusetts Institute of Technology, Cambridge, MA   Medical Research: What is the background for this study? What are the main findings Dr. Karp: Almost all patients with ulcerative colitis will require enema-based therapy at some point in their treatment.  Enema therapy has 3 major issues.
  • It is difficult to retain
  • There is high systemic absorption of the drug (that can lead to toxic side effects), and
  • Compliance is low as patients must take enemas every day.
Our approach can potentially address all three.  The engineered gel that we designed has dual targeting capability. It rapidly attaches to ulcers within seconds to minutes (we have 5-10x less systemic absorption as the gel only attaches to ulcers) and selectively releases drug in the presence of ulcers, and we showed that we could reduce the dosing frequency. (more…)
Accidents & Violence, Author Interviews, PLoS, Technology / 29.07.2015

Conrad Earnest, PhD, FACSM Texas A&M University College Station, Interview with: Conrad Earnest, PhD, FACSM Texas A&M University College Station, TX Medical Research: What is the background for this study? Dr. Earnest: The study presented here is a thesis project performed by Robbyne Smith and Sammy Licence, under the direction of Professor Conrad Earnest. We were curious to about the effects of walking, texting and doing both while simultaneously being cognitively distracted by common tasks - in our case a maths test. Much of our curiosity was born from watching a YouTube video and reading an article on inattentional blindness where people did not notice a unicycling clown while using their mobile phones. Several reports suggest that this type of pedestrian behavior leads to more pedestrian accidents, possibly increases the risk of tripping and increases riskier road crossing behavior due to a lack of attention. While much of the literature has examined this question using a “straight line” model to look at walking characteristics and deviations within ones walking path, we elected to build an obstacle course that imitated common barriers that we measured in the city of Bath, England, that pedestrians might encounter during their walking day. Medical Research: What are the main findings? Dr. Earnest: Our main findings were that people slowed their walking speed, took more steps in their approach to common obstacles, and increased the height of their step to go up steps and over curbs. Interestingly, we did not see an increase in what we called barrier contacts, which were used as a surrogate measure for tripping. (more…)