MedicalResearch.com Interview with:Dr. Juliane Bingener-Casey, M.D.
Mayo Clinic in Rochester, Minn.
MedicalResearch.com: What are the study’s main findings?Dr. Bingener-Casey: “Patient-reported outcomes such as pain and fatigue are sensitive tools to detect how well patients recover from surgery. These patient-reported outcome results are different for men and women and for older versus younger people.”
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MedicalResearch.com Interview with:Martin J. Holzmann, MD, PHD
Department of Emergency Medicine
Karolinska University Hospital, Huddinge
MedicalResearch.com: What are the main findings of the study?Dr. Holzmann: In a cohort of 8900 consecutive patients who sought medical attention for chest pain, we found that an undetectable high-sensitivity cardiac troponin level (<5 ng/l), and an ECG with no ischemic changes has a negative predictive value of 99.8% (95%, 99.7-99.9%). Thus, this will rule out MI with nearly 100% accuracy, and independent of when the troponin was measured in relation to onset of chest pain, and independent of any risk factors for cardiovascular disease.
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MedicalResearch.com Interview with:Dr. Anne Ingeborg Berg:
University of Gothenburg, Sweden
MedicalResearch.com: What are the main findings of the study?Answer: In our study of personality change in individuals aged 80+ we found that over a 6 year period individuals did not change in emotional stability, however, in line with previous research they got less extravert or outgoing. The only health aspect that could be related to an accelerated change in extraversion was impaired hearing at the first measurement occasion.
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MedicalResearch.com Interview with:
Evropi Theodoratou
School of Molecular, Genetic and Population Health Sciences
University of Edinburgh
MedicalResearch.com: What are the main findings of the...
MedicalResearch.com Interview with: Prof Guangwei Li MD
Department of Endocrinology
China-Japan Friendship Hospital
Center of Endocrinology and Cardiovascular Disease, National Center of Cardiology & Fuwai Hospital, Beijing, China
MedicalResearch.com: What are the main findings of the study?Answer: Our study first shows that a six-year period of lifestyle intervention in Chinese people with IGT reduced the incidence of diabetes over a protracted time period and was ultimately associated with a significant reduction in total and cardio-vascular disease mortality. This reduction in mortality appears to be mediated in part by the delay in onset of diabetes resulting from the lifestyle interventions.
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MedicalResearch.com Interview with:Professor Harvey White
MB ChB DSc FRACP FACC FESC FAHA FHKCC (Hon) FCSANZ FRSNZ La'auli (matai); Prince Mahidol Laureate; John Neutze Scholar, Director of Coronary Care & Green Lane Cardiovascular Research Unit, Green Lane Cardiovascular Service
Auckland City Hospital NEW ZEALAND
MedicalResearch.com: What are the main findings of the study?Prof. White: During follow-up (median 3.7 years), the composite primary end point (cardiovascular death, myocardial infarction or stroke) occurred in 9.7% of the 7,924 patients randomly assigned to darapladib and 10.4% of the 7,904 patients in the placebo group (HR 0.94, 95% CI 0.85-1.03 p=0.199).
In the first prespecified secondary endpoint of major coronary events (CHD death, MI or urgent revascularization) compared with placebo, darapladib reduced the rate (9.3% vs. 10.3%; HR=0.9; 95% CI, 0.82-1 p=0.045). Total coronary events (14.6% vs. 16.1%; HR = 0.91; 95% CI, 0.84-0.98,p=0.019). (CHD death, MI, any coronary revascularization, hospitalization for unstable angina) were also reduced. No major safety concerns arose during the trial. (more…)
MedicalResearch.com Interview with: Professor Ludwig Kuntz
Seminar for Business Administration and Health Care Management University of Cologne Albertus-Magnus-Platz
50923 Cologne Germany
MedicalResearch.com: What are the main findings of the study?Professor Kuntz: We have identified the point at which hospitals begin to fail, resulting in deaths of critically ill patients. The Safety Tipping Point for hospitals occurs when they reach occupancy levels far below 100%, namely we identified a tipping point strongly at around 92 per cent [patient occupancy relative to ward capacity]. Our research therefore demonstrates conclusively that far from maximizing efficiency, exceeding a capacity “tipping point” on a hospital ward can have dire consequences. This has major implications for the way we think about capacity and stress in the workplace.
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MedicalResearch.com Interview with:Jeppe Romme Christensen MD PhD
From the Danish Multiple Sclerosis Center
Copenhagen University Hospital Hvidovre, Denmark.
MedicalResearch.com: What are the main findings of the study?Dr. Christensen: This study demonstrates that progressive multiple sclerosis (MS) patients have reduced inflammation and tissue damage in the brain after treatment with natalizumab. These findings highlight that progressive MS is an inflammatory disease and furthermore that peripheral circulating immune cells contribute to brain inflammation and tissue damage in progressive MS.
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MedicalResearch.com Interview with:Niels Graudal, MD, DrMSc
Senior Consultant
Department of Internal medicine/Infectious Medicine/Rheumatology IR4242
Copenhagen University Hospital, Rigshospitalet
Denmark
Dr. Graudal: There are no studies, which show what happens with the risk of cardiovascular death or mortality if you change your sodium intake. Our study shows the association of sodium intake as it is with cardiovascular disease and mortality, which is only the second best way to consider the problem, but as the best way does not exist we have accepted this approach. There have been two different assumptions concerning the risks of sodium intake. One is that there is an increasing risk of heart disease, stroke and death of salt intake above 2300 mg, and one is that salt is not dangerous at all. Our study shows that both positions partially may be true, as a salt intake above 4900 mg is associated with increased risk of cardiovascular disease and mortality, whereas the present normal salt intake of most of the world’s populations between 2300 mg and 4900 mg is not associated with any increased risks. In addition our study shows that a low sodium intake below 2300 mg is also associated with increased risk of cardiovascular disease and death.
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MedicalResearch.com Interview with:
Dr. LydiaPace, MD, MPH
Division of Women’s Health, Brigham and Women’s Hospital
Boston, Massachusetts
MedicalResearch.com: What are the main findings of the study?Dr. Pace: We reviewed the existing literature about the benefits and harms of mammography, focusing on the reduction of breast cancer deaths associated with mammography, as well as the two most often-discussed harms: false positive results and overdiagnosis. We also reviewed the literature about interventions to help patients make informed decisions. We found that the literature suggests that routine screening mammography does reduce mortality associated with breast cancer, across all age groups. However, it is also associated with high rates of false positive results, and considerable rates of overdiagnosis. Overdiagnosis is the most concerning potential risk of mammography screening. Overdiagnosis is the detection of a tumor through screening that would never have caused problems for a patient. It occurs either because of a very slow-growing tumor, or because a woman has medical problems (or is old enough) such that she will likely die of another cause before the cancer became apparent. Overdiagnosis is concerning because we cannot know when a cancer is overdiagnosed, and thus a patient who is overdiagnosed will receive unnecessary treatment for cancer. The scientific literature on mammography is complex, and there are important limitations to the studies both of mammography’s benefits and harms. However, we feel that the best available data suggest that among 10,000 50 year old women undergoing annual mammography for 10 years, 5 deaths will be averted through screening mammography, while about 6130 women will experience at least one positive result. Furthermore, there is about a 19% chance that, if that woman is diagnosed with cancer detected by a mammogram, that cancer is one that would never have caused her problems. Lastly, our review showed that we need more studies to guide us in how an individual woman’s risk should dictate her mammography decisions, and how to support women in making those decisions. However, we know that most women with higher risk for breast cancer will experience higher benefit from mammography screening. (more…)
MedicalResearch.com Interview with: Woon-Puay Koh (Associate Professor)
Office of Clinical Sciences
Duke-NUS Graduate Medical School Singapore
8 College Road Level 4 | Singapore 169857
MedicalResearch.com: What are the main findings of the study?Answer:The main finding is that coffee intake was associated with a lower risk of death from cirrhosis, specifically for non-viral hepatitis related cirrhosis. Subjects who drank two or more cups per day had a 66% reduction in mortality risk, compared to non-daily coffee drinkers. However, coffee intake was not associated with viral hepatitis B related cirrhosis mortality.
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MedicalResearch.com Interview with:
Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory,
Director, Cardiovascular Outcomes Group,
Associate Professor of Medicine,
New York University School of Medicine
New York, NY 10016.
MedicalResearch.com: What are the main findings of your study?Dr.Bangalore: Patients with transient ischemic attack (TIA) are at increased risk of future full blown stroke, making institution of secondary prevention measures critical
Our data from 858,835 patients from 1545 sites indicate that hospital adherence to evidence-based secondary prevention discharge measures was consistently less for patients with transient ischemic attack when compared with those with ischemic stroke, thus representing a missed opportunity at instituting preventive measures to reduce the risk of future stroke.
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MedicalResearch.com Interview with:
Shanthi Srinivasan, M.D. Associate Professor of Medicine
Division of Digestive Diseases Department of Medicine
Emory University Atlanta, GA 30322MedicalResearch.com: What are the main findings of the study?Dr. Srinivasan:The main findings of this study are that the neurotrophic factor GDNF is was able to protect against the weight gain induced by mice on a high fat diet. The mice that had overexpression of GDNF showed less weight gain while eating the same high fat diet as the control mice. GDNF seems to have effects on the genes regulating fat metabolism and energy expenditure and this could be the mechanism of prevention of weight gain.
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MedicalResearch.com Interview with: Daniel J. Elliott, M.D., MSCE, FACPAssociate Chair of Research
Department of Medicine and Research Scholar
Value Institute, Christiana Care Health System
MedicalResearch.com: What are the main findings of the study?Dr. Elliott:The optimal workload for hospitalists has been a question since the earliest days of hospital medicine. However there has been very little empirical evidence to understand the relationship between workload and outcomes.
The objective of our study was to determine the association of daily workload for hospitalists on the efficiency, quality, and cost of care. We analyzed data from a single private practice hospitalist group at a community-based health system between February 2008 and January 2011. Our research showed that both length of stay and cost increased for patients as hospitalist workload increased.
At the same time, our research showed that workload did not affect patient satisfaction as measured by HCAHPS scores or quality and safety outcomes including admissions, rapid response team activation and mortality.
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MedicalResearch.com Interview with:Dr. Milan K Piya
NIHR Clinical Lecturer in Diabetes and Endocrinology
Warwick Medical School, University of Warwick;
University Hospitals Coventry and Warwickshire NHS Trust
Coventry, UK
MedicalResearch.com: What are the main findings of the study?Answer: Our studies have identified two main findings:
Firstly that the size or frequency of the meal doesn’t affect the calories we burn in a day, but what matters most for losing weight is counting calories.
Secondly, by carrying more weight, more endotoxin enters the circulation to cause inflammation and eating more often will exacerbate this risk which has been linked to metabolic diseases such as type-2 diabetes.
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MedicalResearch.com Interview with:Professor Rodney Sinclair
University of Melbourne and Epworth Hospital
Melbourne, VIC, Australia
MedicalResearch.com: What are the main findings of the study?Answer: Activation of Wnt signalling promoted hair growth and fat growth. Inhibition of Wnt signalling reduces fat growth and hair growth. We looked at the fat layer on the scalp. It was reduced by 50% over the bald areas of alopecia areata. The patch of alopecia areata we looked at was new- only appeared a few days earlier and so the changes in fat thickness are rapid.
What is interesting is that the fat layer is dynamic, and significant fluctuations can occur in a rapid period of time in sync with the hair cycle. It is also interesting that ligands for BMP6 and IGF2 are pro-adipogenic.
There are a couple of bigger questions that earlier media reports did not focus on- namely upstream factors regulating the hair cycle clock and the beauty of synchronization of fat and hair growth for seasonal thermal insulation.
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MedicalResearch.com Interview with:Dr Oyinlola Oyebode
Specialist Registrar in Public Health
Dept of Epidemiology & Public Health
University College London
MedicalResearch.com: What are the main findings of the study?Dr. Oyebode: We found that the more fruit and vegetables consumed, the lower the risk of death from any cause, from cancer or from heart disease or stroke. We found that vegetables were better than fruit at equivalent amounts.
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MedicalResearch.com Interview with: Jan Akervall, M.D., Ph.D.
Co-director, Head and Neck Cancer Multidisciplinary Clinic
Beaumont Hospital, Royal Oak
Clinical Director of Beaumont’s BioBank
MedicalResearch.com: What are the main findings of the study?Dr. Akervall: We identified biomarkers that can predict who will have an unfavorable response from radiation for head and neck cancer. These can be analyzed using standard laboratory techniques on biopsies that routinely are taken for diagnosis.
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MedicalResearch.com Invitation with:Dr Valerie Sung MBBS(Hons) FRACP MPH
NHMRC PhD Candidate, Department of Paediatrics, University of Melbourne, and Community Health Services Research, Murdoch Childrens Research Institute
Paediatrician, Centre for Community Child Health
The Royal Children’s Hospital
MedicalResearch.com: What are the main findings of the study?Dr. Sung: Lactobacillus reuteri was NOT effective in reducing crying or fussing in infants with colic, whether they are breast or formula fed. This is the largest and most rigorous trial to date to show this.
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MedicalResearch.com Interview with: Mary A.M. Rogers, PhD, MS
Research Associate Professor
Research Director, Patient Safety Enhancement Program
Department of Internal Medicine
University of Michigan Ann Arbor, MI 48109-2800
MedicalResearch.com: What are the main findings of the study?Dr. Rogers: The risk of serious infection is considerably elevated after receiving allogeneic (donor) red blood cell transfusions. For every 38 patients under consideration for transfusion, 1 patient could be spared an infection if more restrictive hemoglobin thresholds were used. When patients were given transfusions only after their hemoglobin fell below 7.0 g/dL, 1 patient avoided an infection of every 20 patients treated. The results were most consistent in elderly patients receiving hip and knee replacement surgeries. Their risk of infection decreased by 30% when lower hemoglobin thresholds were used.
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MedicalResearch.com Interview with:Dr. Thomas M. Pisansky MD
Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What are the main findings of the study?Dr. Pisansky:This patient-reported outcomes research did not identify a beneficial effect of once-daily tadalafil to prevent radiotherapy-related erectile dysfunction in men with prostate cancer.
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MedicalResearch.com Interview with: Rosebud O Roberts, M.B., Ch.B.
Professor of Epidemiology
Professor of Neurology
Mayo Clinic
MedicalResearch.com: What are the main findings of the study?
Dr. Roberts: We found that among persons 70 years and older, people with type 2 diabetes had a reduced glucose uptake (hypometabolism) in brain cells. We also found a similar association for people without type 2 diabetes but who had elevated hemoglobin A1c levels levels at the time of enrollment (HBA1c is a measure of glucose control, and represents the average blood glucose levels over a 3 month period). However, we did not find an association of diabetes with increased brain amyloid accumulation. Our findings were based on an investigation of the association of type 2 diabetes with markers of brain pathology: brain hypometabolism was assessed by 18F-fluorodeoxyglucose positron emission tomography [PET] and amyloid accumulation was assessed by 11-C Pittsburgh Compound B PET imaging.
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MedicalResearch.com Interview with:Karen E Lasser, MD MPH
Associate Professor of Medicine
Boston University School of Medicine, Boston, MA
MedicalResearch.com: What are the main findings of the study?Dr. Lasser: After controlling for variables that could affect the risk of readmission, we found that:
There was a slightly increased risk of all-cause readmission in Massachusetts (MA) relative to control states (New York and New Jersey) post-reform.
Racial and ethnic disparities in all-cause readmission rates did not change in MA relative to control states.
However, both blacks and whites in counties with the highest uninsurance rates had a decreased risk of readmission following MA health reform relative to blacks and whites in counties with lower uninsurance rates.
MedicalResearch.com interview with:Mary E. Arthur, MD
Cardiothoracic and ICU Anesthesia
Department of Anesthesiology and Perioperative Medicine
Georgia Regents University, Augusta, GA
MedicalResearch.com: What made this cardiac case challenging?Dr. Arthur:The left ventricle of our patient’s heart was functioning very poorly, and he required maximum pharmacologic support after he was weaned from cardiopulmonary bypass at the end of a 4-vessel coronary artery bypass graft procedure. His blood pressure and cardiac output were extremely low and his heart was not pumping well and so we put him back on bypass. Under routine circumstances, using an intra-aortic balloon pump is the next logical step, however it was inadvisable in this patient because he had moderate aortic insufficiency (a leaky aortic valve).
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MedicalResearch.com Interview with: Evan A. Stein, M.D., Ph.D. FRCP(C), FCAP
Metabolic and Atherosclerosis Research Center
Cincinnati, OH 45225,
MedicalResearch.com: What are the main findings of the study?Dr. Stein:The study which is the first 52 week randomized double blind trial of a PCSK9 to report results (all others have been 12 weeks) demonstrated that the excellent LDL-C reductions of 55-60% seen at 12 weeks are maintained through 52 weeks, with no fall off in patient compliance, tolerability of efficacy. It also demonstrated that with longer treatment no new or unexpected side effects.
The study also had a unique design in that prior to randomization to the PCSK9 inhibitor (evolocumab) or placebo patients had a run in period during which time they were assigned, based on NCEP-ATP III criteria, to appropriated background therapy which ranged from diet only, to atorvastatin 10 mg a day, to atorvatatin 80 mg a day or atorvastatin 80 mg a day plus ezetimibe - reflecting how these patients are treated in practice. Only then if their LDL-C was still above 75 mg/dL were they randomized into the treatment part of the study with the new drug. The study showed that irrespective of background therapy the reduction with evolocumab was consistent.
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MedicalResearch.com Interview Invitation with: Timothy Hughes, PhD, MPH
Roena B. Kulynych Center for Memory & Cognition Research
Department of Internal Medicine
Division of Gerontology and Geriatric Medicine
Wake Forest School of Medicine
Medical Center Boulevard, Winston-Salem, NC 27157-1207
MedicalResearch.com: What are the main findings of the study?Dr. Hughes: This study is a follow-up to our recent paper that showed a novel relationship between arterial stiffness (commonly measured by pulse wave velocity) and the presence and extent of amyloid deposition in the brain, a hallmark of Alzheimer’s disease. For this study, we repeated brain amyloid imaging (using the Pittsburgh Compound B during PET imaging) in order to look for predictors of change in amyloid over two years in n=81 elderly adults aged 80+ and free from dementia. We observed that measures of systemic arterial stiffness (e.g. brachial ankle pulse wave velocity) was strongly associated with the extent of amyloid deposition in the brain at both baseline and follow-up. The change in brain amyloid accumulation over two years resulted in an increase in in the number of participants with Alzheimer’s-like (amyloid-positive) from 45% at baseline to a surprising 75% after just two years. This change in brain amyloid accumulation over two years was strongly related to having greater central stiffness (as measured by carotid femoral pulse wave velocity). These relationships between arterial stiffness and brain amyloid deposition were independent of the effects of age, gender, body mass index, antihypertensive medication use and even current blood pressure.
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MedicalResearch.com Interview with James D. Sargent, MD, Professor of Pediatrics
Professor of Community and Family Medicine
Professor of The Dartmouth Institute
Co-Director, Cancer Control Research Program
Norris Cotton Cancer Center Norris Cotton Cancer Center,
Department of Pediatrics
Geisel School of Medicine at Dartmouth
Lebanon, New Hampshire
MedicalResearch.com: What are the main findings of the study?Dr. Sargent: We showed children aged 3-7 years depictions of healthy foods in McDonald’s and Burger King television advertisements that aired in 2010-11. Children were asked what they saw in the images and not prompted to respond specifically to any aspect of the images. All images contained the two healthy foods—apples and milk—the companies purported to be advertising through the Children’s Food and Beverage Advertising Initiative. Only 52% and 70% of children correctly identified McDonald’s and Burger King images of milk. Whereas 80% correctly identified McDonald’s image of apples, only 10% identified the Burger King apples as apples. Instead, 81% mistook them as french fries.
Please see the video of children responding to the BK apples depiction at
http://cancer.dartmouth.edu/about_us/newsdetail/66129/(more…)
MedicalResearch.com Interview with:M.S. Reimers, MD PhD Student
and
Dr. Jan Liefers MD
Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
MedicalResearch.com: What are the main findings of the study?Answer: Aspirin use was associated with an improved survival, as we have published before when investigating this cohort (Bastiaannet et al, Brit J Cancer 2012/ Reimers et al. J Am Geriatr Soc. 2012. In this study we have focused on investigating which patients will benefit from aspirin treatment by investigating some tumor markers, such as PTGS2 expression, HLA class I expression and PIK3CA mutation status. Interestingly, only patients with HLA class I expression on their tumor membrane will benefit from aspirin treatment and have a better outcome. We raise the hypothesize that aspirin inhibits platelet aggregation to circulating tumors cells. By interfering with this process, the metastatic potential of these circulating tumour cells is inhibited, thereby preventing metastasis and colon cancer death.HLA class I expression might be needed for signalling between platelets and circulating tumor cells. If this hypothesis is confirmed by others or in vitro studies, than this might explain the finding that aspirin seems not only beneficial as an adjuvant therapy for colorectal cancer patients, but also for patients with other malignancies (oesophagus, breast, etc). Interestingly, preliminary findings from our team investigating aspirin use in oesophageal cancer also showed that aspirin use in these tumors was associated with an improved survival.
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MedicalResearch.com Interview with:Eleftherios Mylonakis, M.D., Ph.D., FIDSA
Dean's Professor of Medical Science
Chief, Infectious Diseases Division
Alpert Medical School and Brown University
and Dr. Irene Kourbeti MD
Research Associate
Infectious Disease Division
Rhode Island Hospital, Providence, RI
MedicalResearch.com: What are the main findings of the study?Answer: There was high quality of evidence that biologic agents are associated with increased risk of all opportunistic infections, but there was no difference in mortality attributed to the opportunistic infections. Patients receiving biologics were twice more likely to develop opportunistic infections (OIs) compared to controls (OR 1.79; 95% CI, 1.17-2.74) with a number needed to harm (NNH) of 582 patients. That means that 1 opportunistic infection would occur in every 582 patients receiving biologics. The opportunistic infections usually occurred at the commencement of the use of the biological agent and they were not statistically more in patients with a previous exposure to anti-TNF agents as compared to the patients that had never received an anti-TNF agent..
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MedicalResearch.com Interview with:
Gao-Jun Teng, MD
Chair and Professor, Dept of Radiology
Zhongda Hospital, Southeast University
Nanjing 210009, China
MedicalResearch.com: What are the main findings of the study? Answer: This current study demonstrates that the aberrant resting-state functional connectivity among default mode network (DMN) regions, especially the posterior cingulated cortex (PCC) to right middle temporal gyrus (MTG), is associated with insulin resistance and cognitive performance, which might be the key to understanding the cognitive impairment in type 2 diabetes (T2DM).
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