Author Interviews, Brigham & Women's - Harvard, Diabetes, Ophthalmology / 16.06.2023

MedicalResearch.com Interview with: Ali Hafezi-Moghadam, Ph.D., M.D Director, Molecular Biomarkers Nano-Imaging Laboratory (MBNI) Associate Professor of Radiology, Harvard Medical School Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? Response: “It is very easy to answer many fundamental biological questions” said Richard Feynman in his 1959 address, where he also offered his simple and ingenious solution: “you just look at the thing!”[1]. As a biologist, I am familiar with the challenges surrounding looking at things in the context of life. There is no single device or technology that lets me simply see the answers to my questions. How does diabetes harm the tissues in the body? When exactly does the pathology start and which molecules and cells are involved? Trying to answer these questions, I have spent the past two decades innovating new ways of quantifying expression of molecules in the living organism [2]. At the same time to study diabetes, we needed a realistic rodent model that mirrors the human disease. In collaboration with KC Hayes[3], we first introduced the Nile grass rat (NGR, Arvicanthis niloticus), a gerbil that recapitulates the main features of the human type 2 diabetes [4]. For visualization of early changes, the eye offers a unique site. Much of my lab’s work focused on the first effects of diabetes in the retina, the site of the neurons that perceive light in the back of the eye [5], [6], [7]. In recent studies, we focused on how diabetes affects the lens in the eye of our animals [8], [9]. Diabetes is a major risk factor for cataract formation, a condition during which the lens loses its original transparency to visible light. How diabetic cataracts are formed is not well understood. A popular and prevailing theory, termed “sugar cataracts”, has been around for over half a century. According to the sugar hypothesis of cataracts, the excess levels of the sugar molecule, glucose, in the lens are transformed through the polyol pathway into the sugar-alcohol sorbitol. The resulting osmotic dysbalance leads to swelling of the fiber cells and opacity of the lens. Even though the sugar hypothesis has never been proven, it was generally accepted and remained unchallenged for a very long time. That is where our latest experimental results became relevant. (more…)
Alzheimer's - Dementia, Author Interviews, Lifestyle & Health, Nutrition, Vegetarians / 30.05.2023

MedicalResearch.com Interview with: JoAnn E. Manson, MD, DrPH, MACP Chief, Division of Preventive Medicine Brigham and Women's Hospital Professor of Medicine and the Michael and Lee Bell Professor of Women's Health Harvard Medical School Boston, Massachusetts  02215   MedicalResearch.com: What is the background for this study?  Any particular types of vitamins, ie with/without iron etc? Response: Preserving memory and cognitive health is a high priority for most mid-life and older adults.  However, few strategies have been rigorously tested in randomized clinical trials and shown to have cognitive benefits. Nutritional approaches hold promise because the brain requires several nutrients for optimal health, and deficiencies in one or more of these nutrients may lead to accelerated memory loss and cognitive decline. The COcoa Supplement and Multivitamin Outcomes Study (COSMOS), a large-scale nation-wide randomized trial of multivitamins and cocoa flavanols had recently reported that multivitamins slowed global cognitive decline and memory loss (in COSMOS-Mind). The current study was a 2nd parallel trial, a collaboration between Brigham and Women’s Hospital and Columbia University, looking at a web-based assessment of the role of a  standard multivitamin and of cocoa flavanols in slowing age-related memory loss. The report in AJCN is on the multivitamin-cognition findings. The multivitamin tested was Centrum silver for adults (without iron). (more…)
Author Interviews, Brigham & Women's - Harvard, Melatonin, Pediatrics, Sleep Disorders / 28.09.2022

MedicalResearch.com Interview with: Rebecca Robbins, Ph.D. Instructor in Medicine Associate Scientist, Division of Sleep and Circadian Disorders Investigator, Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Teens face myriad challenges to sleep, ranging from biological factors, including a preference for later bedtimes and increased need for sleep, to social factors, including social pressures and increased academic workloads, all limiting teenagers in their ability to keep a healthy sleep schedule. In a nationally representative sample, we explored the prevalence of another potential barrier to sleep among teens, which are a set of beliefs that are held in the population, yet are actual counter to scientific principles regarding sleep and circadian rhythms. (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus / 23.06.2022

MedicalResearch.com Interview with: SCOTT DRYDEN-PETERSON, MD Assistant Professor, Medicine, Harvard Medical School Research Affiliate, Immunology and Infectious Diseases Harvard T.H. Chan School Of Public Health Associate Physician, Medicine, Infectious Diseases Brigham And Women's Hospital Research Associate, Botswana Harvard AIDS Institute MedicalResearch.com:  What is the background for this study?  Response: The combination of the antiviral medicine nirmatrelvir and ritonavir (Paxlovid) which boosts antiviral levels was found to reduce the need for hospitalization by nearly 90% among unvaccinated people. Whether nirmatrelvir plus ritonavir can also help vaccinated people was uncertain. (more…)
Author Interviews, Brigham & Women's - Harvard, Neurology, Parkinson's / 21.06.2022

MedicalResearch.com Interview with: Vikram Khurana, MD, PhD Chief of the Division of Movement Disorders Department of Neurology Brigham and Harvard Medical School Principal investigator, Ann Romney Center for Neurologic Diseases at the Brigham MedicalResearch.com:  What is the background for this study?   Response: Proteins abnormally accumulate in brain cells (neurons and glial cells) in all neurodegenerative diseases. In Parkinson’s disease and related disorders, the key protein that accumulates and aggregates is called “alpha-synuclein.” Presumably, when a protein like alpha-synuclein abnormally folds and aggregates, the abnormal form of the protein can become toxic to the neuron, eventually leading to cell death. Equally, the protein may no longer be able to carry out its normal function. This begs the question – what does alpha synuclein actually do? Most evidence to date points to alpha-synuclein being involved in the transport of other proteins and chemicals around the cell, by closely associating with vesicles that are small circular containers enclosed by fat (“lipid) membranes. But alpha-synuclein is not just found associated with these vesicle membrane. It is found away from the membrane and it’s been unclear what it does there. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA / 09.06.2022

MedicalResearch.com Interview with: Benjamin N. Rome MD Instructor, Harvard Medical School Internal Medicine Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital MedicalResearch.com:  What is the background for this study? What are the main findings?  Response: Manufacturers of brand-name drugs are granted periods, free from direct competition, during which they can set and raise prices as they choose. We found that the prices for newly marketed brand-name drugs increased by 20% per year from 2008 to 2021. In 2020 and 2021, nearly half of new drugs were launched at a price greater than $150,000 per year, compared with 9% of drugs in 2008-2013. These dramatic trends are only partly explained by changes in the types of drugs coming to market. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Genetic Research, Nature / 18.04.2022

MedicalResearch.com Interview with: Jason Vassy, MD, MPH Brigham and Women's Hospital Division of General Internal Medicine & Primary Care Brigham’s Precision Population Health at Ariadne Labs and VA Boston  MedicalResearch.com:  What is the background for this study?    Response: A person’s risk of developing diseases such as type 2 diabetes or breast cancer may be influenced by thousands of genetic differences, the effects of which can be combined to derive a single score, often called a polygenic risk score (PRS). PRS might be useful to help patients and their physicians make tailored decisions about their health care, but several challenges to the clinical implementation of PRS remain. Most importantly, most PRS are less accurate in individuals of non-European descent, since most genomic research to date has been conducted in European populations. Another key challenge is that physicians and patients will need support to understand polygenic risk score and use them to make medical decisions. Clinical guidelines do not yet exist to help a physician know whether and how they should treat a patient with a high-risk score differently than an average-risk patient. We designed the Genomic Medicine at VA (GenoVA) Study to address some of these challenges. (more…)
Author Interviews, Brigham & Women's - Harvard, Neurology, Pain Research / 29.03.2022

MedicalResearch.com Interview with: William R. Renthal, MD, PhD Director of Research, John R. Graham Headache Center Department of Neurology Brigham and Women's Hospital Assistant Professor of Neurology, Harvard Medical School MedicalResearch.com:  What is the background for this study?  Response: We know that a nervous system structure called the trigeminal ganglion plays a critical role in migraine headache, but the cell types that exist in this structure are poorly understood. We have used cutting-edge, single-cell genomic technologies to profile the genes expressed within each trigeminal ganglion cell type in both human and mouse with the goal of identifying molecular features that could allow us to inhibit head pain selectively without affecting other cell types. (more…)
Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Sleep Disorders / 18.03.2022

MedicalResearch.com Interview with: Peng Li, Ph.D. Assistant Professor of Medicine, Harvard Medical School Research Director, Medical Biodynamics Program (MBP) Division of Sleep and Circadian Disorders Associate Physiologist, Brigham and Women's Hospital MedicalResearch.com:  What is the background for this study?  Response: People commonly see increased sleep during daytime in older adults. In people with Alzheimer’s disease or dementia, daytime drowsiness or sleepiness are even more common. Prior studies have showed protective effects of short naps on cognitive performance and alertness acutely, while also there are studies that have demonstrated more daytime naps are associated with faster cognitive decline in the long-term. We sought to investigate whether daytime napping behavior predicts future development of Alzheimer’s dementia. And we noted that there had been no studies to date that have documented the longitudinal profile of daytime napping during late life objectively. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Chocolate, Heart Disease, Supplements / 16.03.2022

MedicalResearch.com Interview with: Howard D. Sesso, ScD, MPH Associate Professor of Medicine Division of Preventive Medicine Brigham and Women's Hospital MedicalResearch.com:  What is the background for this study? How does the amount of flavanols in the study arm compare to what might be obtained in a typical diet? Response: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a randomized, double-blind, placebo-controlled clinical trial that tested the effects of two promising dietary supplements on cardiovascular disease (CVD) and cancer in 21,442 older adults. Cocoa flavanols have been shown to have favorable vascular effects in small and short-term clinical trials. The 500 mg/day flavanols tested in COSMOS exceeds that readily obtained in the diet typically from cocoa, tea, grapes, and berries. Of note, flavanol content in not typically listed on food labels. COSMOS also tested a multivitamin, the most common dietary supplement taken by US adults and previously linked with a potential modest reduction in cancer in a previous long-term trial of men conducted by our research group at the Division of Preventive Medicine at Brigham and Women’s Hospital. (more…)
Author Interviews, Brigham & Women's - Harvard, Circadian Rhythm, Diabetes, Occupational Health, Science, Weight Research / 06.12.2021

MedicalResearch.com Interview with: Sarah L. Chellappa, MD PhD Medical Chronobiology Program Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women’s Hospital Division of Sleep Medicine, Harvard Medical School Boston, MA Department of Nuclear Medicine Faculty of Medicine and University Hospital Cologne University of Cologne, Cologne, Germany. Frank A.J.L. Scheer, M.Sc., Ph.D. Professor of Medicine. Medical Chronobiology Program Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women’s Hospital Division of Sleep Medicine, Harvard Medical School Boston, MA MedicalResearch.com: What is the background for this study? Would you explain the difference between the central circadian ‘clock’ and endogenous circadian glucose rhythms?  Response: Night work increases diabetes risk. This increased risk is not fully explained by differences in lifestyle, family history, and/or socioeconomic status, thus other mechanisms are likely involved. Laboratory studies in humans have shown glucose intolerance in both non-shift workers and shift workers exposed to simulated night work. Animal experimental data suggests that this may be in part due to a misalignment between central and peripheral rhythms. Central circadian rhythms (e.g., body temperature) are primarily modulated by the central circadian “clock”, which is located in the brain’s suprachiasmatic nucleus and is responsible for synchronizing our physiology and behavior with the 24-hour cycle. Peripheral rhythms, including endogenous circadian glucose rhythms, are likely modulated by peripheral “clocks” across the body that play an integral role in modulating the circadian expression of physiology, including metabolic functions. These central and peripheral clocks share a common molecular mechanism underlying their circadian rhythm generating capacity, including transcription-translation feedback loops of circadian “clock” genes.  (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lipids / 16.11.2021

MedicalResearch.com Interview with: Nicholas A. Marston, MD, MPH Thrombolysis in Myocardial Infarction (TIMI) Study Group Brigham and Women’s Hospital Harvard Medical School Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: There has been recent debate about how much of lipid-associated cardiovascular risk is from LDL cholesterol versus triglycerides. However, genetic studies suggest that apolipoprotein B is actually the primary driver of atherosclerotic risk. Since there is exactly one apoB lipoprotein on each lipid particle (LDL, IDL, VLDL), its measurement is a surrgate for the total number of apoB-containing lipoproteins. So in this study, we asked the question: Do common measures of cholesterol concentration, triglyceride concentration, or their ratio carry predictive value for cardiovascular risk beyond the number of apo-B containing lipoproteins? (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Kidney Disease, Transplantation / 27.09.2021

MedicalResearch.com Interview with: Joel T. Adler, MD, MPH Department of Surgery, Brigham and Women’s Hospital Center for Surgery and Public Health Brigham and Women’s Hospital Boston, Massachusetts  MedicalResearch.com: What is the background for this study? Response: For patients who require renal replacement therapy for failed kidneys, kidney transplantation increased length of life and improves quality of life.  For many of these patients, their dialysis centers are the source of referral for evaluation for transplantation.  These dialysis centers have a number of publicly-reported quality measures, but they largely focus on the provision of dialysis care and not how often the centers’ patients undergo a kidney transplant.  Because these higher-rated facilities provide better dialysis care, we wanted to know if that benefit also spilled over into higher transplant listing rates. (more…)
Author Interviews, Brigham & Women's - Harvard, Electronic Records, JAMA, Pediatrics, Primary Care / 09.07.2021

MedicalResearch.com Interview with: Lisa Rotenstein, MD, MBA Assistant Medical Director Population Health and Faculty Wellbeing Department of Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Our previous work in JAMA Internal Medicine demonstrated significant differences in time spent on the electronic health record (EHR) by specialty, and specifically showed that primary care clinicians spent significantly more total and after-hours time on the EHR than surgical and medical specialty counterparts. Primary care clinicians spent twice as long as surgical colleagues on notes, and received more than twice as many messages from team-mates, five times as many patient messages, and fifteen times as many prescription messages each day. Given these findings, the heavy administrative burden placed on primary care clinicians, and previous data about burnout among primary care clinicians, we wanted to better understand differences in time spent on the EHR among the different types of primary care clinicians. (more…)
Author Interviews, Brigham & Women's - Harvard, Medical Imaging, Neurological Disorders / 02.07.2021

MedicalResearch.com Interview with: Michael Ferguson, PhD Instructor in Neurology | Harvard Medical School Lecturer on Neurospirituality | Harvard Divinity School Center for Brain Circuit Therapeutics Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? Response: Over 80% of the global population consider themselves religious with even more identifying as spiritual, but the neural substrates of spirituality and religiosity remain unresolved. MedicalResearch.com: What are the main findings? Where is this circuit located in the brain? What other effects does this circuit control or influence? Response: We found that brain lesions associated with self-reported spirituality map to a human brain circuit centered on the periaqueductal grey. (more…)
Author Interviews, Brigham & Women's - Harvard, Chocolate, Weight Research / 24.06.2021

MedicalResearch.com Interview with: Frank A. J. L. Scheer, PhD, MSc, Neuroscientist and Marta Garaulet, PhD, Visiting Scientist Division of Sleep and Circadian Disorders Departments of Medicine and Neurology, Brigham and Women's Hospital. MedicalResearch.com: What is the background for this study? Response: We and others have shown that not only “what” but also “when” we eat relates to obesity and weight loss
  • Meal timing can influence circadian rhythms and eating a high energy and high sugar food, such as chocolate, either at night or in the morning may have a different effect on the circadian system, and consequently on body weight and metabolism.
  • Milk chocolate has a name for contributing to weight gain due to its high fat, sugar and caloric content. Chocolate eating habit has been associated with long-term weight gain especially in postmenopausal females who are particularly vulnerable to weight gain.
(more…)
Author Interviews, Brigham & Women's - Harvard, Journal Clinical Oncology, Prostate Cancer, Radiation Therapy / 04.06.2021

MedicalResearch.com Interview with: Anthony D'Amico, MD, PhD Professor and Chief of Genitourinary Radiation Oncology Brigham and Women's Hospital and Dana-Farber Cancer Institute MedicalResearch.com: What is the background for this study? Response: 3 randomized trials published in Sept, 2020 in the Lancet and Lancet Oncology concluded that delivering radiation therapy (RT) after surgery for prostate cancer   when the PSA rises signaling recurrence (i.e. early salvage RT) as opposed to when the PSA is undetectable (i.e. adjuvant RT) did not compromise subsequent cancer progression. However these trials may have missed the benefit of adjuvant RT because a minority of men (9 to 17% of the study cohorts) were found to have adverse factors at prostatectomy which are associated with cancer progression and death from prostate cancer. Specifically, men with adverse pathology at prostatectomy comprise the vast majority of men who go on to die from prostate cancer and therefore have the most to gain from adjuvant RT. Yet, given the results of the 3 randomized trials many physicians are no longer offering adjuvant RT, even in men with adverse pathology at surgery. (more…)
Author Interviews, Brigham & Women's - Harvard, Clots - Coagulation, Hematology, Neurological Disorders, Pain Research / 22.05.2021

MedicalResearch.com Interview with: Daniel Chasman, PhD Pamela Rist, ScD, Yanjun Guo, MD, PhD Division of Preventative Medicine Brigham and Women’s Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been speculation in the field about relationships between coagulation and migraine susceptibility for some time, but previous research has been largely inconclusive. In this study, we leveraged Mendelian randomization, a mode of genetic analysis that can support or refute potential causal effects on a health outcome, to examine whether hemostatic factors may contribute to risk of MA. (more…)
Asthma, Author Interviews, Brigham & Women's - Harvard, Race/Ethnic Diversity / 09.05.2021

MedicalResearch.com Interview with: Justin Salciccioli, MBBS, MA Research Fellow in Medicine Elliot Israel, MD Professor of Medicine, Harvard Medical School Pulmonary and Critical Care, Rheumatology, Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Asthma attacks account for almost 50% of the cost of asthma care, which costs $80 billion each year in the United States. Asthma is more severe in African-American/Black and Hispanic/Latinx patients, with these groups having double the rates of attacks and hospitalizations as the general population. The PREPARE study is an ongoing national clinical trial for African American/Black and Hispanic/Latinx adults with moderate-to-severe asthma from different U.S. cities in which reporting of asthma control and asthma exacerbations was monitored entirely remotely. With the arrival of the Covid19 pandemic, several studies suggested that asthma exacerbations may have decreased during the pandemic. However, multiple reports have suggested people were avoiding health services because of the pandemic, making it difficult to tell whether exacerbations truly decreased or whether people were simply avoiding their doctors. This is the first study done to assess asthma exacerbations before and during the pandemic that is unlikely to be impacted by patient healthcare avoidance. (more…)
Author Interviews, Genetic Research, Parkinson's / 06.05.2021

MedicalResearch.com Interview with: Clemens R. ScherzerClemens R. Scherzer, M.D. Center for Advanced Parkinson Research Harvard Medical School Brigham and Women’s Hospital Boston, MA MedicalResearch.com: What is the background for this study? Response: Parkinson's disease is the fastest growing brain disorder. The number of patients is projected to double to 14 million by 2040. The total cost of Parkinson's is $52 billion every year in the U.S. Yet, there are no medicines available to slow the disease. Current treatments temporarily alleviate symptoms, but do not address the underlying disease process, which continues to relentlessly progress. To begin to solve this puzzle, we searched the genome of 3,821 Parkinson's disease patients for genetic variants linked to rapid progression over time to dementia, which is a major determinant for a Parkinson's disease patient’s quality of life. These patients were deeply characterized in the International Genetics of Parkinson Disease Progression (IGPP) Consortium, a grass-roots, collaborative network of Parkinson’s investigators, with 31,578 longitudinal study visits over up to 12 years from disease onset.  (more…)
AACR, Author Interviews, Brigham & Women's - Harvard, Cancer Research, Nutrition, Prostate Cancer / 10.04.2021

MedicalResearch.com Interview with: Dr. Anna Plym PhD Postdoctoral Research Fellow Brigham and Women's Hospital Harvard T.H. Chan School of Public Health  MedicalResearch.com: What is the background for this study? What are the main elements of the healthy lifestyle? Response: Prostate cancer is the most heritable of all cancers, with genetic factors accounting for a large proportion of cases. Although we do not currently know about all the genetic factors contributing, a recent study identified 269 genetic markers for prostate cancer, validated in multiple independent populations (Conti et al., Nature Genetics 2021, Plym et al, JNCI, 2021: https://academic.oup.com/jnci/advance-article-abstract/doi/10.1093/jnci/djab058/6207974). Based on a polygenic risk score derived from these 269 markers, we observed that men with a high polygenic risk score have over a 50% risk of developing prostate cancer within their lifetime. With this excess risk in mind, we were interested in possible ways in which the genetic risk of prostate could be attenuated. An increasing number of studies have suggested that lifestyle factors can affect the risk of lethal prostate cancer – however, these studies have seldom incorporated genetic factors. We know from other diseases that a healthy lifestyle is of benefit for individuals at high genetic risk, and we hypothesized that this would be the case for prostate cancer as well. In this study, we examined a healthy lifestyle score for lethal prostate cancer consisting of six components: healthy weight (BMI < 30), not smoking (never smoked or quit > 10 years ago), vigorous physical exercise (3 or more hours per week), high intake of tomatoes or tomato-based products (7 servings or more per week), high intake of fatty fish (1 or more serving per week) and low intake of processed meat (less than 3 servings/week of beef or pork hot dogs, bacon, salami, bologna, or other processed meat sandwiches) (Kenfield et al, JCO, 2016).  (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus / 25.03.2021

MedicalResearch.com Interview with: Hesam Dashti, PhD Brigham and Women's Hospital, Harvard Medical School Senior Computational Scientist The Broad Institute of MIT and Harvard  MedicalResearch.com: What is the background for this study? What parameters does the SARS2 score take into consideration? Response: While complex models have been developed for predicting the severity of COVID-19 from the medical history, laboratory, and imaging results of patients, simplified models with similar accuracy would be more practical for individualizing the decision making, especially when detailed medical history of patients is not readily available. In this study, we developed the SARS2 risk equations for estimating risk of hospitalization of patients with COVID-19 and also the risk of mortality among hospitalized patients. The “SARS2” risk equations are named for their input variables: Sex, Age, Race, Socioeconomic and Smoking status. To develop and validate the models, we used the electronic records from 12,347 patients who tested positive for COVID-19 at the Mass General Brigham medical centers in Massachusetts between 02/26/2020 and 07/14/2020 to construct derivation and validation cohorts for estimating 1) risk of hospitalization within 30 days of COVID-19 positive PCR test, and 2) for the hospitalized patients, risk of mortality within approximately 3 months. (more…)
Author Interviews, Brigham & Women's - Harvard, Endocrinology, Insomnia, Menopause, Sleep Disorders, Weight Research / 23.03.2021

MedicalResearch.com Interview with: Leilah K. Grant, PhD Postdoctoral Research Fellow in Medicine Brigham and Women’s Hospital Harvard Medical School  MedicalResearch.com: What is the background for this study? Response: The prevalence of obesity increases in women around the age of menopause which increases the risk of diseases like diabetes and heart disease. Changes in hormones, like estrogen, are thought to contribute to weight gain during menopause, but other common symptoms of menopause such as sleep interruption may also play a role. While short sleep is known to adversely affect metabolism, little is known about the metabolic consequences of the type of sleep disruption most common in menopausal women – increased nighttime awakenings (i.e., sleep interruption) caused by hot flashes, but no change in overall sleep duration. We therefore did this study to see how an experimental model menopause-related sleep interruption would affect metabolic outcomes that may contribute to weight gain.  (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus / 17.03.2021

MedicalResearch.com Interview with: Benjamin E. Gewurz MD, PhD Broad Institute of MIT and Harvard, Cambridge, Division of Infectious Disease, Department of Medicine, Brigham and Women’s Hospital, Department of Microbiology, Harvard Medical School Boston, MABenjamin E. Gewurz MD, PhD Broad Institute of MIT and Harvard, Cambridge, Division of Infectious Disease, Department of Medicine, Brigham and Women’s Hospital, Department of Microbiology, Harvard Medical School Boston, MA  MedicalResearch.com: What is the background for this study? Response: When the Covid-19 virus infects cells, it takes over and redirects our cells resources towards the projection of virus building blocks and new viruses.  Building blocks include large amounts of RNAs that encode for the viral proteins, much as the mRNA vaccines direct our bodies to make the spike protein. We wondered how the virus changes cell metabolism in order to support the synthesis of vast amounts of viral RNAs within hours of infection. (more…)
Author Interviews, Brigham & Women's - Harvard, Kidney Disease, Transplantation / 12.03.2021

MedicalResearch.com Interview with: Jamil R. Azzi MD Associate Professor of Medicine, Harvard Medical School Medical Director, Vascularized Composite Allotransplantation Associate Director, Kidney and Pancreas Transplantation Director, Kidney Transplant Fellowship Engineering in Medicine, Brigham and Women’s Hospital Renal Division, Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Would you explain what is meant by an exosome?  Response: Kidney transplant recipients are always at risk of developing rejection where the immune system recognizes the transplanted kidney as “foreign body” and attacks it. The risk is up to 20% the first year after transplant and many more develop chronic rejection which ultimately leads to kidney failure. Currently, most clinicians monitor for kidney rejection by measuring serum creatinine and urine protein. However, creatinine is neither sensitive nor specific for rejection. On the other hand, performing kidney biopsies to make accurate diagnosis of rejection is invasive and has many complications. In our study, when clinicians decided on performing biopsies based on the clinical informations they have including changes in serum creatinine, the biopsies did not show rejection in almost 70% of the cases. Furthermore, serum creatinine can remain stable while the patient may be undergoing a rejection (subclinical rejection). In fact, some centers currently perform routine biopsies at different time points for all their patients regardless of creatinine despite the high risks, costs and inconveniences of doing biopsies. Out of this frustration with the current tools, we have been working on novel technologies to diagnose rejection through the urine. The idea started from the bench as we were studying exosomes, those are tiny vesicles (less than 100 nm in size) released by all cells. We were interested on how immune cells communicate via those vesicles so we developed assays to identify them. We then showed that if immune cells are invading the kidney during rejection, vesicles derived from those immune cells are found in the urine. This gave us the idea of developing a urine test based on these findings. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Stem Cells / 05.03.2021

MedicalResearch.com Interview with: Khalid Shah, MS, PhD Vice Chair of Research, Department of Neurosurgery Director, Center for Stem Cell Therapeutics and Imaging Director, Center for Excellence in Biomedicine Brigham and Women's Hospital Associate Professor, Harvard Medical School Principal Faculty, Harvard Stem Cell Institute  MedicalResearch.com: What is the background for this study? Response: Approximately 15-to-30 percent of patients with metastatic breast cancer have brain metastasis (BM), with basal-like breast cancer (BLBC) metastasizing to the brain most frequently. The prognosis for BLBC-BM patients is poor, as the blood-brain barrier prevents most therapeutics from reaching the brain. Testing candidate therapies in clinical trials is also challenging because animal models that mimic BM are limited. In this study we engineered a bimodal tumor-suppressing and killing molecule that can be delivered to the brain by stem cells and tested them in mouse models of brain metastases that mimic clinical setting. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, COVID -19 Coronavirus, Electronic Records, JAMA, Technology / 04.03.2021

MedicalResearch.com Interview with: Carlo Giovanni Traverso, MB, BChir, PhD Associate Physician, Brigham and Women's Hospital Assistant Professor, Peter R. Chai, MD, MMS Emergency Medicine Physician and Medical Toxicologist Harvard Medical School Brigham and Women's Hospital Department of Medicine   Dr-Spot-HealthCare-Assistant.jpgMedicalResearch.com: What is the background for this study? What are some of the functions that Dr. Spot can facilitate? Response: During the COVID-19 pandemic, we wanted to consider innovative methods to provide additional social distance for physicians evaluating low acuity individuals who may have COVID-19 disease in the emergency department. While other health systems had instituted processes like evaluating patients from outside of emergency department rooms or calling patients to obtain a history, we considered the use of a mobile robotic system in collaboration with Boston Dynamics to provide telemedicine triage on an agile platform that could be navigated around a busy emergency department. Dr. Spot was built with a camera system to help an operator navigate it through an emergency department into a patient room where an on-board tablet would permit face-to-face triage and assessment of individuals. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Nature / 04.02.2021

MedicalResearch.com Interview with: Dr. Hugo Aerts, PhD Dana-Farber Cancer Institute Associate Professor, Brigham and Women's Hospital Harvard Medical School Director, Program for Artificial Intelligence in Medicine Brigham And Women's Hospital  MedicalResearch.com: Deep convolutional neural networks to predict cardiovascular risk from computed tomography  Response: Cardiovascular disease is the most common preventable cause of death in Europe and the United States. Effective lifestyle and pharmacological prevention is available, but identifying those who would benefit most remains an ongoing challenge. Hence, efforts are needed to further improve cardiovascular risk prediction and stratification on an individual basis. One of the strongest known predictors for adverse cardiovascular events is coronary artery calcification, which can be quantified on computed tomography (CT). The CT coronary calcium score is a measure of the burden of coronary atherosclerosis and is one of the most widely accepted measures of cardiovascular risk. Recent strides in artificial intelligence, deep learning in particular, have shown its viability in several medical applications such as medical diagnostic and imaging, risk management, or virtual assistants. A major advantage is that deep learning can automate complex assessments that previously could only be done by radiologists, but now is feasible at scale with a higher speed and lower cost. This makes deep learning a promising technology for automating cardiovascular event prediction from imaging. However, before clinical introduction can be considered, generalizability of these systems needs to be demonstrated as they need to be able to predict cardiovascular events of asymptomatic and symptomatic individuals across multiple clinical scenarios, and work robustly on data from multiple institutions. (more…)
Author Interviews, Brain Injury, Brigham & Women's - Harvard / 03.01.2021

MedicalResearch.com Interview with: Nitin Joshi, Ph.D. Engineering in Medicine/Department of Medicine Brigham and Women's Hospital   Dr. Jeffrey M Karp Ph.D Principal Investigator Professor of Medicine at Brigham and Women’s Hospital Harvard Medical School MedicalResearch.com: What is the background for this study? Would you explain what is meant by the blood brain barrier? How will nanoparticles facilitate transport of drugs into the brain? Response: Over the past few decades, researchers have identified promising therapeutic agents that can target the biological pathways involved in brain diseases. Unfortunately, clinical translation of these therapeutics is limited by their inability to cross the blood brain barrier (BBB) and enter the brain at therapeutically effective levels. The BBB is a highly selective semipermeable border of cells that prevents molecules in the circulating blood from non-selectively crossing into the brain tissue. We have developed a simple targeted nanoparticle platform that can stably encapsulate therapeutic agents and enable their therapeutically effective delivery into the brain. In this work, we have demonstrated the utility of this platform for the treatment of traumatic brain injury (TBI), which is a leading cause of death and disability in children and young adults, with millions of people suffering TBI each year in accidents, sports, and military conflicts. Following primary injury, which is a result of the mechanical impact to the brain, secondary injury gradually occurs over months to years and can lead to neurological dysfunctions, including Alzheimer’s and Parkinson’s diseases. After TBI, the BBB is physically breached for a short time and previous approaches to achieve therapeutically effective transport of drugs across the BBB have been severely limited to utilizing this very short window. However, the extent to which the BBB is physically breached in TBI varies greatly across the patient population. Therefore, current approaches are applicable to only a subset of injuries with substantially breached BBB. Moreover, BBB can self-repair within a few hours to weeks post-injury to restore its integrity. Hence, physical breaching of BBB offers a limited window for therapeutic interventions, which is not ideal as the secondary injury can last months to years and may require repeated dosing over long term. The nanoparticle platform developed in this work can enable therapeutically effective delivery of drugs into the brain, irrespective of the state of the BBB. We achieved this by precise engineering of the surface properties of nanoparticles, which maximized their transport across the BBB. The therapeutic used in this study was a small interfering RNA (siRNA) molecule designed to inhibit the expression of the tau protein, which is believed to play a key role in neurodegeneration. Poly(lactic-co-glycolic acid), or PLGA, a biodegradable and biocompatible polymer used in several existing products approved by the U.S. Food and Drug Administration was used as the base material for nanoparticles. We systematically engineered and studied the surface properties of the nanoparticles to maximize their penetration across the intact, undamaged BBB in healthy mice. This led to the identification of a unique nanoparticle design that maximized the transport of the encapsulated siRNA across the intact BBB and also significantly improved the uptake by the brain cells.  (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, End of Life Care / 14.12.2020

MedicalResearch.com Interview with: Isaac Chua, MD, MPH Division of General Internal Medicine and Primary Care Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Patient surveys have shown that most people prefer to die at home at the end-of-life. However, during the initial wave of the COVID-19 pandemic, anecdotal evidence from our colleagues and findings from a prior study published in the Journal of the American Geriatrics Society suggested that majority of COVID-19 decedents died in a medical facility. However, less is known about care intensity at the end-of-life according to place of death among patients who died of COVID-19. Therefore, we characterized end-of-life care by place of death among COVID-19 decedents at Mass General Brigham (MGB), the largest health system in Massachusetts.  (more…)