MedicalResearch.com Interview with: John Tower, PhD Professor, Molecular and Computational Biology Program Department of Biological Sciences USC Dana and David Dornsife College of Letters,...
MedicalResearch.com Interview with:
Uzma Samadani, M.D., Ph.D.
Assistant Professor
Departments of Neuroscience and Physiology
NYU Langone Medical Center
Medical Research: What is the background for this study? What are the main findings?
Dr. Samadani: Research dating back as early as 3,500 years ago suggests the eyes serve as a window into the brain, with disconjugate eye movements -- eyes rotating in different directions -- considered a principal marker for head trauma. Current estimates suggest up to 90 percent of patients with concussions or blast injuries exhibit dysfunction in their eye movements.
We wanted to find a way to objectively track and analyze eye movements following a head injury to measure injury severity and replace the current “state of the art” method of asking a patient to follow along with a finger. CT-scans and MRIs may not necessarily reveal concussion or traumatic brain injury (TBI) in the absence of structural damage, presenting a need for a diagnostic measure of head injury severity.
In a study published earlier this year in the Journal of Neurosurgery, my team at the NYU Cohen Veterans Center tested our novel eye-tracking technology on military veterans, and found our device and tracking algorithm could reveal edema in the brain as a potential biomarker for assessing brain function and monitoring recovery in people with head injuries.
Our latest paper, published January 29 in Journal of Neurotrauma, looked at a civilian population of patients admitted to the Bellevue Medical Center emergency department in New York City, with whom the NYU School of Medicine has an affiliation agreement. We compared 64 healthy control subjects to 75 patients who had experienced trauma that brought them to emergency department. We tracked and compared the movements of patients' pupils for over 200 seconds while watching a music video.
We found that 13 trauma patients who had hit their heads and had CT scans showing new brain damage, as well as 39 trauma patients who had hit their heads and had normal CT scans, had significantly less ability to coordinate their eye movements than normal, uninjured control subjects. Twenty-three trauma subjects who had bodily or extremity injuries but did not require head CT scans had similar abilities to coordinate eye movements as normal uninjured controls.
Among patients who had hit their heads and had normal CT scans, most were slightly worse at 1-2 weeks after the injury, and subsequently recovered about one month after the injury. Among all trauma patients, the severity of concussive symptoms correlated with severity of disconjugacy.
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MedicalResearch.com Interview with:
Agnel Sfeir PhD Assistant Professor
Skirball Institute - NYU
New York, NY 10016
Medical Research: What is the background for this study? What are the main findings?
Dr. Sfeir: The main finding of this study, published in the journal Nature, is that inhibiting the action of a particular enzyme dramatically slows the growth of tumor cells tied to BRCA1 and BRCA2 genetic mutations which, in turn, are closely tied to breast and ovarian cancers.
This discovery about the enzyme — called polymerase theta, or PolQ — resulted from efforts to answer a fundamental biological question: How do cells prevent the telomere ends of linear chromosomes, which house our genetic material, from sticking together? Cell DNA repair mechanisms can stitch together telomeres broken as part of cell metabolism. But such fusions, the researchers say, compromise normal cell growth and survival.
In the purest biological sense, our findings (in experiments in mice and human cells) show how this particular enzyme, which we know is active in several tumors, promotes unwanted telomere fusions by inserting whole segments of DNA via a disruptive DNA repair pathway termed alt-NHEJ. It was quite remarkable to find that by blocking PolQ action, cancer cell growth was cut by more than half.
Additional experiments confirmed that PolQ is needed to activate the alt-NHEJ pathway of DNA repair. Unlike the main, error-free pathway — or HDR pathway — the alt-NHEJ pathway does not use a related chromosome’s genetic material as a template to meticulously correct any damaged genetic material. As such, alt-NHEJ is highly likely to leave coding mistakes.
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MedicalResearch.com Interview with:
Mark Slifstein, PhD
Associate Professor of Neurobiology (In Psychiatry) Dept. of Psychiatry
Columbia University NYSP
Dr New York NY 10032
MedicalResearch: What is the background for this study?
Dr. Slifstein: There has been considerable basic and clinical neuroscience research showing that the neurotransmitter dopamine plays a role in tuning cognitive processes taking place in the cortex. It has long been thought that dopamine is involved in the cognitive difficulties experienced by patients with schizophrenia, but it has been challenging to study dopamine in the cortex and other parts of the brain except in a deep structure rich in this neurotransmitter and its receptors, the striatum. In our study, we used an experimental design with Positron Emission Tomography (PET) imaging that allowed us to infer the amount of dopamine in the cortex.
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MedicalResearch.com Interview with:
Dr. Judy Stevens PhD
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
Medical Research: What is the background for this study? What are the main findings?
Dr. Stevens: Falls among people aged 65 and older are a serious, costly, and growing public health problem. As our population ages, falls will continue to increase unless we implement effective prevention strategies that are also cost-effective.
This study found that three evidence-based fall prevention programs, the Otago Exercise Program, Tai Chi: Moving for Better Balance, and Stepping On, were not only practical and effective but also provided a positive return on investment (ROI) or net benefit. An ROI of 150% means for each $1 spent on implementing the program, you can expect a net benefit of $1.50.
The analysis found that the cost of implementing each of these fall prevention programs was considerably less than the potential medical costs needed to care for someone injured from a fall. These research findings can help community organizations and policymakers identify and use programs that can both save lives and reduce costs.
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MedicalResearch.com Interview with:
Dr Stefan M Gold
Institute of Neuroimmunology and Multiple Sclerosis (INIMS)
Centre for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf
Hamburg, Germany
Medical Research: What is the background for this study? What are the main findings?
Dr. Gold: Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system (brain and the spinal cord). In addition to motor symptoms such as walking impairment, patients with Multiple sclerosis frequently suffer from psychological problems including difficulties with learning and memory as well as depressed mood. Depression is particularly common in this patient group with a 3-4 fold elevated risk for developing major depressive disorder compared to the general population. Depression in Multiple sclerosis is associated with decreased quality of life, absence from work, and numerous other psychosocial problems. Despite this major impact on patients’ lives, depression in Multiple sclerosis is often not adequately diagnosed and treated: Antidepressant medication in this patient group often has side effects and the neurological problems associated with MS such as difficulties with concentration and fatigue make it particularly difficult for MS patients to complete “classical” depression treatments such as psychotherapy. The goal of our study was to make psychological treatments available for the many patients with Multiple sclerosis suffering from depression, who often have difficulties to find adequate treatment.
For this study, published in The Lancet Psychiatry, we conducted a randomized controlled trial of a fully-automated, computer-based program that can be accessed directly from patients’ homes over the internet. The program called “deprexis” was developed by the Hamburg-based company GAIA and uses methods of “cognitive behavioral therapy” or “CBT”. Ninety Multiple sclerosis patients were enrolled in the trial and randomly assigned to a 3 months therapy using the deprexis program or a waitlist control group. At the end of the intervention, depression had significantly decreased in the treatment group but remained unchanged in patients who did not have access to the program. In addition, patients using the computer program also reported reduced fatigue and improved quality of life. (more…)
Dr Matthew R Moore, MD
National Center for Immunization and Respiratory Diseases,
Centers for Disease Control and Prevention, Atlanta, GA, USA
MedicalResearch: What is the background for this study?
Dr. Moore: Since introduction, pneumococcal conjugate vaccines have resulted in dramatic decreases in the number of cases of invasive pneumococcal disease in both children and adults. The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced into the routine infant immunization program in the United States in 2000. It was recommended for infants using a 4-dose schedule: 2, 4, 6, and 12 through 15 months of age. Studies showed that PCV7 was highly effective in preventing invasive pneumococcal disease. In 2010, the 13-valent pneumococcal conjugate vaccine (PCV13) replaced PCV7 using the same 4-dose schedule. PCV13 is similar to PCV7, but includes protection against six additional serotypes of Streptococcus pneumoniae. There are more than 90 serotypes of pneumococcal bacteria.
Streptococcus pneumoniae, or pneumococcus, is a major cause of illness and death globally. Pneumococcus can cause many types of illness that ranging from mild to life-threatening, including pneumonia, ear and sinus infections, meningitis, and bacteremia. Some of these infections are considered invasive because they invade parts of the body that are normally free from bacteria. Invasive pneumococcal disease, including meningitis and bacteremia, is often severe and can be deadly.
MedicalResearch: What are the main findings?
Dr. Moore: Invasive pneumococcal disease decreased substantially in the first 3 years after PCV13 was introduced into the U.S. infant immunization schedule. By June 2013, more than 30,000 cases of invasive pneumococcal disease and 3,000 deaths are estimated to have been prevented in the United States due to PCV13. Children under the age of five, which is the age group that actually received the vaccine, experienced the greatest and quickest benefit from PCV13. For example, the overall number of cases of invasive pneumococcal disease decreased by 64% in this age group between 2010 and 2013. Significant decreases were seen as early as six months after the immunization recommendation was made.
Adults, who were not targeted for vaccination, also experienced health benefits from PCV13 introduction. For example, the overall number of cases of invasive pneumococcal disease decreased by 32% for adults aged 18 to 49 years, while adults 65 and older experienced a more modest 12% decrease. These reductions are further evidence that both PCV7 and PCV13 reduce the spread of pneumococcus, which is why vaccinating children leads to disease reductions in adults.
For both children and adults, the greatest reductions were seen in the number of cases of invasive pneumococcal disease that were caused by serotypes that are covered by PCV13 but not PCV7 (serotypes 19A and 7F specifically).
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MedicalResearch.com Interview with
John Holcomb, M.D.
Principal investigator, Retired U.S. Army Surgeon
Director of the Division of Acute Care Surgery
The University of Texas Health Science Center at Houston
UTHealth Medical School
MedicalResearch: What is the background for this study?
Dr. Holcomb: This study is the result of two decades of work by literally hundreds of investigators. It started as an observation in 1993 in Somalia that whole blood was a superior resuscitation product in casualties that were bleeding to death. Unfortunately, whole blood is not widely available, and 1:1:1 is the closest we can get at this time. After many studies from the battlefield, and even more in the civilian area, we have now published a randomized study documenting that 1:1:1 is a superior transfusion strategy, safe and helps prevent patients from bleeding to death.
MedicalResearch: What are the main findings?
Dr. Holcomb: The 1:1:1 resuscitation strategy significantly decreased the rate of bleeding to death, and there were no increased complications between groups.
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MedicalResearch.com Interview with:
Robert Hutchins, M.D., M.P.H.
Department of Medicine, Division of General Internal Medicine
UCSF
Medical Research: What is the background for this study? What are the main findings?
Dr. Hutchins: "Utility" refers to the effect on quality of life that a certain intervention carries and a utility value generally varies from 0-1.0. The more negative the effect is, the lower the utility value (closer to 0), and the less it affects quality of life, the closer to 1.0 it is. On a theoretical scale, "perfect health" is 1.0 and death is 0. There are a number of studies that -- USE a utility value for taking pills, generally between 0.95 and 1.0. However, many cost-effectiveness analyses ignore the utility value altogether, or arbitrarily choose 1.0 as the utility. We found that a small change in the utility value can have a very large effect on the overall cost-effectiveness of an intervention. We found that the utility value of taking pills, assessed by three different commonly used methods, to be 0.990-0.994, depending on the method.
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MedicalResearch.com Interview with:
Dr. Ryan Merkow, M.D. M.S.
American College of Surgeons
Chicago, Illinois
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Merkow: The measurement of hospital readmissions has become an important quality and cost-containment metric. Hospitals, policy makers, and individual practitioners are closely tracking readmissions. For the past decade the focus has been primarily on three medical conditions (pneumonia, heart failure and myocardial infarction) and although controversial, many thought leaders and policy makers believed that readmissions were preventable, and stemmed from poor transition of care, outpatient follow up or simply a failure of the medical system to appropriately care for these patients. Recently, the Center for Medicare and Medicaid Services has become increasingly interested in using readmissions as a quality measure and is now mandated by the Hospital Readmission Reduction Program to track hospital-wide readmissions (including all surgical patients), and for the first time, after individual surgical procedures (i.e., total hip and knee replacement). Future inclusion of additional surgical procedures is anticipated.
However, despite the growing focus on readmissions after surgery, there have been few studies comprehensively evaluating the underlying reasons and factors associated with readmissions after surgical hospitalizations. Furthermore, the relationship between readmissions and complications that occur during the initial hospitalization after surgery is not clearly established. Importantly, unlike medical conditions, surgical patients undergo a discrete invasive event with known risks of complications. By studying this topic, initiatives to decrease readmissions can be more precisely determined, and national policy decisions that are now targeting readmissions can be appropriately formulated.
The primary findings of our study identified surgical site infections as the most frequent reason that patients are readmitted after surgery, Importantly, in >95% of patients this complication was new, occurring after they left the hospital. The other common reason for readmission was obstruction or ileus, which was the second most frequent reason for readmission, particularly after abdominal surgery. Overall, the vast majority of readmissions were the result of new postdischarge, postoperative complications. With respect to factors associated with readmissions, most of the variation was due to differences in patient factors, such as ASA class, renal failure, ascites and/or steroid use.
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MedicalResearch.com Interview with:
Dr. Jean-Pol Frippiat
Stress, Immunity and Pathogens Laboratory
Lorraine University
Vandoeuvre-lès-Nancy, France
What is the background for this study? What are the main findings?
Dr. Frippiat: Osteoporosis is associated to spaceflight. Consequently, we wondered whether changes in bone micro-structure induced by a ground-based model of spaceflight, hindlimb unloading (HU) that simulates some of the effects of spaceflight on mice, induces changes in B lymphocyte production in the bone marrow.
To this end, we analyzed both bone parameters and the frequency of cells of the B lineage in the bone marrow of young, old and HU mice. We found that HU leads to a decrease in both bone micro-structure and the frequency of B cell progenitors in the bone marrow. A major block at the pro-B to pre-B cell transition was observed indicating a decrease in the formation of B cells in the bone marrow. Interestingly, the modifications in B cell production were similar to those observed in aged mice.
These findings demonstrate that mechanical unloading, to which astronauts are subjected during spaceflight, results in a decrease in B cell differentiation that resemble age-related modifications in B lymphopoiesis.
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MedicalResearch.com Interview with:
Adeel A. Butt, MD, MS, FACP, FIDSA
Adjunct Associate Professor of Medicine and Clinical and Translational Science
University of Pittsburgh School of Medicine
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Butt: Studying clinical consequences of hepatitis C virus (HCV) infection is often limited by the lack of knowledge of actual time of infection. We used the Electronically Retrieved Cohort of HCV-Infected Veterans (ERCHIVES), a well-established national cohort of HCV infected veterans and corresponding HCV-uninfected controls, to identify patients with a known time frame for HCV infection. Our primary aim was to determine the rate of liver fibrosis progression among HCV-infected persons over time, with and to determine factors associated with development of cirrhosis and hepatic decompensation among these persons.
Among 1840 persons who were HCV+ and 1840 HCV− controls, we found that fibrosis progression started early after HCV infection tapered off after 5 years. After 10 years of follow-up, 18.4% of HCV+ and 6.1% of HCV- persons developed liver cirrhosis. Nine years after diagnosis of cirrhosis, only 1.8% of HCV+ and 0.3% of HCV- persons had developed hepatic decompensation.
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MedicalResearch.com Interview with
Gavin M. Bidelman, Ph.D.
Assistant Professor Institute for Intelligent Systems
School of Communication Sciences & Disorders
University of Memphis
Memphis, TN 38105
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Bidelman: Musical training as been shown to enhance brain function and impact behavioral skills (e.g., speech and language functions) in younger adults. In the current study, we investigated whether or not these advantages extend to older brains, which are thought to be less "plastic" (i.e., less malleable to experience/training). Older adults also often experience reduced speech recognition abilities later in life so we wanted to see if musicianship can serve as an effective means to bolster speech listening skills that decline across the lifespan.
Main findings:
1) On average, older musicians were 20% faster in identifying speech sounds behaviorally than their nonmusician peers. Interestingly, this is similar to the benefit we have observed in young people with musical training.
2) We were able to predict how well people classify/identify speech via (EEG) brain activity in both groups. However, this brain-behavior correspondence was ~2-3x better in older musicians. In other words, old musicians' brains provide a much more detailed, clean, and accurate depiction of the speech signal which is likely why they are much more sensitive to speech behaviorally.
3) We compared neural responses generated from multiple levels of the auditory system and found that musicians had more coordination (significantly higher correlations) between different regions. This implies that the "musical brain" operates more in concert than in non-musicians.
All of these findings challenge conventional views that older brain's are no longer plastic, are somehow noisier, and show poorer coordination across brain regions. In fact we show just the opposite. In older brains, musicianship does produce pervasive plasticity, provides cleaner (less noisy) representations of speech, and orchestrates more neural coordination.
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MedicalResearch.com Interview with:
Peter Bayley PhD
War Related Illness and Injury Study Center
Veteran Affairs Palo Alto Health Care System
Palo Alto, California
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Bayley: There is currently widespread interest and debate surrounding the topic of screening for Alzheimer’s disease and other types of dementia The study describes results from National Memory Screening Day in 2010, an annual community event sponsored by the Alzheimer Foundation of America. Face-to-face screening takes place in a private setting; only the individual being tested and the screener are present. The memory screening consists of one of seven validated cognitive tests: the GPCOG (General Practitioner Assessment of Cognition), MINI-COG, MIS (Memory Impairment Screen), the BAS (Brief Alzheimer’s Screening), Kokmen Short Test of Mental Status, Mini-Mental State Examination, Montreal Cognitive Assessment, or the Saint Louis University Mental Status Examination. Participants with scores below cutoff for possible dementia are encouraged to bring the results to their healthcare professional for follow-up and/or inclusion in medical files.
We report the results from a subset of 3,064 participants. Overall, 11.7% failed one of the memory screening tests. As expected, failure rates were higher in older and less-educated participants (P’s < .05). Subjective memory concerns were associated with a 40% greater failure rate for persons of similar age and education but no memory concerns (odds ratio = 1.4, 95% confidence interval = 1.07–1.78). However, most individuals who expressed concern about their memories passed the screening tests (54-96%, depending on age and education).
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MedicalResearch.com Interview with:
A/Prof Rana Hinman PhD
Australian Research Council Future Fellow
Centre for Health Exercise & Sports Medicine
Department of Physiotherapy School of Health Sciences
The University of Melbourne, Carlton, Victoria, Australia
Medical Research: What is the background for this study?
Response: It has been well established that hip and knee osteoarthritis (OA) is a major causes of musculoskeletal disease burden worldwide. There is currently no cure and joint replacement is typically reserved for advanced disease. Non-operative management strategies are the mainstay of osteoarthritis treatment. Clinical guidelines recommend the use of aerobic and/or resistance exercises, hydrotherapy and weight loss for those who are overweight for people with hip or knee osteoarthritis. Little is known about how often these treatments are used, and whether treatment use differs for those with hip osteoarthritis compared to those with knee osteoarthritis.
Medical Research: What are the main findings?
Response: The use of non-drug non-operative interventions was generally low amongst the entire cohort of people with hip or knee osteoarthritis. Although half reported making efforts to lose weight, very few were undertaking muscle strengthening, hydrotherapy or aerobic exercises, all of which are strategies most strongly endorsed by international guidelines. 12% of the cohort had never used any of the interventions listed in our survey.
Interestingly, use of five treatments was significantly higher among people with knee osteoarthritis than those with hip osteoarthritis, suggesting people with knee osteoarthritis may be more likely to try non-drug non-operative treatments than those with hip osteoarthritis, however there is no clear explanation for this.
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MedicalResearch.com Interview with:
Dmitry Yaranov, MD
Danbury Hospital
Western Connecticut Health Network
Medical Research: What is the background for this study? What are the main findings?
Dr. Yaranov: Obstructive sleep apnea (OSA) is an independent risk factor for ischemic stroke (CVA) that is not included in the usual cardioembolic risk assessments for patients with atrial fibrillation. The aim of this study was to investigate the impact of OSA on CVA rate in patients with atrial fibrillation. We found that Obstructive sleep apnea in patients with atrial fibrillation is an independent predictor of CVA and this association may have important clinical implications in CVA risk stratification. (more…)
MedicalResearch.com Interview with:
Timothy R. Smith, M.D., Ph.D., M.P.H.
Pituitary/Neuroendoscopy Fellow
Department of Neurosurgery
Brigham & Womens Hospital
Harvard University Boston, MA 0211
Medical Research: What is the background for this study? What are the main findings?
Dr. Smith: Defensive medicine is the practice of prescribing unnecessary medical treatment for fear of being sued – it is widely practiced in the United States and contributes to our rising healthcare costs. In high-risk specialties such as neurosurgery, the fear of litigation leads to defensive practices that actually impact clinical decisions. A 2009 American College of Emergency Physicians report created malpractice risk profiles for each state based on its legal atmosphere, tort reform, and insurance availability. Based on these profiles, each state was ranked from 1 to 50 and sorted into separate categories, ranging from A, for the best liability environment, to F, for the worst. We sent a 51-question, anonymous online survey, which covered topics ranging from patient characteristics to surgeon liability profiles, to board-certified US neurosurgeons in the American Association of Neurological Surgeons. The purpose was to determine how neurosurgeons’ perceptions of their medico-legal environments correlated with these established state risk profiles, as well as whether each state’s liability risk environment was a predictor of defensive medical practices.
We found that though the average malpractice insurance premium was $103,000 per year, neurosurgeons from high-risk states paid significantly more ($128,000) than those from low-risk states did ($75,000). Even with these amounts, almost 70% of respondents felt that their insurance coverage was inadequate, and 90% felt that the insurance premium was a financial burden. Neurosurgeons from high-risk states were also twice as likely to have been sued as those from low-risk states were. More than 80% of respondents ordered additional imaging for defensive medical purposes, and more than 75% said they ordered additional laboratory tests and made unnecessary referrals for defensive purposes; this behavior was more prevalent in high-risk states. After controlling for important confounders, we found that for every letter-grade change from “A” to “F”, neurosurgeons are 1.5 times more likely to engage in defensive behaviors. For example, moving from a “D” state to an “A” state represents 4.5 fold difference in defensive behaviors.
(more…)MedicalResearch.com Interview with: Byron Caughey, PhD Senior Investigator Rocky Mountain Laboratories National Institute for Allergy and Infectious Diseases National Institutes of Health Hamilton, Montana 59840 MedicalResearch: What...
MedicalResearch.com Interview with:
Richard J. Holden, PhD Assistant Professor
Department of BioHealth Informatics
Indiana University
School of Informatics and Computing – Indianapolis
Indianapolis, IN 46202
Medical Research: What was your motivation for this study?
Dr. Holden: Many patients arrive in the emergency room with acute heart failure (AHF), a worsening of their chronic heart failure condition. These visits and subsequent hospital admissions and readmissions for acute heart failure represent a sizeable cost in the US healthcare system. Evidence suggests that some of these cases could be prevented if patients were better able to perform self-care activities such as monitoring their symptoms, taking medications, getting exercise, and maintaining a sodium-restricted diet. However, in community-based studies that we and others have done, patients with heart failure face a variety of barriers to optimally performing self-care. We therefore created an instrument to assess barriers to self-care, which we designed to be implemented in the emergency room. We tested the instrument with 31 patients with acute heart failure at Vanderbilt University’s adult Emergency Department.
Medical Research: What are the main findings?
Dr. Holden: Almost everyone who participated reported experiencing barriers to self-care. A median of 15 barriers per patient were reported. Of the 47 barriers that we tested, 34 were reported by at least one quarter of participants. The top ten most prevalent barriers included individual-level factors such as physical disability, disease knowledge, and memory deficits as well as factors related to the organization of home life, including major disruptions such as holidays. Other barriers were related to inadequate health information, low literacy, and lack of resources. Many barriers interacted with one another, for example, lack of transportation yet not wanting to rely on others. We found that the instrument could be feasibly administered within a short period following the patient’s emergency room arrival.
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MedicalResearch.com Interview with:
Xuemei Sui, MD, MPH, PhD
Assistant Professor Department of Exercise Science
Graduate Director Division of Health Aspects of Physical Activity
Arnold School of Public Health University of South Carolina
Columbia, SC 29208
Medical Research: What is the background for this study?
Dr. Sui: Previous studies have established that low levels of cardiorespiratory fitness (CRF), an indicator of regular physical activity, and body compositions with higher fat mass serve as risk factors for cardiovascular disease and predictors of deaths related to cardiovascular disease. These studies have examined long-term trends of fatness (i.e., body fat) and cardiorespiratory fitness in children, adolescents and men, but few have looked at these factors in female populations. Therefore, the aim of this study was to investigate secular change of cardiorespiratory fitness and body composition during 35 years in a large sample of women enrolled in the Aerobics Center Longitudinal Study.
13 037 women aged 20 to 64 were enrolled in our study from January first, 1970, through December 31st, 2004. We divided our participants into 2 age groups, and divided 35 years into 7 time groups. Cardiorespiratory fitness was assessed by maximal treadmill testing using a modified Balke protocol, and the percentage of body fat was assessed by hydrostatic weighing or the sum of 7 skinfold measures, following standardized protocols. According to percent body fat, we divided body composition into fat mass and fat free mass.
Medical Research: What are the main findings?
Dr. Sui: The data showed that body mass index (BMI) increased over the 35-year period even though cardiorespiratory fitness levels rose as well. By looking at the body composition of the participants along with their BMIs, the researchers were able to observe that their body fat did not increase. This finding suggests that the weight gains that led to higher BMIs over time were not necessarily comprised of body fat. Participants may have been putting on muscle mass due to their increased physical activity, as indicated by their higher cardiorespiratory fitness.
Another interesting finding was that when leisure-time physical activity (LTPA) reaches 668.5 MET min/wk, cardiorespiratory fitness stays at a higher level. So in order to improve cardiorespiratory fitness for physically inactive women, we should encourage them to meet this level. The drift downward in cardiorespiratory fitness among women indicates the need for continuing efforts to promote their physical activity and fitness.
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MedicalResearch.com Interview with:
Samuel Dominguez MD
Departments of Pediatric Infectious Diseases
Children's Hospital Colorado and University of Colorado School of Medicine Aurora, CO
Medical Research: What is the background for this study? What are the main findings?
Dr. Dominguez: Due to global poliovirus eradication efforts, clusters of acute flaccid paralysis (AFP) and/or cranial nerve dysfunction in children are rare and associated with few pathogens, primarily enteroviruses and flaviviruses. Our study reports the first geographically and temporally defined cluster of acute flaccid paralysis and cranial nerve dysfunction in children associated with an outbreak of EV-D68 respiratory illness, strengthening the potential link between EV-D68 and neurologic disease in children.
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MedicalResearch.com Interview with:
Miss Charlotte Vrinten, MSc, BA, BSc
Research psychologist
Cancer Research UK Health Behaviour Research Centre
Department of Epidemiology and Public Health
University College London
Medical Research: What is the background for this study? What are the main findings?
Response: Many people are afraid of getting cancer, but fear doesn’t have the same effect on everyone. For some people, cancer fear motivates them to get checked up, for others it puts them off finding out whether they have cancer. No-one before has worked out why fear might have such opposite effects. We hypothesized that it might be due to how people experience fear, because some fearful people tend to worry a lot about cancer, while others feel physically uncomfortable thinking about it. In our study, instead of using a combined measure of cancer fear as is often done, we distinguished these different aspects of fear to see whether they had different effects on people’s decisions about cancer screening. We found that the effect of cancer fear depended on the type of fear: worriers were more likely to want to get screened for colon cancer, but those who felt uncomfortable thinking about cancer were 12% less likely to go for the test. Twelve percent may not seem like a lot, but given that tens of thousands of people are eligible for this type of screening, it means a big difference in the number of people actually having the test.
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MedicalResearch.com Interview with:
Peter White, Ph.D.
Principal Investigator, Center for Microbial Pathogenesis
Director, Biomedical Genomics Core
Director of Molecular Bioinformatics, The Research Institute at Nationwide Children's Hospital
Assistant Professor of Pediatrics, The Ohio State University
Medical Research: What is the background for this study? What are the main findings?
Dr. White: Next generation sequencing has revolutionized genomics research and has opened the door to a new era of genomic medicine. It’s now possible to sequence a patients entire genome in about two days, but the output from the sequencer must go through multiple computationally challenging steps before it can be processed for clinically relevant information. The challenge we found is that this data analysis process was requiring days to perform, by highly qualified bioinformaticians and required enormous computational resources.
To overcome the challenges of analyzing that large amount of genomic sequence data, we developed a computational pipeline called “Churchill”, which we published in the latest issue of Genome Biology (http://genomebiology.com/2015/16/1/6/abstract). Churchill fully automates the analytical process required to take raw sequence data through a series of complex and computationally intensive processes, ultimately producing a list of genetic variants ready for clinical interpretation and tertiary analysis. The major impact of our work was the development of a novel balanced parallelization strategy that allows efficient analysis of a whole genome sequencing sample in as little as 90 minutes.
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