Author Interviews, Diabetes, Sugar, Weight Research / 24.02.2021

MedicalResearch.com Interview with: Eric Crosbie, PhD, MA Assistant Professor School of Community Health Sciences Ozmen Institute for Global Studies University of Nevada Reno MedicalResearch.com: What is the background for this study? Response: My colleague Dr. Laura Schmidt and I established a framework for studying preemption (when a higher level of government limits the authority of lower levels to enact laws) by studying the history of state preemption of local tobacco control policies in the U.S., which we published last year (2020) in AJPH. We noticed the same strategies that the tobacco industry employed were now being used by the beverage industry to suppress local taxation policies on sugar sweetened beverages (e.g. soda, coffee drinks, energy drinks, etc). We used this preemption framework to publish a new study this year in AJPH that analyzed state preemption of local sugar sweetened beverage taxes in the U.S.  (more…)
Author Interviews, Biomarkers, Cancer Research, Science / 18.02.2021

MedicalResearch.com Interview with: Muhammed Murtaza M.B.B.S. (M.D.), Ph.D. Translational Genomics Research Institute Phoenix, AZ MedicalResearch.com: What is the background for this study? Response: Liquid biopsies and cell-free DNA analysis using blood samples have transformed cancer diagnostics in recent years. We started this project wondering whether cell-free DNA in urine is a viable alternative to blood, since urine could be collected completed non-invasively. Our very first experiment showed the lengths of DNA fragments in urine very similar across healthy individuals, leading us to wonder whether urine was actually as randomly degraded as we had previously thought. (more…)
Author Interviews, Colon Cancer, Heart Disease, JAMA, Nutrition / 18.02.2021

MedicalResearch.com Interview with: Nathorn (Nui) Chaiyakunapruk PharmD, PhD Professor, Department of Pharmacotherapy University of Utah College of Pharmacy  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colorectal cancer is one of the cancers for which we found that the risk can be significantly reduced by modifying diet. Individual components of your diet can contribute to an overall healthy diet pattern to lower the risk of colorectal cancer or increase it. Strong scientific evidence shows that limiting red meat and alcohol consumption, eating foods containing fiber and calcium, consumption of dairy products especially yogurt can help prevent colorectal cancer.  (more…)
Author Interviews, Heart Disease, JAMA, OBGYNE, Pediatrics / 18.02.2021

MedicalResearch.com Interview with: Amanda Marma Perak, MD, MS Assistant Professor of Pediatrics (Cardiology) and Preventive Medicine (Epidemiology) Ann & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois 60611  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The American Heart Association has formally defined cardiovascular health (CVH) based on the combination of 7 key health metrics: body mass index (weight versus height), blood pressure, cholesterol, glucose, diet, exercise, and smoking status. As we previously showed, the vast majority of pregnant women in the US have suboptimal CVH levels during pregnancy. We also showed that maternal CVH during pregnancy was associated with the risk for adverse newborn outcomes (such as high levels of body fat), but it was unknown what this might mean for longer-term offspring health. In the current study, the key finding was that mothers' CVH levels during pregnancy were associated with their offspring's CVH levels 10-14 years later, in early adolescence. For example, children born to mothers in the poorest category of CVH (representing 6% of mothers) had almost 8-times higher risk for the poorest CVH category in early adolescence, compared with children born to mothers who had ideal CVH in pregnancy. Even children born to mothers with any "intermediate" CVH metrics in pregnancy -- for example, being overweight but not obese -- had over 2-times higher risk for the poorest CVH category in early adolescence. (more…)
Author Interviews, Blood Pressure - Hypertension, COVID -19 Coronavirus / 17.02.2021

MedicalResearch.com Interview with: Pam R. Taub, MD, FACC, FASPC Director of  Step Family Foundation Cardiovascular Rehabilitation and Wellness Center Associate Professor of Medicine UC San Diego Health System Division of Cardiovascular Medicine MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by postural orthostatic tachycardia syndrome?  Is it more common in patients who have incompletely recovered from a COVID-19 infection?  Response: Postural Orthostatic Tachycardia Syndrome (POTS) is a, complex multisystem clinical syndrome Patients experience a wide spectrum of symptoms of varying severity, which are often debilitating.  Upon assuming an upright standing position from being supine, patients experience an increase in heart rate by 30 beats per minute (bpm) from supine position, This is often accompanied by lightheadedness, palpitations, dyspnea, mental clouding (“brain fog”), headaches. POTS can occur after infections as it thought to be triggered by the immune system .  The hypothesis is that when the body is fighting an infection some of the antibodies it produces can attack our regulatory systems that control heart rate and blood pressure. We are seeing an increase in POTS cases occurring after COVID-19 infection.  These patient are referred to as the “long haulers” These long haulers have elevated heart rate, fatigue, brain fog and shortness of breath with activity consistent with POTS. We are seeing that  COVID-19 is another infection that can lead to POTS. Some articles on this https://www.thedenverchannel.com/news/national/coronavirus/some-covid-19-survivors-being-diagnosed-with-syndrome-called-pots (more…)
Author Interviews / 11.02.2021

MedicalResearch.com Interview with: Raymond L. Benza, MD, FACC, FAHA, FACP Primary Study Investigator and Professor of Medicine at The Ohio State University MedicalResearch.com: What is the background for this study? Would you briefly explain the significance of Pulmonary Arterial Hypertension? Response: Pulmonary arterial hypertension (PAH) is a silently progressive disease with no known cure and is often fatal. It’s a specific form of pulmonary hypertension (PH) that causes the walls of the pulmonary arteries to become thick and stiff, narrowing the space for blood to flow, and causing an increased blood pressure to develop within the lungs. PAH has a variety of etiologies and long-term impact on patients' functioning as well as their physical, psychological and social wellbeing. Assessing a patient's risk of 1-year mortality is a crucial component to the management and treatment of PAH, as the main treatment goal is for patients to achieve a low-risk status. Given the severity of the disease, physicians need to be able to risk stratify patients in order to characterize their disease better, know how to intelligently implement their medications, and when to refer them for lung transplantation. There are different approaches to assessing risk in PAH, including the use of variables, equations, and calculator tools; however, real-world evidence indicates risk assessment in the clinical setting is suboptimal. This is why we conducted an analysis to determine the validity of the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL) Lite 2 risk calculator, an abridged version of the REVEAL 2.0 risk calculator, in patients with PAH.  (more…)
Author Interviews, Leukemia, Stem Cells, Technology / 11.02.2021

MedicalResearch.com Interview with: Eirini Papapetrou, MD, PhD Associate Professor Department of Oncological Sciences Icahn School of Medicine at Mount Sinai New York, NY 10029 MedicalResearch.com: What is the background for this study? Would you tell us a little about acute myeloid leukemia? Response: Acute myeloid leukemia is a form of cancer of the blood. It is typically very aggressive and lethal without treatment. The main treatment is high-dose chemotherapy and it has not changed very much in decades. Some more recent "targeted" therapies that are less toxic help somewhat but still do not result in cures. We believe a reason for this might be that both chemotherapy and newer "targeted" therapies target the cells at the later stages of the disease and spare the earlier ones, which can then give rise to disease resistance and relapse.  (more…)
Author Interviews, CMAJ, COVID -19 Coronavirus, Kidney Disease / 05.02.2021

MedicalResearch.com Interview with: Peter G. Blake MD, FRCPC, FRCPI,MSc MB Professor of Medicine in the Division of Nephrology Ontario Renal Network University of Western Ontario and London Health Sciences Centre London, Ontario  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Covid-19 pandemic has been very difficult for people on dialysis with reports of high infection rates and high mortality. We prospectively collected data on SARS-CoV-2 infection every week from all renal programs in the province of Ontario, Canada from the start of the pandemic. Between March and August 2020, 187 people on dialysis, equivalent to 1.5% of all those in the province, were infected with the SARS-CoV-2 virus. Over 60% were hospitalized, 20% required ICU and the mortality rate was very high at over 28%. Risk factors for infection included center hemodialysis versus home dialysis, residing in long term care, black, south Asian and other non-white ethnicity, and low neighbourhood income. (more…)
Author Interviews, COVID -19 Coronavirus, Education, Race/Ethnic Diversity, Social Issues / 04.02.2021

MedicalResearch.com Interview with: Ankur Dalsania Rutgers New Jersey Medical School (NJMS) M.D. Candidate 2021 MedicalResearch.com: What is the background for this study? Response: Similar to past pandemics, prior studies and news articles have highlighted the disproportionate impact of COVID-19 mortality in marginalized populations, especially Black Americans. Rather than biological differences, other factors like neighborhood conditions, educational attainment, economic stability, healthcare access, and social contexts have been hypothesized to influence the racial disparities. Using county-level data, we sought to quantitatively determine how these factors, collectively referred to as social determinants of health, impact COVID-19 mortality in Black Americans.  (more…)
Author Interviews, Dengue, PLoS, Zika / 04.02.2021

MedicalResearch.com Interview with: Gregor J. Devine, Ph.D Mosquito Control LaboratoryQIMR Berghofer Medical Research Institute Brisbane, Queensland, Australia MedicalResearch.com: What is the background for this study? Scale of the problem: Dengue, Zika and chikungunya are all transmitted by the same mosquito species.  That mosquito, Aedes aegypti, is superbly adapted to the human, urban environment – it lays its eggs and develops in the standing water that collects in the myriad containers associated with modern living (plastic bottles, food packaging, buckets, planters, crumpled tarpaulins etc.). Unusually they rely almost entirely on human blood for their nutritional requirements and they subsequently bite multiple times during each egg laying cycle. That reliance on human blood means that they are usually found resting indoors, a behaviour that also offers them some protection from weather extremes and predators. Once infected, and having incubated the virus until it is transmissible, a mosquito that survives for just a couple of weeks can infect many humans within the same and neighbouring households. In poorer tropical urban environments with dense human populations, unscreened houses, no air-conditioning, and innumerable rain-filled containers to develop in, Aedes aegypti proliferates and so do those diseases, causing ca 400M annual infections of dengue alone by some estimates. The economic impact of the dengue, which normally causes a high fever, muscle and joint pains and nausea, is pronounced; especially in poor households with few savings and no welfare system. Every year, about 500,000 of those dengue cases develop into severe dengue, or dengue haemorrhagic fever (typified by plasma leakage, severe bleeding and organ impairment). There are about 25,000 deaths annually. mosquito-Aedes aegypti-feeding-human.jpgThe Zika pandemic of 2015-2016 resulted in 1000s of babies born with microcephaly and damage to their brains and eyes. For 1000s of other children, the impacts of Zika on their cognitive development did not manifest in their first, formative years.  Chikungunya is endemic in Asia and Africa but between 2010 and 2014, outbreaks and epidemics spread across the Indian Ocean, the Caribbean, the Americas and the Pacific Islands. It causes severe, often debilitating joint pain in infected patients. Those affected also suffer from headaches, fever, severe muscle pain and conjunctivitis. Joint pain can persist in subacute or chronic form for several months or even years, particularly in older patients. The ubiquity of the mosquito Aedes aegypti across the tropics and sub tropics ensures that further epidemics of Zika and chikungunya will occur, outside their usual ranges. It’s simply impossible to predict when that will occur. (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, BMJ, COVID -19 Coronavirus, Gout, Rheumatology / 03.02.2021

MedicalResearch.com Interview with: Dr Rene Oliveira Department of Internal Medicine Ribeirao Preto Medical School University of Sao Paulo Ribeirao Preto, Brazil  MedicalResearch.com: What is the background for this study? Response: As rheumatologists our background for testing colchicine for COVID-19 was the effect of the drug on gout, Behçet's disease and familial Mediterranean fever. For these diseases, the drug is able to reduce systemic inflammation by acting in some cytokine pathways which the first reports in COVID-19 suggested being the same. We found that colchicine was able to reduce systemic inflammation and diminish the length of need for supplemental oxygen and hospitalisation. (more…)
Author Interviews, CDC, JAMA, OBGYNE / 03.02.2021

MedicalResearch.com Interview with: Jiajia Chen, PhD Division of Reproductive Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention, Atlanta, Georgia MedicalResearch.com: What is the background for this study? Response: Severe maternal morbidity (SMM) includes a range of serious pregnancy complications that result in significant short-term or long-term consequences to a woman’s health. Most research and prevention efforts addressing SMM focus on the delivery hospitalization, but less is known about SMM diagnosed after delivery discharge. (more…)
Author Interviews, Cannabis / 03.02.2021

MedicalResearch.com Interview with: Benjamin J. Warnick, PhD Assistant Professor of Entrepreneurship Carson College of Business Washington State University Vancouver MedicalResearch.com: What is the background for this study? Response: Popular culture has perpetuated a notion that cannabis users are more creative. Along these lines, some successful CEOs and entrepreneurs—like Steve Jobs, for example—have claimed that cannabis use has benefitted their creativity at work. Despite such claims and increased legalization and use of cannabis, the implications of cannabis use for entrepreneurs’ creativity has yet to be rigorously tested. My coauthors and I were very intrigued to dive into the implications of cannabis use for entrepreneurs, whether good or bad. This seemed all the more relevant given the increasing legalization, destigmatization, and use of cannabis.  (more…)
Author Interviews, Genetic Research / 03.02.2021

MedicalResearch.com Interview with: Igor Chesnokov, Ph.D Department of Biochemistry and Molecular Genetics School of Medicine University of Alabama at Birmingham, Alabama MedicalResearch.com: What is the background for this study? Response: DNA replication is fundamentally important for tissue development, growth and homeostasis. Impairments of the DNA replication machinery can have catastrophic consequences for genome stability and cell division. Meier-Gorlin Syndrome (MGS) is an autosomal recessive disorder that is also known as ear, patella, short stature syndrome and/or microtia, absent patella, micrognathia syndrome, traits highlighting the core clinical phenotypes. The genes affected by MGS mutations include many members of pre-replicative complex (pre-RC), such as Origin Recognition Complex (ORC) subunits (Orc1, Orc4, Orc6), Cdc6, Cdt1, CDC45, MCM5 as well as Geminin, suggesting that the clinical phenotype is caused by defects in DNA replication initiation. As the pre-RC complex is essential for DNA replication, the mutations in its components are expected to impair cell proliferation and reduce growth. The smallest subunit of ORC, Orc6, is the most divergent and enigmatic among ORC subunits. Orc6 is important for DNA replication in all species. Metazoan Orc6 proteins consist of two functional domains: a larger N-terminal domain important for binding of DNA and a smaller C-terminal domain important for protein-protein interactions. A mutation coding for a tyrosine 232 to serine alteration (Y232S) in the C-terminal domain of Orc6 is linked to MGS in humans. Recently, a new Orc6 mutation was described that also resulted in MGS. Unlike the previously described MGS mutation, this amino acid substitution, Lysine 23 to Glutamic acid (K23E), localizes in the N-terminal domain of Orc6.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, COVID -19 Coronavirus, Prostate, Prostate Cancer, Surgical Research, Urology / 01.02.2021

MedicalResearch.com Interview with: David-Dan Nguyen Research Fellow | Center for Surgery and Public Health, Brigham and Women's Hospital MPH (Health Policy) Student | Harvard T.H. Chan School of Public Health Medical Student | McGill University MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has forced hospitals to delay the definitive treatment of cancers via surgery or radiation therapy. While previous evidence has shown that delaying the treatment of low-risk prostate cancer is not associated with worse outcomes, treatment delays for intermediate-risk and high-risk prostate cancer are more controversial. As such, we sought to determine if delays for these disease states negatively impacted oncological outcomes. (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Gender Differences, Pediatrics, University of Pennsylvania / 30.01.2021

MedicalResearch.com Interview with: Christina L. Master, MD, FAAP, CAQSM, FACSM Professor of Clinical Pediatrics Perelman School of Medicine at the University of Pennsylvania Co-Director, Minds Matter Concussion Program Pediatric and Adolescent Sports Medicine, Division of Pediatric Orthopedics Attending Physician, Care Network - Karabots Center The Children's Hospital of Philadelphia Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? Response: There have been multiple studies investigating potential sex differences in outcomes from concussion which have sometimes had conflicting results with some studies indicating that females take longer to recover than males and some studies reporting no difference in recovery between females and males, with most of these studies being conducted either retrospectively or prospectively in smaller cohorts. This large-scale multi-center prospective study in collegiate athletes provided an opportunity to compare females and males across comparable sports to examine both potential intrinsic or biologic factors (sex differences) or extrinsic (environmental or gender differences) that contribute to outcomes. (more…)
Author Interviews, BMJ, Cannabis, Opiods, Yale / 29.01.2021

MedicalResearch.com Interview with: Balázs Kovács PhD Associate Professor of Organizational Behavior Yale School of Management MedicalResearch.com: What is the background for this study? Response: Our study looks at the association between the prevalence of legal cannabis stores, called “dispensaries”, and opioid-related mortality rates in the U.S.  We find that higher cannabis dispensary counts are associated with reduced opioid-related mortality rates.   We find this relationship holds for both medical dispensaries, which only serve patients who have a state-approved medical card or doctor’s recommendation, as well as for recreational dispensaries, which sell to adults 21 years and older.  The statistical associations we find appears most pronounced with the class of opioids that includes fentanyl and its analogs.  (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Race/Ethnic Diversity, Social Issues / 29.01.2021

MedicalResearch.com Interview with: Renuka Tipirneni, MD, MSc, FACP Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine, Divisions of General Medicine and Hospital Medicine, and Institute for Healthcare Policy & Innovation Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: As there have been significant racial/ethnic disparities in US COVID-19 infections and health outcomes including death, we investigated county-level social factors that may explain these inequities. Specifically, we examined the association between the Centers for Disease Control and Prevention’s Social Vulnerability Index (a composite measure of social disadvantage) and COVID-19 incidence and mortality rates. We found that with just a one-point increase in the ten-point scale, there was a 14% increase in incidence rate and 14% increase in mortality rate. This equated to approximately 87 excess COVID-19 infections and 3 deaths per 100,000 population.  (more…)
Cancer Research / 29.01.2021

Cancer occurs when cancerous cells in one area of the body reproduce rapidly and invade surrounding cells, tissue, and organs. Occasionally, these cells can spread to other parts of the body. Symptoms, treatments and the prognosis will depend on the type and stage of the cancer.

Give them emotional support

Your parent is probably as confused and overwhelmed as you are, if not more. Offer them a comforting ear and allow them to talk through how it is affecting them, their concerns, their treatment options, and their wishes. Offer assistance, but don’t force it. Being too helpful could end up with your parent feeling a loss of control or independence. Organize what type and level of support you can offer, sustainable to their wellbeing, and yours. Offer spontaneous and scheduled companionship to help them to feel a sense of normalcy and provide opportunities to spend time together. If you both decide you should accompany them to their physician’s appointments and treatments, take notes, and don’t be scared to speak up if you have a question.

cancer-chemotherapy-cancer-treatment.jpegTry to understand what they’re going through

Take the time to understand the individual symptoms that they are experiencing and suggest proven solutions to relieve and manage. For example, the symptoms of mouth or esophageal cancer will be very different from that of any other part of the body. Namely, these cancers can cause loss of the ability to chew and swallow (medically referred to as dysphagia), which are alleviated using a thickener in food and beverages. In contrast, individuals suffering from cancer of the spine are more likely to have trouble mobilizing, which would be improved by a walking aid. Managing conditions like cancer begin with a full understanding. Read about the origin of SimplyThick Easy Mix and see the value in understanding health conditions from a patient perspective. (more…)
Author Interviews, JAMA, Primary Care, Smoking, USPSTF / 28.01.2021

MedicalResearch.com Interview with: Dr. Michael Silverstein M.D., M.P.H Professor of Pediatrics Director of the Division of General Academic Pediatrics Vice Chair of Research, Department of Pediatrics Boston University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Tobacco use is the leading preventable cause of disease, disability, and death in the United States and quitting is one of the best things people can do for their health. Additionally, smoking during pregnancy can cause serious harms to both the pregnant person and the baby. The Task Force continues to recommend that clinicians ask all adults and pregnant people about their tobacco use, advise those who use tobacco to quit, and connect them to proven, safe methods to help them quit.  (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Memory, Surgical Research / 23.01.2021

MedicalResearch.com Interview with: Pascual Sánchez-Juan, MD, PhD Servicio de Neurología Hospital Universitario "Marqués de Valdecilla" Unidad de Deterioro Cognitivo https://www.facebook.com/deteriorocognitivovaldecilla Director científico Biobanco Valdecilla Avda Marqués de Valdecilla s/n  MedicalResearch.com: What is the background for this study? Response: Alzheimer's disease is one of the greatest public health challenges. From the moment the first lesions appear in the brain to the clinical manifestations, up to 20 years can pass. Today we can detect the presence of these initial lesions through biochemical markers such as amyloid-β, which is one of the main proteins accumulated in the brains of Alzheimer's patients. The prevalence of cerebral amyloid-β pathology in cognitively asymptomatic individuals increases with age. It has been estimated that 21.1% of the population at the age of 65 will have a positive amyloid scan or a pathological cerebrospinal fluid (CSF) amyloid-β determination, and which will double by the age of 90. Due to the aging of our societies and advances made in medical care, an increasing number of elderly and more fragile people are considered candidates for major surgery. In preoperative screenings, respiratory and cardiovascular functions are routinely checked; however, it is not commonly assessed how the brain is going to cope with the intervention. In the clinic, the patient’s relatives frequently tell us that the memory problems began after a surgical procedure or a hospital admission. This posed us the following question: is this just a recall bias or has surgery triggered the appearance of the symptoms in a previously affected brain?” (more…)
Author Interviews, Health Care Systems, JAMA / 22.01.2021

MedicalResearch.com Interview with: Sara Machado PhD Fellow at the Department of Health Policy London School of Economics and Political Science MedicalResearch.com: What is the background for this study? Response: Physician distribution is a determinant of health care access, so knowing how physician density patterns evolve over time is important if we are trying to address disparities in access to care. Moreover, the last 10 years have brought about changes in health care coverage, across the US. Recent evidence points to an uneven physician distribution between urban and rural communities. We examined recent trends in physician density by physician category across rural and urban US counties.  MedicalResearch.com: What are the main findings? Response: We have two main findings.
  • First, density of primary care physicians steadily decreased in more than half of rural counties (994 out of 1,976).
  • Second, medical specialist density, which would care for cardiovascular and pulmonary disease, for example, has been largely stagnant in rural counties, at the lowest density levels (less than 10 physicians per 100,000), and increasing in metropolitan counties.
(more…)