Medical research.com slideshare april 3 2012

MedicalResearch.com
Medical Research Author interviews
Editor: Marie Benz, MD
info@hemodialysis.com
April 3 2013

For Informational Purposes Only: Not for Specific Medical Advice.

For Informational Purposes Only.
4/3/13 1
Not for Specific Medical Advice.

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4/3/13 2

Genome-wide reprogramming of the chromatin landscape underlies endocrine therapy resistance in breast cancer
MedicalResearch.com eInterview with Dr. Mathieu Lupien PhD
Princess Margaret Cancer Centre, University Health Network
Ontario Cancer Institute (OCI) Assistant Professor
Department of Medical Biophysics University of Toronto

• MedicalResearch.com: What are the main findings of the study?
• Dr. Lupien: Approximately 50% of breast cancer patients fail to
respond to the standard of care based on endocrine (hormonal)
therapy. Our research identifies a mechanism that accounts for this
resistance. Drugs against this mechanism are already tested for
other diseases. Hence, our discovery should rapidly help reposition
these drugs against endocrine therapy resistant breast cancer.
MedicalResearch.com: Were any of the findings unexpected?
• Dr. Lupien: The key scientific discovery is that our findings came
from interrogating the epigenome of breast cancer cells, the
cosmetic layer of information on top of the DNA. This allowed us to
understand how regions outside of genes differed in endocrine
therapy responsive versus resistant breast cancer cells. These non-
genic regions harbor a wealth of functional information that we are
just starting to explore for cancer research.
4/3/13 3

Genome-wide reprogramming of the chromatin landscape underlies endocrine therapy resistance in breast cancer
MedicalResearch.com eInterview with Dr. Mathieu Lupien PhD
Princess Margaret Cancer Centre, University Health Network
Ontario Cancer Institute (OCI) Assistant Professor
Department of Medical Biophysics University of Toronto
(cont)

• MedicalResearch.com: What should clinicians and patients take away from your
report?
• Dr. Lupien: Understanding the mechanisms that lead to drug response or
resistance can help identify alternatives. Our work identifies a mechanism of
resistance and also provides the companion test to identify endocrine therapy
resistant patient. Taken together, our work should be of significant benefit as we
move forward in validating our discoveries in the clinic.
• MedicalResearch.com: What recommendations do you have for future research
as a result of this study?
• Dr. Lupien: The field of epigenetic is just starting to reveal its immense potential to
help understand the mechanism underlying cancer development and progression.
We need to increase funding in this field of research.
• Citation:
• Genome-wide reprogramming of the chromatin landscape underlies endocrine
therapy resistance in breast cancer
• Luca Magnani, Alexander Stoeck, Xiaoyang Zhang, András Lánczky, Anne C.
Mirabella, Tian-Li Wang, Balázs Gyorffy, and Mathieu Lupien
• PNAS 2013 ; published ahead of print April 1, 2013, doi:10.1073/pnas.1219992110

4/3/13 4

Interpolated memory tests reduce mind wandering and improve learning of online lectures
MedicalResearch.com Interview with Karl K. Szpunar PhD
Department of Psychology,
Harvard University, Cambridge, MA 02138

• edicalResearch.com: What are the main findings of
the study?
• Dr. Szpunar: The results of our experiments
demonstrate that students can have difficulty paying
attention to online lectures, and that including brief
quizzes during lectures can help to alleviate this
problem. Specifically, we found that students who were
tested throughout a 21-minute long Statistics lecture
were half as likely to mind wander during the
lecture, three times as likely to take additional
notes, and much better able to retain the contents of
the lecture at a later time.

4/3/13 5

(cont)

• MedicalResearch.com: Were any of the findings unexpected:
• Dr. Szpunar: Perhaps the most unanticipated finding in our
experiments was the extent to which students mind wandered
during lectures in the absence of intermittent testing. Throughout
the lecture, we would ask students whether or not they were
paying attention to the lecture at that moment or whether their
mind’s had wandered to another topic or concern (e.g., what will I
be doing later today, what are my weekend plans, etc.).
• Students who never received tests during the lecture reported mind
wandering 40% of the time. That is, they were not paying attention
to the lecture almost every other time we probed them. This
number is quite high considering that we conducted our
experiments in a controlled experimental setting. In fact, this
number may be higher when considering the various distractions
that are present when students learn from online lectures in the
comfort of their own homes or in actual classrooms.
4/3/13 6

(cont)

report?
• Dr. Szpunar: The results of our studies may have important implications for
teaching and learning practices associated with people who have heightened
difficult paying attention to their immediate surroundings, such as those
diagnosed with Attention Deficit/Hyperactivity Disorder.
• Dr. Szpunar: The primary purpose of the present study was to attempt to identify
methods of teaching that can help students make better use of their study time.
Along these lines, we would recommend that tightly controlled experimental
studies can be a strong source of information in helping to develop online learning
platforms.
• Citation:
• Interpolated memory tests reduce mind wandering and improve learning of online
lectures
• Karl K. Szpunar, Novall Y. Khan, and Daniel L. Schacter
PNAS 2013 ; published ahead of print April 1, 2013, doi:10.1073/pnas.1221764110

4/3/13 7

Pathway-based personalized analysis of cancer
MedicalResearch.com Author Interview:
Prof. Eytan Domany
Department of Physics of Complex Systems and Department of Biological Regulation
Weizmann Institute of Science, Rehovot, 76100, Israel

• Prof. Domany: The findings are two-fold: methodological and clinical. A novel
method was introduced for personalized analysis of cancer, and was applied on
large colon cancer and glioblastoma datasets.
• The method uses high throughput (gene expression) data to infer a pathway
deregulation score (PDS) for individual tumors, for hundreds of pathways and
biological processes. The method is knowledge-based in that it uses well known
information about the assignment of genes to biologically relevant pathways. No
detailed knowledge of the underlying networks of interactions and activations is
necessary. Each tumor is represented by a few hundred of these PDSs, and further
analysis uses this representation.
• One of the clinically relevant findings is the discovery that the reported relatively
longer survival of subjects with neural and proneural glioblastoma is due to a new
subtype of these tumors – when these are excluded, the neural/proneural patients
do not survive longer than the other subgroups. For both diseases, pathways
whose deregulation level is indicative of prognosis were discovered and validated
on independent datasets.

4/3/13 8

Prof. Eytan Domany
(cont)

• MedicalResearch.com: What should clinicians and
patients take away from your report?
• Prof. Domany: This is a new and promising way to use high-
throughput genomic data for prognosis, and hopefully also
for personalized prediction of response to therapy. Even
though there is still a long way to go till direct clinical
applicability of the method, some of the findings are very
promising. The reported sub-stratification of glioblastoma
patients provides a robust prognostic predictor. In colon
cancer two pathways were found with deregulation scores
that exhibit very significant correlation with survival:
CXCR3-mediated signaling and oxidative phosphorylation –
both may find their way into the clinic as prognostic tools.

4/3/13 9

Prof. Eytan Domany
(cont)


• Prof. Domany: On the methodological side, this study demonstrates how tumors
can be represented by individual “higher level” biologically relevant scores. On a
more fundamental level, the study proves the strengths and advantages of a
phenomenological approach, taking a golden path between ignorance-based
machine learning approaches and the overkill of requiring full knowledge of every
mechanistic detail. As to resulting clinical research, once the clinical relevance of
the deregulation score of a pathway is substantiated, its level of deregulation in a
particular tumor sample may be assessed directly, with no need for measurement
of expression. Such direct measurements of pathway activity can then be used as a
reliable and robust personalized prognostic biomarker.
• Citation:
• Pathway-based personalized analysis of cancer
• Yotam Drier, Michal Sheffer, and Eytan Domany
PNAS 2013 ; published ahead of print April 1, 2013, doi:10.1073/pnas.1219651110

4/3/13 10

Discontinuation of Statins in Routine Care Settings: A Cohort Study
MedicalResearch.com Interview Dr. Alexander Turchin M.D.,M.S.
Director of Informatics Research, Assistant Professor, Harvard Medical School
Endocrinology, Diabetes and Hypertension
Brigham and Women’s Hospital Boston, MA

• Dr. Turchi: A large number of patients – 17% of individuals included
in our study – report side effects to statins in routine care settings.
Nearly 60% of these patients stopped the statin at least
temporarily. However, overwhelming majority of patients who
stopped taking a statin after experiencing a possible side effect,
could tolerate a statin long-term if they tried taking one again. In
other words, it appears that many statin-related events are
tolerable, specific to individual statins or have other causes. These
findings are consistent with the current guidelines that urge a
conservative approach to statin discontinuation. They are
particularly important because statins have been convincingly
shown to save lives – they decrease all-cause mortality, and also
cardiovascular mortality and incidence of cardiovascular events in
patients with ischemic heart disease and / or elevated cholesterol
levels.

4/3/13 11

(cont)

• MedicalResearch.com: Were any of the findings
unexpected?
• Dr. Turchi: Based on our clinical experience, we
expected to see some degree of tolerability of statins in
patients who previously stopped them because of
possible side effects. However, the sheer magnitude –
more than 90% of patients who tried a statin again
were able to take it long-term – was a surprise. These
results underscore how important it is to consider
another trial of a statin – possibly a different statin or
the same statin at a lower dose – for patients who have
stopped a statin because of a possible adverse
reaction.
4/3/13 12

(cont)

• Dr. Turchi: Both clinicians and patients should note
that a re-trial of a statin should be considered in
individuals who have experienced mild to moderate
symptoms that were thought to be due to a statin. Not
everyone would be a candidate; restarting a statin
would not be appropriate, for example, in someone
who had a life-threatening reaction, such as
rhabdomyolysis. Therefore the findings of our study
should not lead to a hard and fast rule but rather be a
factor taken into consideration when evaluating the
whole patient and their particular circumstances.
4/3/13 13

(cont)

• MedicalResearch.com: What recommendations do you have for future
research as a result of this study?
• Dr. Turchi: Our study was based on observational data. Its results should
be confirmed with an interventional clinical trial aimed to determine
whether rechallenging patients who stopped their statins after a possible
side effect improves important clinical outcomes, such as incidence of
cardiovascular events and / or death. It is also important to continue to
look into other reasons why statins may be stopped by patients and their
clinicians, and how unnecessary discontinuation of statins can be
prevented or minimized.
• Citation:
• Discontinuation of Statins in Routine Care Settings: A Cohort Study
• Huabing Zhang, MD; Jorge Plutzky, MD; Stephen Skentzos, BA, BS; Fritha
Morrison, MPH; Perry Mar, PhD; Maria Shubina, ScD; and Alexander
Turchin, MD, MS
Ann Intern Med 2 April 2013: Vol. 158, No. 158, pp. I-40

4/3/13 14

Time to First Cigarette and 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanol (NNAL) Levels in Adult Smokers; National
Health and Nutrition Examination Survey (NHANES), 2007–2010
Dr. Steven A. Branstetter, PhD
The Pennsylvania State University, 315 E. HHD, University Park, PA 16810.

• Dr. Branstetter: This study demonstrated that the time to the first cigarette of the
day after waking is associated with increased levels of a NNAL, a metabolite of a
powerful tobacco-specific carcinogen, NNK — even after controlling for the total
number of cigarettes smoked per day.
• For years, the time to the first cigarette of the day after waking was one of several
questions assessing nicotine dependence on the Fagerstrom Test for Nicotine
Dependence (FTND), the gold standard questionnaire int he field. Over time, it was
found that much of the predictive validity of the FTND was due to the time to first
cigarette item. Researchers have found that single time to first cigarette item was
highly correlated with other measures of nicotine dependence, and was predictive
of more difficulty quitting smoking and increased intake of nicotine. Our current
study demonstrates that this behavioral measure, is predictive of exposure to the
cancer-causing components of cigarettes, regardless of the total number of
cigarettes smoked per day. The results suggest that researchers, clinicians and
smokers can assess the level of nicotine dependence and potential cancer risk by
looking at the time to the first cigarette of the day after waking.

4/3/13 15

The Pennsylvania State University, 315 E. HHD, University Park, PA 16810. (cont)

unexpected?
• Dr. Branstetter: Given our previous work, we did expect
that time to first cigarette of the day after waking would
relate to levels of NNAL among these smokers.
However, the fact that time to first cigarette continued to
predict NNAL levels even after controlling for a number of
other potential explanatory factors, including the number
of cigarettes smoker per day, number of years as a regular
smoker, and having other smokers in the home, was
somewhat surprising. The emerging evidence suggests that
this single behavioral measure may be among the best at
predicting nicotine dependence, risk exposure, and
difficulty quitting.
4/3/13 16


• MedicalResearch.com: What should clinicians and patients take away
from your report?

• Dr. Branstetter: The take home message is that how soon after waking up
a smoker reaches for a cigarette is a very strong indicator of dependence
and risk. Traditionally, clinicians have asked about the number of
cigarettes smoked per day, which is still an important factor. However, the
total number of cigarettes smoked may not always be the best question to
ask to assess dependence or risk: for example, there is a non-linear
relationship between cigarettes per day and blood levels of cotinine (the
metabolite of nicotine). At some level after about 20 cigarettes per day,
nicotine levels plateau such that someone smoking 25 cigarettes may have
similar blood cotinine levels as someone smoking 40 cigarettes per day.
Therefore, asking about the time to the first cigarette of the day after
waking may tell clinicians (and patients) about the level of addiction, how
difficult it may be to quit, and perhaps even the risk of lung cancer.

4/3/13 17


• Dr. Branstetter: The biggest question that we are looking into is what
exactly the time to first cigarette is telling us. Our best guess is that time
to first cigarette reflects how smokers are going about smoking their
cigarettes. They are likely inhaling more deeply, holding their smoke
longer, and taking more puffs per cigarette. Unfortunately, we don’t yet
fully understand why time to first cigarette is so strongly related to these
outcomes. Our future studies will be providing smokers with a small
topography device that measures exactly how each cigarette, especially
the first cigarette of the day, is smoked.
• Citation:
• Time to First Cigarette and 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanol
(NNAL) Levels in Adult Smokers; National Health and Nutrition
Examination Survey (NHANES), 2007–2010
• S. A. Branstetter, J. E. Muscat. Cancer Epidemiology Biomarkers &
Prevention, 2013; 22 (4): 615 DOI: 10.1158/1055-9965.EPI-12-0842

4/3/13 18

Cancer Survivors in the United States: Prevalence across the Survivorship Trajectory
and Implications for Care
MedicalResearch.com Interview with Janet S. de Moor, PhD, MPH
Program Director, Office of Cancer Survivorship Division of Cancer Control and Population Sciences
National Cancer Institute/National Institutes of Health Bethesda, MD 20891-8336

• Dr. de Moor: The number of people who have been diagnosed with
cancer during their lifetime has been steadily increasing. As of
January 1, 2012, approximately 13.7 million cancer survivors were
living in the United States with projected prevalence to approach 18
million by 2022. Women with breast cancer and men with prostate
cancer represent the two largest groups of cancer survivors,
accounting for 22% and 20% of the population respectively. Sixty-
four percent of cancer survivors have survived 5 years or more; 40%
have survived 10 years or more; and 15% have survived 20 years or
more after diagnosis. Over the next decade, the number of people
who have lived 5 years or more after their cancer diagnosis is
projected to increase approximately 37% to 11.9 million.

4/3/13 19

(cont)

• MedicalResearch.com: What should clinicians and patients take
away from your report?
• Dr. de Moor: Over the next decade, the number of cancer survivors
is projected to increase as a result of increasing cancer incidence
rates associated with the aging of the population and
improvements in long-term survival rates. The largest group of
survivors, currently and moving forward, are those who are 5 years
are more from diagnosis. This growing cohort of cancer survivors
presents a significant challenge to the health care system. This is
especially true given that most survivors can now expect to live
longer after diagnosis and often have complex needs stemming
from chronic and late effects of treatment as well as co-morbid
diseases. Over the next decade, a coordinated agenda for research
and practice is needed to better understand and address the
medical, psychosocial, and practical needs of cancer survivors from
the point of diagnosis forward.

4/3/13 20

(cont)

• Dr. de Moor: A multi-pronged approach is essential to address the diverse and
evolving needs of cancer survivors. Efforts are needed to identify effective and
efficient models for delivering long-term follow-up care; develop infrastructure to
collect long-term clinical and patient-reported outcome data from survivors;
harness health IT and other technologies that facilitate care coordination and
improvement in survivors’ long-term health outcomes; address important
knowledge gaps about long-term survivors; and improve integrative palliative care.
Progress in these areas is critical to optimize the health and quality of life of all
people diagnosed with cancer.
• Citation:
• Cancer Survivors in the United States: Prevalence across the Survivorship
Trajectory and Implications for Care
• Cancer Epidemiol Biomarkers Prev. 2013 Mar 27. [Epub ahead of print]
• de Moor JS, Mariotto AB, Parry C, Alfano CM, Padgett L, Kent EE, Forsythe
L, Scoppa S, Hachey M, Rowland JH.

4/3/13 21

The subjective–objective mismatch in sleep perception among those with insomnia and sleep apnea
MedicalResearch.com Interview with
Matt T. Bianchi MD PhD MMSc
Assistant Professor Department of Neurology
Director, Sleep Division Massachusetts General Hospital

• Dr. Bianchi: We showed that patients reporting symptoms of
insomnia tend to under-estimate the amount of time they slept
during overnight sleep testing in our clinical sleep laboratory.
• Dr. Bianchi: It has been known for decades that many patients with
insomnia exhibit so-called “misperception” of sleep: that is, they
feel awake despite objective evidence by electro-encephalogram
that they are in fact asleep. What was surprising in our study was
that this tendency was not related to the quality of sleep. We
expected that patients with very light or interrupted sleep would
tend to show this misperception, but this was not the case.

4/3/13 22

(cont)

• Dr. Bianchi: There is much to be learned about sleep
misperception. Knowing whether we are awake or asleep during
the night seems so natural and obvious that few patients (or
clinicians) might question the reliability of that subjective sense.
• However, misperception turns out to be common, and difficult to
predict (there were in fact no predictors found in our study, despite
extensive efforts). Where a patient with insomnia stands on the
spectrum of (mis)perception of their own sleep is an important
component of assessing the risk-benefit balance when it comes to
insomnia drug therapy for example. Some patients may be
reassured to know they are sleeping better than they think.

4/3/13 23

(cont)

• MedicalResearch.com: What recommendations do you have for future research as a result of this
study?
• Dr. Bianchi: There is an urgent need to understand misperception, and how this common finding
impacts individual medical decisions (for example, about the need for medication for sleep). Also,
much of what is written in the epidemiology literature is based on self-reported sleep durations –
our study adds to the growing evidence that self-reported sleep durations may not match with
objective data. Currently, in an epidemiology study linking short sleep durations to adverse health
outcomes, the group who reports sleeping less than, say, 6 hours per night consists of individuals
who have objectively short sleep, and those who have longer sleep but perceive it to be less. These
subgroups should be teased apart in future studies, to improve our understanding of sleep-duration
correlations in the literature.

• Citation:
• The subjective–objective mismatch in sleep perception among those with insomnia and sleep
apnea
• Bianchi MT, Williams KL, McKinney S, Ellenbogen JM.
• Sleep Division, Neurology Department, Massachusetts General Hospital, Boston, MA, USA; Division
of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
• J Sleep Res. 2013 Mar 25. doi: 10.1111/jsr.12046.
[Epub ahead of print]

4/3/13 24

Predictors of depression in breast cancer patients treated with radiation:
Role of prior chemotherapy and nuclear factor kappa B
MedicalResearch.com Interview with Mylin A. Torres, M.D.
Assistant Professor Department of Radiation Oncology
Emory University School of Medicine Atlanta, GA 30322

• Dr. Torres: Radiation treatment for breast cancer is not associated
with increased depressive symptoms, but of disease and treatment-
related factors, prior chemotherapy treatment is a significant
predictor of depression before and after radiation treatment. Prior
chemotherapy treatment was associated with inflammatory
mediators, including nuclear factor-kappa B DNA binding, soluble
tumor necrosis factor-alpha receptor 2, and interleukin-6, which
predicted for depressive symptoms after radiation on univariate
analysis.

• MedicalResearch.com: Were any of the findings unexpected?
• Dr. Torres: It was surprising to find that radiation had no significant
effect on depressive symptoms or fatigue.

4/3/13 25

Predictors of depression in breast cancer patients treated with radiation:
Role of prior chemotherapy and nuclear factor kappa B
MedicalResearch.com Interview with Mylin A. Torres, M.D.
Assistant Professor Department of Radiation Oncology
Emory University School of Medicine Atlanta, GA 30322 (cont)

report?
• Dr. Torres: Breast cancer patients treated with chemotherapy are at higher risk for
developing depression and fatigue during and after treatment.
• MedicalResearch.com: What recommendations do you have for future research as
a result of this study?
• Dr. Torres: Longitudinal studies are warranted to investigate the relationship
among prior chemotherapy, inflammation, and persistent depression after breast
cancer treatment.
• Citation:
• Predictors of depression in breast cancer patients treated with radiation: Role of
prior chemotherapy and nuclear factor kappa B
• Torres MA, Pace TW, Liu T, Felger JC, Mister D, Doho GH,
Kohn JN, Barsevick AM,
Long Q, Miller AH.
• Department of Radiation Oncology, Emory University, Atlanta, Georgia.
• Cancer. 2013 Mar 19. doi: 10.1002/cncr.28003.
[Epub ahead of print]

4/3/13 26

Adipocyte Fatty Acid storage factors enhance subcutaneous fat storage in postmenopausal women
Dr. Sylvia Santosa, PhD
Department of Exercise Science Concordia University
Department of Exercise Science Montreal, Quebec, Canada H4B 1R6

• Dr. Santosa: Our results show that postmenopausal women burn
less fat making more available to be stored. Our results also
suggest that greater fat storage in postmenopausal women are
likely to be attributed to changes in the pathways our fat cells use
to store fat. We found that some of the proteins that help our fat
cells store fat were more active and this greater activity
corresponded with the amount of fat stored from our circulation.
• Dr. Santosa: We thought that one of the main enzymes involved in
breaking down fat for storage, lipoprotein lipase, would be a
greater contributor to fat storage in postmenopausal women. Our
results show that though lipoprotein lipase plays a role, it’s not as
big a role as we thought.

4/3/13 27

Adipocyte Fatty Acid storage factors enhance subcutaneous fat storage in postmenopausal women
Dr. Sylvia Santosa, PhD
Department of Exercise Science Concordia University
Department of Exercise Science Montreal, Quebec, Canada H4B 1R6
(cont)

• MedicalResearch.com What should clinicians and patients take away from your
report?
• Dr. Santosa: Our results indicate that female sex hormones have important effects
on fat tissue storage and oxidation that likely promote fat gain after menopause.

• MedicalResearch.com What recommendations do you have for future research
• We hope that future research is able to build on our results by delving further into
the mechanisms by which sex steriods affect how and where we store fat.

• Citation:
• Adipocyte Fatty Acid storage factors enhance subcutaneous fat storage in
postmenopausal women.
• Santosa S, Jensen MD.
Diabetes. 2013 Mar;62(3):775-82. doi: 10.2337/db12-0912. Epub 2012 Dec 3.

4/3/13 28

Relationship of Early-Onset Baldness to Prostate Cancer in African-American Men
MEDICALRESEARCH.COM INTERVIEW WITH
Charnita Zeigler-Johnson, Ph.D., M.P.H.
Research Assistant Professor CCEB
University of Pennsylvania

• MEDICALRESEARCH.COM: What are the main findings
of the study?
• Dr. Zeigler-Johnson: The main findings of the study
are:
• Younger African-American men diagnosed with
advanced prostate cancer at an early age (under the
age of 60) are more likely to have had a personal
history of early-onset baldness (baldness by age 30.)
• For older patients, this is not necessarily the case, and
future studies will need to focus on which factors place
men in this age group at risk for prostate cancer.
4/3/13 29

Research Assistant Professor CCEB University of Pennsylvania
(cont)

• MEDICALRESEARCH.COM: Were any of the findings unexpected?
• Dr. Zeigler-Johnson: We were surprised to find the association of early onset
baldness and prostate cancer only in younger prostate cancer cases and in more
advanced cases. Other studies have not typically considered the age at diagnosis
or the stage and grade of disease in the outcome.
• Frontal baldness rather than vertex (crown) balding was associated most strongly
with advanced prostate cancer among younger African-American men. This is
different from the vertex baldness association that has been reported among
other studies with very few African-Americans.
• MEDICALRESEARCH.COM: What should clinicians and patients take away from
your report?
• Dr. Zeigler-Johnson: Our study findings suggest to clinicians and patients that
early baldness may one day be a clinical indicator of increased risk for prostate
cancer. In other words, men that experience baldness at an early age may also
have a predisposition for developing prostate cancer because of certain male
hormones that are common in both baldness and prostate cancer progression.
However, these findings need to be confirmed by other studies so that we can be
certain of the relationship that we observed in this study which was the first study
to focus exclusively on this relationship in African-American men.

4/3/13 30

Research Assistant Professor CCEB University of Pennsylvania
(cont)

• MEDICALRESEARCH.COM: What recommendations do you have
for future research as a result of this study?
• Dr. Zeigler-Johnson: Recommendations for future research include
confirming these results with other populations of high risk patients
(including other populations of African descent), determining if
early onset baldness is associated with other prostate cancer
outcomes, and understanding more about the biological link
between baldness and prostate cancer.
• Citation:
• Relationship of Early-Onset Baldness to Prostate Cancer in African-
American Men
• Charnita Zeigler-Johnson, Knashawn H. Morales, Elaine Spangler,
Bao-Li Chang, and Timothy R. Rebbeck
Cancer Epidemiol Biomarkers PrevPublished OnlineFirst March 26,
2013; doi:10.1158/1055-9965.EPI-12-0944

4/3/13 31

Genetic factors in evolution of sleep length – a longitudinal twin study in Finnish adults
MedicalResearch.com Interview with: Christer Hublin
– Assistant Chief Medical Officer, Docent (Adjunct Professor) in Neurology (Helsinki University)
Sleep medicine specialist (NOSMAC/ESRS)
Finnish Institute of Occupational Health FIN-00250 Helsinki Finland

• MedicalResearch.com What are the main findings of the study?
• Answer: We found in an adult twin cohort (the Finnish Twin Cohort)
that the proportion of variance in sleep length accounted for by
genetic effects was relatively low (about one third) but stable
(correlation 0.76 over a period of 15 years.). In contrast, the
proportion of variance accounted for by environmental effects was
high (about 0.7) and these effects were less stable (correlation over
the time period 0.18). The proportion of short sleepers was more
than doubled in both genders, whereas in the proportion of long
sleepers no major change was seen during the follow-up. To our
knowledge, this is the first longitudinal study providing data on the
contribution of genetic factors to stability and change of sleep
length over time.

4/3/13 32

(cont)

unexpected?
• Answer: There was considerable change in sleep length
over the 15 year period as indicated by the relatively low
correlation of sleep length (0.34) between 1975 and 1990.
During the last decades, many studies have been published
showing a significant (in many cases U-shaped) association
between sleep length and several health outcomes, usually
with the smallest risk in those sleeping around 7 hours. It is
interesting to speculate what other possible factors are
reflected in the association between sleep length and the
health outcomes, as the stability of sleep length seems to
be quite low.

4/3/13 33

(cont)

• MedicalResearch.com: What should clinicians
and patients take away from your report?
• Answer: Environmental factors have relative high
effects with low stability over time, which would
suggest that there are major external effects on
sleep length. In clinical a context this would
indicate that there are good possibilities for
effective treatments for those suffering from
short sleep, for example insomnia – one major
subgroup among short sleepers.
4/3/13 34

(cont)

• Answer: Multiple measures are a more robust basis for genetic analyses
than a single cross-sectional measure when studying the evolution of
sleep length. It would be of interest to investigate whether stable or
variable sleep length is important in predicting different health outcomes
given that genetic factors underlie much of the stability. It is possible that
the genetic factor underlying sleep length stability may also be of
importance in the outcomes of interest.
• Citation:
• Genetic factors in evolution of sleep length – a longitudinal twin study in
Finnish adults.
• Hublin C, Partinen M, Koskenvuo M, Kaprio J.
Finnish Institute of Occupational Health, Helsinki, Finland; Department of
Public Health, University of Helsinki, Helsinki, Finland.
J Sleep Res. 2013 Mar 20. doi: 10.1111/jsr.12051. [Epub ahead of print]

4/3/13 35

Independent associations between fatty acids and sleep quality among obese patients
with obstructive sleep apnoea syndrome.
MedicalResearch.com Interview with Dr. Christopher Papandreou
Department of Social Medicine, Preventive Medicine and Nutrition Clinic, Medical School
University of Crete, Heraklion, Greece.

• Dr. Papandreou: Certain adipose tissue fatty acids measured in the
gluteal site were found to be associated with sleep quality
parameters in obese patients with obstructive sleep apnoea
syndrome after controlling for possible confounders.

• More specifically:
• Saturated fatty acids were positively related to total sleep time,
sleep efficiency and rapid eye movement in obese patients with
obstructive sleep apnoea syndrome.
• Polyunsaturated fatty acids were positively associated with sleep
efficiency and rapid eye movement.
• N-3 fatty acids were positively associated with sleep efficiency, slow
wave sleep and rapid eye movement.

4/3/13 36

University of Crete, Heraklion, Greece. (cont)

• Dr. Papandreou First of all, the clinical application of the study’s
data may be valid only for patients with similar characteristics to
those in the population studied.
• The aforementioned adipose tissue fatty acids measured in the
gluteal site would have acted as precursors for sleep-inducing
substances that in turn may have signaled in the brain to impact
sleep quality. Clinicians should take into consideration the
importance of these fatty acids in sleep quality beyond the
syndrome itself and depression that is often diagnosed in these
patients. Since gluteal adipose tissue is considered a reliable
measure of long-term dietary fat intake it would be important to
provide this information to the patients in order to change their
dietary fatty acids intake in the frame of a healthy diet.

4/3/13 37

University of Crete, Heraklion, Greece. (cont)

• MedicalResearch.com: What recommendations do you have for
future research as a result of this study?
• Dr. Papandreou A randomized controlled trial causing a change in
the fatty acid content of the gluteal adipose tissue via a
modification in the dietary fat intake would be examined in relation
to sleep quality in order to shed more light on this issue.
• Citation:
• Independent associations between fatty acids and sleep quality
among obese patients with obstructive sleep apnoea syndrome.
• Papandreou C.
Department of Social Medicine, Preventive Medicine and Nutrition
Clinic, Medical School, University of Crete, Heraklion, Greece.
J Sleep Res. 2013 Feb 25. doi: 10.1111/jsr.12043. [Epub ahead of
print]

4/3/13 38

Novel Susceptibility Variants at 10p12.31-12.2 for Childhood Acute Lymphoblastic Leukemia
in Ethnically Diverse Populations
MedicalResearch.com Author Interview: Jun J. Yang, Ph.D.
Assistant Member Dept. of Pharm. Sci. St. Jude Children’s Research Hospital
262 Danny Thomas Pl., MS313 Memphis, TN 38105

• MedicalResearch.com: What are the main findings of the
study?
• Dr. Yang: We performed a comprehensive survey of
inherited genetic variations for their contribution to the
susceptibility of acute lymphoblastic leukemia (ALL), the
most common cancer in children. This is by far the largest
study of its kind (in terms of the number of subjects
involved), and also the first one to include multi-ethnic
populations. We identified 4 genomic loci related to the
predisposition to ALL, 2 of which contributed to racial
differences in the incidence of ALL. This study provided
unequivocal evidence for inherited susceptibility of
childhood ALL and pointed to novel biology of the
pathogenesis of this disease.
4/3/13 39

(cont)

unexpected?
• Dr. Yang: The racial differences in ALL
susceptibility variants are somewhat surprising.
But this was the first GWAS to include non-
European populations, so we didn’t quite know
what to expect.
• MedicalResearch.com: What should clinicians
and patients take away from your report?
• Dr. Yang: To recognize the contribution of
inherited risk of childhood ALL.
4/3/13 40

(cont)

• Dr. Yang: First of all, the role of inherited genetic variation
is substantial in cancer pathogenesis and the interactions
between germline and tumor genetic variations can be an
very exciting new direction for cancer research.
• Secondly, future genomic studies should strive to include
more non-European subjects, not only to reduce the stark
racial disparities but also to gain novel knowledge of cancer
etiology in general..
• Citation:
• Novel Susceptibility Variants at 10p12.31-12.2 for
Childhood Acute Lymphoblastic Leukemia in Ethnically
Diverse Populations
• J Natl Cancer Inst. 2013 Mar 19. [Epub ahead of print]

4/3/13 41

Coupled Cognitive and Functional Change in Alzheimer’s Disease and the Influence of Depressive Symptoms
MedicalResearch.com Interview with: Laura B. Zahodne, PhD
Postdoctoral fellow in the cognitive neuroscience division in the Department of Neurology and the Taub Institute for
Research on Alzheimer’s Disease and the Aging Brain
Columbia University Medical Center.

• MedicalResearch.com: What are the main findings of the
study?
• Dr. Zahodne: Having more depressive symptoms early on in
Alzheimer’s disease was associated with more rapid
declines in the ability to handle tasks of everyday living,
and this relationship was independent of cognitive decline.
unexpected?
• Dr. Zahodne: Previous studies have shown that depressive
symptoms are associated with more difficulties with
thinking and daily activities. This study additionally shows
that depressive symptoms herald not only more rapid
declines in thinking, but also daily functioning, over time.

4/3/13 42

(cont)

• Dr. Zahodne: Although these findings are
observational, they could suggest that providing
mental health treatment for people with Alzheimer’s
disease might slow the loss of independence.
• Additionally, when making a prognosis for an
Alzheimer’s patient, clinicians should consider not only
memory and thinking abilities, but also levels of
depression, anxiety, and other psychological
symptoms.

4/3/13 43

(cont)

• MedicalResearch.com: What recommendations do you have for
future research as a result of this study?
• Dr. Zahodne: Based on these findings, a question that should be
explored in future research is whether intervention for depression
can be demonstrated to slow cognitive decline, functional decline,
and/or the progression of pathological changes in the brain.
• Citation:
• Coupled Cognitive and Functional Change in Alzheimer’s Disease
and the Influence of Depressive Symptoms.
• Zahodne LB, Devanand D, Stern Y.
• Cognitive Neuroscience Division, Department of Neurology and
Taub Institute for Research on Alzheimer’s Disease and The Aging
Brain, College of Physicians and Surgeons, Columbia University, New
York, NY, USA.
J Alzheimers Dis. 2013 Jan 8. [Epub ahead of print]

4/3/13 44

MedicalResearch.com
Medical Research Author interviews
Editor: Marie Benz, MD
info@hemodialysis.com
April 3 2013

For Informational Purposes Only: Not for Specific Medical Advice.

4/3/13 45

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