Research Recap: July 19 - July 30
A new biweekly overview of recent studies published by Institute investigators and their collaborators spans a wide variety of topics, including:
HIV Pre-Exposure Prophylaxis (PrEP), COVID-19 transmission, genomics, benefits of green space, breast cancer screening of childhood cancer survivors, and medication safety.
For all faculty publications, see our Publications page. For up-to-date media coverage and research findings, visit In the Media, and follow us on Twitter. To search for a subject matter expert, visit our Investigator Directory.
Taking a closer look at PrEP prescribing in urban safety-net settings
In a new report senior-authored by Julia Marcus, the study team evaluated PrEP prescribing among potential PrEP candidates in a safety-net health system that serves a county designated as an Ending the HIV Epidemic (EHE) initiative priority area using electronic health records (EHR) for patients receiving outpatient primary care within the network. Study results suggest low frequency of PrEP prescribing among potential PrEP candidates engaged in primary care at an urban safety-net health system. The authors suggest that investments in strategies be made to increase prescribing in these safety-net settings to scale up PrEP.
Institute Investigator(s): Julia Marcus
Does adherence to cancer prevention guidelines improve colorectal cancer survival?
Because evidence for specific recommendations for cancer survivors is scarce, cancer patients are advised to follow cancer prevention guidelines. In a study published in Cancer Epidemiology, Biomarkers & Prevention, a team including Joshua Petimar examined whether diet and lifestyle scores measuring adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention guidelines were associated with colorectal cancer-specific and overall mortality among 1,491 colorectal cancer (CRC) patients in two prospective cohorts. The team concluded that adherence to the WCRF/AICR cancer prevention recommendations was associated with improved survival in colorectal cancer patients, and suggest that future studies on cancer survivors will continue to contribute to evidence-based lifestyle and diet recommendations for cancer patients.
Institute Investigator(s): Joshua Petimar
A case study on the adequacy of hospital room ventilation
A highly symptomatic patient with undiagnosed COVID-19 and high viral load was inadvertently placed in a positive-pressure room in the Brigham and Women’s Medical Intensive Care Unit (MICU). What followed was a case study on the risk of long-range SARS-CoV-2 transmission associated with positive-pressure rooms, published in Infection Control & Hospital Epidemiology by Chanu Rhee, Meghan Baker, and Michael Klompas. Of the 59 people (7 patients, 52 healthcare workers) exposed to the COVID19+ patient, none tested positive. The authors speculate that the lack of transmission in this particular case was due to the high rate of air changes in the patient’s room, which would have rapidly diluted aerosols; the protection afforded by distance from the source patient leading to further aerosol dilution; universal staff masking; and high vaccination rates.
Exploring the relationship between dietary fat intake in early pregnancy and fetal growth
The mechanisms underlying the relationship between fat consumed during pregnancy and effects on fetal growth remain unclear. A team including Marie-France Hivert, Emily Oken, Sheryl Rifas-Shiman and former fellow Andres Cardenas examined the associations of maternal fat intake during first and second trimesters of pregnancy of mothers with majority normal BMI with DNA methylation levels at the IGF2-DMR and H19-DMR in cord blood nucleated cells. Participants of the study included members of Project Viva. The team, whose observations were published in Environmental and Molecular Mutagenesis, noted that maternal omega-6 and omega-3 intake during early gestation was associated with differential IGF2 and H19 DNA methylation at birth. Saturated fat intake during mid-pregnancy was positively associated with IGF2-DMR DNA methylation.
Exploring a possible link between early exposure to green space and cognition
Do children with early life access to green spaces have better cognition than those who don’t? A new study in American Journal of Epidemiology led by research fellow Marcia Pescador-Jimenez with Sheryl Rifas-Shiman, Marie-France Hivert, Emily Oken, and senior author Peter James explored this question within the Project Viva cohort. The team estimated residential greenness of study participants at birth and at early and mid-childhood, administered standardized assessments of verbal and nonverbal intelligence, visual-motor abilities, and visual memory. Findings suggest that greenness was nonlinearly associated with higher mid-childhood visual memory, highlighting the importance of nonlinear associations between greenness and cognition. In short, exposure to land that is partly or completely covered with grass, trees, shrubs, or other vegetation is important early in life.
Does a child’s participation in genomic studies effect their parent(s) psychologically?
Few studies have addressed parental psychological health effects associated with their child's participation in genomic studies, particularly when parents meet the threshold for clinical concern for depression. To help begin to close this knowledge gap, a team including Kurt Christensen published a study in Journal of Genetic Counseling that aimed to determine if parents’ depressive symptoms were associated with their child's participation in a randomized-controlled trial of newborn exome sequencing. They found that, within the population studied, parents with elevated scores on the Edinburgh Postnatal Depression Scale (EPDS) were typically temporary and parents attributed their symptoms to postpartum life stressors rather than participation in a trial of newborn exome sequencing.
Institute Investigator(s): Kurt Christensen
Evaluating crisis standards of care guidelines during COVID-19
Over 30 states within the U.S. published guidelines, known as crisis standards of care (CSCs) for allocating scare critical care resources during the pandemic. The guidelines outline ethical principles and triage algorithms to support resource allocation decision – in other words, they aim to identify patients most likely to survive if offered scarce resources. How well did they maximize population-wide benefit? A team including Chanu Rhee, with a team of outside collaborators on behalf of STOP-COVID investigators, published a study in Cell Reports Medicine. They tested three approaches to CSC algorithms within a cohort of 2,272 COVID-19+ adults from the STOP-COVID multicenter. Their work stresses the importance of testing triage algorithms to ensure they achieve the ethical principles they are designed to operationalize.
Institute Investigator(s): Chanu Rhee
Benefits and cost-effectiveness of early breast cancer screening of childhood cancer survivors
Female survivors of childhood cancer treated with chest radiation fall into the category of “high risk” for early onset breast cancer, and thus are recommended for early screening. Although female survivors of childhood leukemia or sarcoma treated without chest radiation are also at elevated risk, the potential clinical benefits and cost-effectiveness of early breast cancer screening among these women are uncertain. A study in Journal of the National Cancer Institute senior-authored by Natasha Stout used data from the Childhood Cancer Survivor Study to adapt two Cancer Intervention and Surveillance Modeling Network (CISNET) breast cancer simulation models to reflect the elevated risks of breast cancer and competing mortality among leukemia and sarcoma survivors. Study findings suggest that the early initiation of breast cancer screening at age 40 for survivors of childhood leukemia or sarcoma may reduce breast cancer deaths by half and is cost-effective. This may help inform screening guidelines for survivors treated without chest radiation.
Institute Investigator(s): Natasha Stout
Filling a knowledge gap: examining PFAS concentration trends in overweight and prediabetic adults
A study team led by research fellow Pi-I Debby Lin with former fellow Andrews Cardenas and current faculty Marie-France Hivert and Emily Oken looked at the trend of blood concentration of polyfluoroalkyl substances (PFAS) among U.S. adults. Individuals who are overweight and obese may be at especially at risk for adverse effects of PFAS, but most studies concentrate on adults with diabetes. In this study, they sought to expand upon the limited information available for pre-diabetic adults, and to also evaluate any variations by sex, race/ethnicity, and age. Results, published in Environment International, showed that males had higher geometric means of PFOS and PFNA than females, while Black participants had higher geometric means than white participants.
Institute Investigator(s): Marie-France Hivert, Pi-I Debby Lin, Emily Oken
Risk factors associated with rituximab use in pediatric patients
A new study led by Mei-Sing Ong published in Rheumatology investigated the incidence and risk factors for hypogammaglobulinemia and infectious complications associated with rituximab treatment in childhood-onset rheumatic diseases. The team examined approximately 85 patients ages 6 to 24 at Boston Children’s Hospital who received rituximab for the treatment of a childhood-onset rheumatic disease between 2009 - 2019. Findings showed that rituximab, sold under the brand name Rituxan, use in children resulted in higher incidences of hypogammaglobulinemia and subsequent serious infections than in adults.
Institute Investigator(s): Mei-Sing Ong