Lab Notes

Negative test results impact adherence to lung cancer screening Screening with low-dose computed tomography (LDCT) has been shown to reduce mortality from lung cancer by at least 20% in large randomized clinical trials but with an important caveat: those reductions show up as long as patients show up for annual screening. Failing to maintain annual adherence to recommended screening may diminish the lifesaving ability of these tests to achieve the same mortality benefits found in large clinical trials. A new study led by UCLA investigators aimed to identify factors associated with risk for patient nonadherence to screening recommendations. The findings suggest that patients with consecutive negative screening results are more likely to become nonadherent to screening over time. The authors say individuals who have consecutive negative results are potential candidates for tailored outreach to improve adherence to recommended annual lung cancer screening. Read the May 25 study in JAMA Network Open.

Axillary ultrasound may be unnecessary in diagnostic screening for breast cancer  Adding axillary scanning –scanning under the armpits—in patients undergoing a diagnostic breast ultrasound had minimal impact on cancer detection in a large retrospective study. Only a single cancer, a lymphoma, was incidentally found during a two-year period with 19,692 diagnostic ultrasounds performed. No otherwise occult breast cancers were found. Axillary ultrasound is often used to evaluate the lymph nodes in the axilla, the area under the arm or armpit, as it has the potential to provide important information about the presence or spread of breast and other cancers. Studies have shown it does not provide additional cancer detection in women undergoing routine screening, but the effectiveness of axillary scanning in diagnostic testing–in women with mammographic findings—remains unknown, even as some hospitals use the test routinely. A new study, led by Dr. Iris Chen, radiology resident at the David Geffen School of Medicine at UCLA, is the first to evaluate routine axillary scanning on all diagnostic breast ultrasounds in a large patient population. The authors say the results demonstrate that decreasing unnecessary axillary scanning would lead to fewer false positives without missing any occult breast cancers. “Omitting routine scanning of the axilla for all diagnostic breast ultrasounds may save time and reduce patient anxiety related to unnecessary follow-up and biopsies, without adversely affecting patient care,” they write. Read the study in Clinical Imaging.

Using AI to checking endotracheal tube placement Despite the many papers published on artificial intelligence (AI) for radiology, there are very few systems in routine clinical use. Systems have limited experimental testing and very few undergo evaluation in real-world use. In a previous study, UCLA researchers developed and tested an AI system that can assist in checking endotracheal tube placement and issue alerts to physicians if the tip is not correctly positioned. This new study deployed AI to assist in checking endotracheal tube placement in clinical practice and evaluate its real-world performance with user feedback to determine if broader usage is appropriate. The clinical evaluation showed good performance of the chest x-ray AI system and consistency with previous experimental testing. The user survey results indicated overall agreement with the AI outputs and appropriateness of the alerts by both radiologists and ICU physicians. In terms of the usefulness of the system, user ratings suggest that while the AI does not save them time, it does increase their confidence and works the way they would expect AI to in their workflow. The variability among user responses suggests that larger surveys of more users are warranted. Read the April 25 study in the Journal of Medical Imaging

New Insights on Mitochondrial DNA Deletion Mutations and Aging  Somatic mitochondrial DNA (mtDNA) deletion mutations have long been associated with aging and age-related diseases. However, due to the low frequency of these mutations in tissue homogenates and the need for DNA amplification, mapping and quantifying them has remained a challenge. A new study led by UCLA Health dermatologist Dr. Amy Vandiver explores a new approach to tackle this problem. The researchers employed nanopore Cas9-targeted sequencing (nCATS) to map and quantitate mtDNA deletion mutations, yielding a more comprehensive picture of the spectrum and quantity of these mutations. The study analyzed mtDNA in muscle samples from 15 men ranging in age from 20 to 81 years, as well as brain samples from six men aged 20 to 79 years. The results showed that mtDNA deletion mutations increased exponentially with age and mapped to a wider region of the mitochondrial genome than previously thought. To address the challenge of identifying these mutations, the study developed two algorithms that identify both previously reported and novel mtDNA deletion breakpoints. The identified mtDNA deletion frequency measured by nCATS strongly correlates with chronological age and predicts the deletion frequency as measured by digital PCR approaches. The study provides new insights into the relationship between mtDNA deletion frequency, mtDNA deletion genomic location, and chronological aging. It also highlights the importance of developing more accurate methods for studying these mutations, which may help us better understand the mechanisms underlying aging and age-related diseases. Ultimately, this research may pave the way for the development of new therapeutic approaches for these conditions. Read the study in Aging Cell 

Lactation induction in a transgender woman A new study looked at the nutritional quality of milk produced by lactation induction with positive findings. Induction of lactation refers to using specific methods and medications to stimulate the production of breast milk in someone who is not carrying a pregnancy. The ability to produce breast milk can have important benefits, including bonding with the child, providing optimal nutrition, and promoting the health of both the child and the breastfeeding parent. For transgender women and nonbinary people on estrogen-based hormone therapy, being able to produce one’s own milk can also be a significant gender-affirming experience. While previous case studies have described induced lactation in transgender women, this study additionally evaluates the nutritional quality of the produced milk, and includes the participant's perspective in her own words. The participant in this study successfully induced lactation through a combination of medication therapy, breast pumping and eventually direct breastfeeding. Analysis of the participant's milk showed robust nutrient levels, similar to those seen with lactation following pregnancy. The findings suggest that the milk produced by non-gestational transgender women and nonbinary people on estrogen-based hormone therapy is nutritionally adequate for their infants, and highlights the importance of this experience on a personal level. Read more in the case study published May 3, 2023 in the Journal of Human Lactation. 

Health policies on gender-affirming care Within the United States, access to gender-affirming surgeries covered by health insurance has increased over the past decade. However, the rapidly changing landscape and inconsistencies of individual state health policies guiding private and public insurance coverage present a lack of clarity for reconstructive surgeons and other physicians attempting to provide gender-affirming care. This study looked at the current policies in the United States regarding health insurance coverage for gender-affirming care. Researchers analyzed policies from each state and found that about half of the states had protective policies for gender-affirming care, while a number of states restricted state health insurance coverage for gender-affirming care, despite federal law prohibiting gender discrimination under the Affordable Care Act. There were also regional differences, with the Northeast and West having more protective policies and the Midwest and South having more restrictive policies. The findings suggest that clear and consistent policies are important for healthcare providers care for transgender and gender-diverse individuals. Read the study published April 25, 2023 in Plastic and Reconstructive Surgery.

Retinal pigmented epithelium “nibbles” away outer segment tips The retinal pigmented epithelium (RPE) serves a key support role in the retina, nourishing and maintaining photoreceptor cells in ways that are crucial for vision. This includes “nibbling” away at the tips of the outer segment (OS) of rods and cones. Photoreceptors are made up of stacks of membranous discs that contain photoreceptive proteins. UCLA researchers studied a process in the retina in which the photoreceptor outer segment tips are ingested by the RPE. Interactions between the photoreceptors and RPE are crucial for retinal health, and many retinal diseases are caused by disruptions in this interaction. Investigators developed high-speed 3D imaging to examine live RPE cells for the first time. Thus, they resolved a long-standing question of the mechanics underlying how the photoreceptor outer segment tips are ingested by the RPE. Read the study published April 14, 2023 in The Journal of Neuroscience.

Mixed ancestry study provides clues to genetic traits A new multi-institutional study led by scientists at the Bioinformatics Interdepartmental Program at UCLA has found that individuals of mixed ancestry, such as African Americans, inherit a mosaic of ancestry segments from multiple ancestral populations, providing a unique opportunity to investigate the similarity of genetic effects on traits across different ancestries within the same population. The study, which analyzed 38 complex traits in African-European admixed individuals, found very high correlations of causal genetic effects across local ancestries, much higher than the correlation of causal effects across continental ancestries. The findings have implications for the inclusion of ancestry-diverse individuals in genetic studies and suggest that genetic analyses should assume minimal heterogeneity in causal effects by ancestry. The study was conducted by researchers using a new approach called radmix to estimate the correlation of causal genetic effects across local ancestries. The results were replicated using regression-based methods from marginal genome-wide association study summary statistics. The study also found scenarios where regression-based methods yielded inflated heterogeneity-by-ancestry due to ancestry-specific tagging of causal effects and/or polygenicity. Read the study published March 20, 2023 in Nature.

Sex rarely considered in obesity studies A review of medical literature on neuroimaging investigations of obesity showed that the sex of the participant was rarely considered as a variable, a factor that may provide useful information in developing sex-specific biomarkers and interventions. Arpana Gupta and colleagues analyzed approximately 200 online studies using specific search terms, finding that only 13 percent considered sex in their analyses or even controlled for it, despite documented evidence that obese men and women show increased activity and connectivity in markedly different areas of their brains. The researchers, who reviewed literature from 2010 to the present, noted that while the number of studies that include sex as a criteria began to increase slightly after 2015, gender- specific information that could lead to better understanding of the neural correlates of obesity and response to its treatment of men and women is currently limited – and should be considered relevant in future research. Read the article published March 18, 2023 in Current Obesity Reports 

Medicaid, low-volume hospitals and surgical outcomes In a new study, UCLA researchers examined how the Affordable Care Act impacted the clinical and financial outcomes of children surgically treated for congenital heart disease. The researchers analyzed the Nationwide Readmissions database from 2010-2018 and found that patients with Medicaid coverage who received congenital heart surgery had increased mortality, hospital readmissions, fragmented care, and higher costs compared to those with private insurance. They also noted that those covered by Medicaid went to low-volume hospitals and may have received lower-quality care. Given these findings, the researchers are calling efforts to refer Medicaid patients to high-performing centers. Read the study in published March 12, 2023 in Pediatric Cardiology. 

Limiting ECMO to experienced centers may reduce treatment disparities A new UCLA Health study has found patients who require extracorporeal membrane oxygenation (ECMO) are more likely to survive at high-volume hospitals compared to low-volume hospitals. ECMO -- a machine that acts as an artificial pump by providing oxygenated blood to the heart and lungs – requires resources-intensive care and surgical expertise. Given the rising use of the device, especially among critically ill COVID-19 patients, and better outcomes at high-volume hospitals, the researchers are calling for centralizing care to reduce disparities in rural or economically disadvantaged communities. The hub and spoke model entails a referral center that will acquire patients who are on or about to be put on ECMO at low-volume hospitals. While this model would require collaboration among hospitals and infrastructural changes, the researchers say there has been significant interest in centralized care among doctors that treat patients with ECMO. Read the March 11, 2023 study in Surgery. 

Influenza vaccination rates are low A new study finds that patient portal interventions to remind patients to receive the influenza vaccine during the COVID-19 pandemic did not raise influenza immunization rates. UCLA researchers evaluated three health system-wide interventions using the electronic health record's patient portal to improve influenza vaccination rates. The investigators examined different interventions to test messaging strategies based upon behavioral economic principles, plus strategies to make influenza vaccinations more accessible. The strategies included pre-commitment messages, monthly patient reminders, allowing patients to directly schedule their own flu vaccine appointments or get the vaccine at multiple UCLA sites, and flu vaccine reminders sent just prior to existing appointments. However, after analyzing the data of 213,773 patients, the results suggest these interventions did not work to raise flu vaccination rates. The authors conclude that more intensive or tailored interventions are needed to increase influenza vaccination rates beyond just using patient portals. Read the study in the March 2, 2023 issue of Preventive Medicine. 

Visual loss and mask-wearing practices Face mask-wearing practices and their impact on the visual field bear particular importance in the COVID-19 pandemic era. This case series examines 10 participants with no history of ocular impairment or visual field defects who underwent age-corrected visual field testing in both eyes with different types of face masks. Wearing duckbill N95 masks was consistently associated with errors in the inferior visual field, the lower area of peripheral vision that identifies potential obstacles such as curbs and other uneven pavement, when compared to wearing surgical masks or no masks. These findings support public health guidance that has attributed increased risks of falls and accidents to face mask wearing. Read the study in the February 2023 issue of Indian Journal of Ophthalmology.

Childhood trauma linked to worse outcomes among Parkinson’s patients: A new study of people with Parkinson’s disease finds that those who experienced childhood trauma had more symptoms, both motor and non-motor, as well as a decreased quality of life compared to others with the disease. While previous research has found people with neurological disorders have higher rates of adverse childhood events (ACE) compared to the general population, this new study – based on a survey of patients with Parkinson’s – is the first to examine the relationship between ACEs and Parkinson’s and adds to our understanding of the long-term health impacts of childhood traumas. The authors say additional research is needed to understand practical clinical implications, which could pave the way for mental health and social support referral of Parkinson’s patients. Read the study published Feb. 20 in Neurology: Clinical Practice.

Body composition, not BMI, may signal risk for cardiovascular disease  Body mass index has long been a measure of a person’s risk of developing cardiovascular disease, but body composition and its role in the disease have not been well studied. In a new study, UCLA researchers predicted higher fat mass would be linked to higher levels of coronary artery calcification (CAC) -- a marker of subclinical cardiovascular disease – and higher fat-free mass would be linked to lower levels of CAC. Using computed tomography scans and bioelectrical impedance analysis to study CAC and body composition in 3,129 non‐Hispanic Whites, Blacks, Hispanics, and Chinese patients, the researchers unexpectedly found that higher fat-free mass and, to a lesser extent, higher fat mass were linked to high levels of CAC. The researchers cautioned that bioelectrical impedance analysis could not identify the quality of fat or fat-free mass. Given these findings, the researchers say measuring body composition rather than using BMI to assess obesity may be a better approach to evaluating cardiovascular disease risk. Read the study published Feb. 8, 2023 in the Journal of the American Heart Association.

Bariatric surgery reduces risks of hospitalization for heart failure Bariatric surgery has been found to reverse the ill effects of diabetes and may be protective against obesity-related cancers. Because obesity rates are on the rise across the globe, UCLA researchers set out to study other health benefits weight loss surgeries confer, in particular the link between the procedures and acute heart failure hospitalizations. After analyzing data from the Nationwide Readmissions Database from 2016 to 2019, the researchers found bariatric surgery was associated with lower odds of being hospitalized with acute heart failure. Among patients hospitalized with acute heart failure, prior bariatric surgery was associated with lower risks of death, prolonged ventilation, and acute renal failure. Beyond the health benefits, those who had undergone surgery stayed one fewer day in the hospital and incurred about $1,200 less in hospital costs compared to age matched cohorts. Read the study in Surgery for Obesity and Related Diseases. 

Pesticides may also worsen Parkinson’s symptoms: While researchers have consistently found an association between pesticide exposure and higher risk of developing Parkinson’s disease, there has been little study of whether such exposure can accelerate the course of the disease. In a new study of 53 pesticides associated with Parkinson’s onset, researchers led by UCLA assistant professor of neurology Kimberly Paul, PhD, identified 10 pesticides that are associated with faster progression of motor and non-motor symptoms. Furthermore, exposure to six of those pesticides was associated with worsening of multiple endpoints researchers measured. Two pesticides, copper sulfate (pentahydrate) and MCPA (dimethylamine salt), were associated with all three endpoints measured: motor function, cognitive function, and depressive symptoms. Read the study in the journal Science of the Total Environment.

Repurposing an old drug for a rare disease: A drug used to treat epilepsy, retigabine, may help manage episodic attacks of paralysis in patients with the rare inherited muscle disease Hypokalemic Periodic Paralysis (HypoPP), according to a new study that tested retigabine in genetically engineered mice. There’s a strong need to identify new HypoPP treatments since existing ones only improve symptoms in about half of patients and have considerable side effects. HypoPP is often marked by reduced potassium levels in the blood during episodes of muscle weakness. While it was known that retigabine affects a potassium channel that plays an important role in the heart and brain, the channel wasn’t previously known to exist in skeletal muscle. However, the new study led by Dr. Stephen C. Cannon, chair of the physiology department at the UCLA David Geffen School of Medicine, found that retigabine helps stabilize the membrane potential of skeletal muscle, thereby protecting against attacks of muscle weakness. Read the study, published online Jan. 30, in the journal Brain.

A new clue about Parkinson’s progression The transmission of misfolded proteins in the brain is a key mechanism for the progression of various neurodegenerative diseases including Parkinson's disease and Alzheimer's disease. Chao Peng, PhD, an assistant professor of neurology, found a novel mechanism that regulates the transmission of one of these pathological proteins, misfolded alpha-synuclein, which leads to disease progression in Parkinson’s. This mechanism is the discovery that many modifications that a cell makes in these proteins alter their ability for transmission in the brain and disease progression. This discovery not only provides critical insights into disease mechanism but also facilitates the development of novel therapy for neurodegenerative diseases. Read the study, published Jan. 23, in Nature Neuroscience.

Gender-affirming hormones tied to mental health for transgender youth Transgender and nonbinary teens who receive gender-affirming hormones experience improvement in body satisfaction, life satisfaction and less depression and anxiety than before treatment. These findings are according to newly-published research by a four-site prospective, observational study and co-authored by Marco A. Hidalgo, PhD. Dr. Hidalgo is a clinical psychologist and Associate Clinical Professor of Medicine at the David Geffen School of Medicine at UCLA. Read the study published January 19, 2023 in the New England Journal of Medicine.

Urban heat islands, redlining and kidney stones The persistent rise in kidney stone prevalence in recent decades has prompted much speculation as to the causes. There has been some discussion about the effect of heat on nephrolithiasis. A review of recent data suggests that heat may play a role in stone formation on a large scale and among African-Americans in particular. A new UCLA-led study led by Dr. Kymora B. Scotland states that African-Americans are the race/ancestry group with faster rates of increasing incidence and prevalence of kidney stones. Researchers also found that urban heat islands in the United States have resulted in part from the effects of redlining, a practice of systematic segregation and racism in housing that led to the development of neighborhoods with substantial disparities in environmental conditions. Dr. Scotland and her team hypothesize that the increased temperatures experienced by residents in redlined communities, many of whom are African American may contribute to the 150% increase in the prevalence of kidney stones in African Americans in recent decades. Read the study in the January 1, 2023 issue of Current Opinion in Nephrology and Hypertension.

Women treated with thrombectomy for pulmonary embolism fare worse A new study led by UCLA researchers analyzed the different outcomes in men and women with a pulmonary embolism who are treated by a percutaneous pulmonary artery thrombectomy- a procedure in which a catheter is placed in a patient’s lung to dissolve or remove a blood clot. After analysis of a national cohort of US patients from an inpatient claims-based database, researchers reported that women had higher rates of procedural bleeding, vascular complications, and needed more blood transfusions compared to men. They also found that women had higher in-hospital death rates and were more likely to go a nursing home or an assisted living facility instead of returning home after discharge. Given these disparities in outcomes, study authors are calling for more sex-based research. Read the study in the January 1, 2023 issue of CHEST. 

Masks for COVID also prevented whooping cough A new analysis by researchers at UCLA Health finds public health prevention measures taken during the COVID pandemic led to a dramatic drop in whooping cough cases in their health system. Whooping cough, or pertussis, spreads rapidly through droplet transmission, impacting individuals of all ages. Whooping cough is vaccine preventable, however immunity wanes over time. When patients seek care, the risk of transmission to other patients and health care workers can be high. The researchers sought to evaluate the impact of COVID-19 mitigation measures, like masking and school closures, on the number of primary pertussis cases in patients and secondary cases in staff members at ambulatory clinics at their institution before and after the COVID-19 pandemic. Pertussis cases for 2019, 2020, and 2021 were 1,008, 87, and 0 respectively. There were no reported health care worker exposures after March 2020. The authors say their findings demonstrate that masking can impact respiratory disease transmission outside of COVID-19, and that the results are of clinical importance in health care as they show how wearing a mask with symptomatic respiratory patients can be beneficial in reducing exposure to health care workers. Read the study in the American Journal of Infection Control

Microbiome approaches to food allergies The prevalence of food allergies continues to rise, and with limited existing therapeutic options there is a growing need for new and innovative treatments. Food allergies are, in a large part, related to environmental influences on immune tolerance in early life, and represent a significant treatment challenge. This review, led by Dr. Diana Chernikova, pediatric allergy and immunology fellow at the David Geffen School of Medicine at UCLA, discusses the intersection between the gut microbiome and the development of food allergies, with particular focus on microbiome therapeutic strategies. These emerging microbiome approaches to food allergies are subject to continued investigation and include dietary interventions, pre- and probiotics, microbiota metabolism-based interventions, and targeted live biotherapeutics. Read about the findings in the Dec. 3, 2022 issue of Nutrients.

Medicaid expansion, increased access may reduce HIV infections Enacting Medicaid expansion and increasing the use of preventive and antiviral medications could result in a decline of new HIV infections among young Black gay, bisexual, and other men who have sex with men (MSM), reports a study co-authored by Dr. Nina Harawa, professor of Medicine and Epidemiology at the UCLA David Geffen School of Medicine and the Fielding School of Public Health. Led by Francis Lee, PhD, of the University of Chicago, the study used a technique called "agent-based network modeling" to simulate the effects of alternative Medicaid expansion strategies on HIV transmission among young Black gay, bisexual, and other MSM in Houston. Simulations projected the effects of Medicaid expansion alone and with the addition of two further strategies that have shown promise in increasing engagement with ART and PrEP. In the study models, all three scenarios were projected to lead to considerable declines in HIV transmission among young Black gay, bisexual, and other MSM. With Medicaid expansion alone, the HIV incidence rate (new cases per 100 uninfected) was projected to decrease by 17.5% by the tenth year, while the number of new infections would decrease by 14.9%. The most aggressive scenario modeled would nearly halve rates of new infections. Read the study in the journal Medical Care.

Hope for a highly lethal brain cancer A study led by Dr. Linda Liau of the Jonsson Comprehensive Cancer Center finds a cancer vaccine co-developed by Dr. Liau at UCLA led to meaningful increases in survival for patients with glioblastoma multiforme (GBM), a highly lethal brain cancer with a nearly 100% recurrence rate and dismal patient survival. Glioblastomas are aggressive and rapidly lethal; there is a pressing need for new treatments and for novel clinical trial designs to streamline their development. This phase 3 nonrandomized controlled trial of 331 patients found newly-diagnosed GBM patients who received DCVax-L had a median overall survival of 19.3 months after randomization (22.4 after from surgery) compared to 16.5 months survival among a group of external control patients treated with standard care.  For patients with recurrent GBM, median overall survival was 13.2 months from relapse in the DCVax-L group vs 7.8 months in the external control cohort. Meaningful increases in the long-term tails of the survival curves in both nGBM and rGBM were also observed. Read the study in JAMA Oncology and hear Dr. Liau discuss its results and implications in this JAMA podcast.

UCLA Health's response to unaccompanied children at the border A new report details the University of California Health (UCH) system-wide, rapid response to the humanitarian crisis of unaccompanied children crossing the southern U.S. border in the midst of the COVID-19 pandemic in 2021.  In collaboration with multiple federal, state, and local agencies, UCH mobilized a multidisciplinary team to deliver acute general and specialty pediatric care to unaccompanied children at two Californian emergency intake sites. The response, which did not disrupt normal UCH operations, mobilized the capacities of the system and resulted in a safe and developmentally appropriate environment that supported the physical and mental health of migrant children during this traumatic period. Overall, 260 physicians, 42 residents and fellows, four nurse practitioners participated as treating clinicians and were supported by hundreds of staff across the 2 sites. Over five months and across both sites, a total of 4,911 children aged 3–17 years were cared for. A total of 782 children had COVID-19, most infected prior to arrival. Most children (3,931) were reunified with family or sponsors. Read more in the Nov. 15, 2022 report in Academic Medicine.

When congenital heart disease patients get cancer: A new study of cancer outcomes in people with adult congenital heart disease (ACHD) indicates the need for more concerted efforts to appropriately screen and care for this unique population. This collaborative study from the UCLA Adult Congenital Heart Disease and cardio-oncology programs found that all cardiac events in this population were able to be addressed successfully without permanent discontinuation of cancer therapy. In this cohort of adults with both conditions, the median age of cancer diagnosis was only 43.5 years. Only 10% of cancers were detected through screening, and a quarter of all patients had metastatic disease at time of diagnosis. Despite predominantly moderate or great anatomic complexity of congenital heart disease and a high incidence of adverse cardiac events, most deaths occurred due to cancer rather than cardiovascular causes. The authors say the data shows that it is feasible to administer systemic cancer therapy to such a cohort and manage cardiotoxicity without prolonged discontinuation of therapy. Additionally, the authors underscore the need to better define cancer screening in this high-risk population to ensure timely diagnosis and improved outcomes. Read the study in Cardio-Oncology.

Diversity in Gastroenterology A new survey of more than 1,200 gastroenterology (GI) and hepatology professionals in the United States assessed current perspectives of racial and ethnic workforce diversity and health care disparities. It finds the most frequently reported barriers to increasing racial and ethnic diversity in GI and hepatology were insufficient representation of underrepresented racial and ethnic minority groups in the education and training pipeline (reported by 35.4% of respondents), in professional leadership (27.9%), and among practicing GI and hepatology professionals (26.6%). The survey also underscored the discrepancy in satisfaction with workplace diversity among GI and hepatology physicians by race and ethnicity. While 63% of Black physicians were very or somewhat unsatisfied with workplace diversity, 78% of white physicians were very or somewhat satisfied. Read the study in the December 2022 issue of Gastroenterology.

An unexpected Alzheimer’s discovery Little is known about how non-neuronal brain cells known as astrocytes – distinguished by their “bushy” star-like shape – differ in structure or function across the brain, or how these cells may contribute to neurological disease. In a new UCLA-led study aimed at better understanding the molecular similarities and differences between astrocytes, researchers found gene networks correlated with the cells’ shape unexpectedly contained Alzheimer’s disease risk genes. When researchers working with mice reduced the expression of key genes related to the cells’ shape in the hippocampus, making the astrocytes less complex, cognitive function was reduced. They also found the expression of the same genes was reduced in human brains of Alzheimer’s patients. The findings suggest that therapies restoring astrocyte structure may help fight Alzheimer’s. The study was led by Fumito Endo, a project scientist in the lab of UCLA professor of physiology and neurobiology Baljit Khakh. Read the Nov. 4, 2022 study in Science.

Environmental risk of neurodegeneration While scientists increasingly recognize long-term exposure to air pollution as contributing to the development of neurodegenerative diseases like Parkinson’s and Alzheimer’s, how this exposure increases the risk is not well understood. A new UCLA study of air pollution exposure in a novel animal model found that the exposure caused neuronal loss, which was at least partly due to a buildup of protein aggregates in the brain. The researchers, led by Dr. Jeff Bronstein, director of the Movement Disorders Program at UCLA, also found that pollution exposure activated inflammatory cells that can be both good and bad, indicating that any medications to combat inflammation should be highly targeted to cells that can damage neurons. Read the study in Scientific Reports

New approach to bladder cancer A new UCLA-led study of 82 patients with a high-risk form of bladder cancer shows that 71% of the patients, all of whom had not responded to typical therapy, responded to an experimental immunotherapy drug called NAI, which works by activating the body’s natural killer cells. After two years, 90% of the patients who responded to the drug avoided surgery to remove the bladder and there were no deaths from bladder cancer among all 82 patients. The study was funded by ImmunityBio and the results appear in the Nov. 10, 2022 issue of NEJM Evidence.

Housing & Health: It's complicated Previous evidence has shown that housing insecurity—that is, difficulty with housing affordability and stability—is prevalent and results in increased risk for both homelessness and poor health. But a new study finds weak evidence that interventions to boost housing affordability and stability make a difference in improving health. Led by Dr. Katherine Chen, health sciences clinical instructor at the David Geffen School of Medicine at UCLA, the authors conclude that existing strategies to prevent housing insecurity, while necessary, are not sufficient to achieve long-term health gains for vulnerable populations and may need to be both modified and partnered with other policies to redress social inequity, including racism in housing. Read the study in the Nov. 2, 2022 issue of JAMA Network Open

A lab in the palm of your hand Using swarms of pinhead-sized magnets inside a handheld, all-in-one lab kit, UCLA researchers have developed a technology that could significantly increase the speed and volume of disease testing, while reducing the costs and usage of scarce supplies. Read more in this Nov. 10, 2022 press release from the UCLA Samueli School of Engineering here.

Young investigator award October 26, 2022: Roni Haas, PhD, postdoctoral scholar in the lab of Paul Boutros has received a 2022 Young Investigator Award from the Prostate Cancer Foundation. The award will support Haas’s prostate cancer research project, Associating Germline Variants with Prostate Tumor Evolution and Lethality, at total of $225,000 over three years. Read more about the PCF Young Investigator Awards here.

Do celebrity endorsements increase vaccination? In the year between October 2020 and October 2022, Americans’ willingness to be vaccinated (defined as being vaccinated or planning to be) increased from 47.6% to 81.1%. A new survey led by Arash Naeim at the Center for SMART Health at UCLA’s Clinical and Translational Science Institute looked at how much impact five strategies had on increasing the willingness of unvaccinated adults to get their shots. It found endorsements by members of the scientific community, healthcare professionals, or celebrities had no positive effect. What did? The chance to relax the need for masks and social distancing, financial incentives, and vaccine requirements for attending sporting events traveling and work. Read the study in Vaccine.