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Feed for "Health + Behavior" newsU.S. News and World Report ranks UCLA in all 10 specialties surveyed

UCLA Mattel Children’s Hospital’s overall excellence in pediatric care is highlighted in a national assessment published online today.

The annual Best Children’s Hospitals rankings by U.S. News and World Report recognizes UCLA for quality in all 10 specialties it measures.

The assessment of 187 hospitals relies on clinical data and reputation surveys of health care providers to identify the top 50 pediatrics programs in the U.S. in each of the disciplines. UCLA Mattel Children’s Hospital placed in all 10 specialties.

Two UCLA pediatric programs ranked in the top 15 nationally — nephrology (12) and orthopaedics (15). Eight other programs placed in the top 50 — gastroenterology (31), neurology/neurosurgery (32), cardiology (35), urology (40), neonatology (43), pulmonology (43), endocrinology (44) and cancer (45).

“UCLA provides outstanding care to children with a wide range of medical conditions, as reflected in these rankings, and we continue to place among the nation’s top children’s hospitals,” said Dr. Sherin Devaskar, physician-in-chief of UCLA Mattel Children’s Hospital and the Mattel Executive Endowed Chair of the department of pediatrics. “We are proud of the continued strong showing of our programs.”

Johnese Spisso, president of UCLA Health and CEO of UCLA Hospital System, said, “We are proud of the highly skilled teams of physicians, nurses, therapists, social workers and others who collaborate closely to provide family-focused, inpatient care to patients at UCLA Mattel Children’s Hospital.”

To determine the rankings, U.S. News surveyed hospitals for data on patient outcomes, number of procedures performed, staffing levels, use of technology, clinical support programs and a wide range of other information. The methodology (PDF) also incorporated responses from more than 3,200 pediatricians who were asked where they would send the sickest children in their specialty, regardless of location or expense.

UCLA Mattel Children’s Hospital, which is located in the Ronald Reagan UCLA Medical Center, has been consistently recognized for broad excellence since the Best Children’s Hospitals rankings were introduced in 2007. UCLA’s facilities are designed to serve the most critically ill children with sophisticated, compassionate care in an environment that is both welcoming and healing to patients and their families.

A $50 million gift from Mattel, Inc., announced in March 2017, will help the hospital continue to expand access to high-quality pediatric care and develop innovative programs to enhance children’s health worldwide.

“The pediatric centers we rank in Best Children’s Hospitals deliver exceptionally high-quality care and deserve to be recognized for their commitment,” said Avery Comarow, U.S. News’ health rankings editor. “Children with life-threatening illnesses or rare conditions need the state-of-the-art services and expertise these hospitals provide every day.”

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Playroom+at+UCLA+Mattel.jpgPlayroom at UCLA MattelUCLA Mattel Children’s Hospital has been consistently recognized since the Best Children’s Hospitals rankings were introduced in 2007.

Playroom at UCLA Mattel Children’s Hospital 

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Playroom+at+UCLA+Mattel.jpgPlayroom at UCLA Mattel

Playroom at UCLA Mattel Children’s Hospital 

PhilHampton310-267-7014phampton@mednet.ucla.eduThe assessment relies on clinical data and reputation surveys of health care providers to identify the top 50 programs in each of 10 disciplines.Phil Hamptonhttp://newsroom.ucla.edu/releases/ucla-mattel-childrens-hospital-recognized-for-broad-excellenceTue, 27 Jun 2017 15:55:00 GMTUCLA RESEARCH ALERTFINDINGS

A streamlined and integrated method of tracking medical records called a laboratory health information exchange narrowed the gap in anti-retroviral therapy and viral suppression between HIV-positive blacks and whites, according to UCLA researchers. Also, the use of these exchanges led to Latinos who are HIV-positive being more likely than whites to use anti-retroviral therapy and higher viral suppression.

At the beginning, blacks in the study used antiretroviral therapy about 25 percent less often than whites did, but, their rates were equivalent by the end. Similarly blacks began the study with 25 percent lower rates of viral suppression than whites, but their rates were equivalent by the end.

Although Latinos’ anti-retroviral therapy use and viral suppression was equivalent to that of whites at the start of the study, after the intervention their levels were 77 percent and 33 percent greater, respectively.

Overall, viral suppression for blacks and Latinos increased by 16 percent compared to the period prior to implementation of the exchange.

BACKGROUND

To better maintain continuity of care for people with HIV, health care providers have increasingly adopted health information exchanges that maintain clinical information, laboratory test results and anti-retroviral therapy prescription filling that augment electronic medical records. Previous UCLA-led research by the same authors about laboratory health information exchange systems found that when the system detected clinically important increases in a person’s viral load, the health care provider changed the anti-retroviral therapy an average of 6 days earlier than before the information exchange was implemented.

Blacks and Latinos are disproportionately affected by HIV, the virus that causes AIDS, and less likely than whites to receive the ongoing, sustained care that is crucial to maintaining their health and viral suppression. For this new study, the researchers examined whether a laboratory health information exchange would increase rates of anti-retroviral therapy use and viral suppression for a large clinic population and if it would reduce racial/ethnic disparities in these outcomes.

METHOD

The researchers examined monthly anti-retroviral therapy use and prescription fills and approximately, quarterly HIV lab results culled between December 2007 and November 2011 from electronic medical records for 1,181 people with HIV at a Southern California HIV/AIDS clinic. They examined rates of anti-retroviral therapy use and viral suppression one year before and two years after start of the laboratory health information exchange.

IMPACT

Use of laboratory health information exchanges in HIV care can both improve use of anti-retroviral therapy and viral suppression for all people living with HIV and reduce disparities between blacks and whites in HIV health care and outcomes.

AUTHORS

The authors of this study are Dr. William Cunningham, Chandra Ford, Janni Kinsler, Danielle Seiden, Terry Nakazono and Dr. Douglas Bell, all of UCLA, and Laral Andrews, of Eisner Health.

JOURNAL

The study was published in the peer-reviewed Journal of Acquired Immune Deficiency Syndromes.

FUNDING

This study was funded by grants from the Health Resources and Services Administration; the National Institutes of Health/National Institute on Aging; NIH/National Institute on Minority Health and Health Disparities; National Center for Advancing Translational Sciences; NIH/National Institute on Drug Abuse; NIH/National Institute of Nursing Research; and the UCLA California Center for Population Research through support from the Shriver National Institute of Child Health and Human Development.

EnriqueRivero310-267-7120erivero@mednet.ucla.eduThe use of laboratory health information exchanges led to Latinos who are HIV-positive being more likely than whites to use anti-retroviral therapy.Enrique Riverohttp://newsroom.ucla.edu/releases/integrated-medical-records-can-reduce-disparities-between-blacks-and-whites-in-hiv-careMon, 26 Jun 2017 22:39:00 GMTCollaboration will expand child health services while leveraging expertise at both campuses and throughout Southern California

Two leading children’s hospitals — UCLA Mattel Children’s Hospital, part of UCLA Health, and Miller Children’s & Women’s Hospital Long Beach, part of MemorialCare Health System — announced today their intent to form a strategic affiliation that brings together their academic, clinical and research expertise, and resources to enhance children’s health care services in Southern California.

The two organizations, which share similar missions and values, plan to establish a wider geographic pediatric collaboration that strengthens and broadens their ability to offer the highest-quality, patient- and family-centered care to their respective and shared communities. In addition to working together with physicians, patients and families, the collaboration will work closely with employers, health plans, public health agencies and other organizations to offer children and families high-quality and compassionate care close to home.

The UCLA Mattel–Miller Children’s Health alliance plans to focus on growing pediatric specialty care and the network of pediatricians and pediatric specialists available in the community, adding more outpatient facilities, expanding efforts to manage the health of children, and addressing other opportunities that offer families easier access to highly specialized children’s health services.

With UC Irvine Health, the organizations intend to collaboratively expand their pediatric residency and medical education programs, as well as their nationally recognized centers of excellence for clinical education of residents and fellows in pediatric medicine. This includes residency rotations for pediatric experiences in related medical and surgical specialties, as well as the establishment of medical and surgical fellowship training programs. UC Irvine Health and Miller Children’s long-standing pediatric residency and teaching relationship will continue and be integrated into the pediatric collaboration.

“We are extremely pleased at the opportunity to work with Miller Children’s leadership, physicians and staff to expand access to care to more children throughout Southern California,” said Johnese Spisso, president of UCLA Health and CEO of UCLA Hospital System. “This pediatric collaboration will enhance our ability to deliver the right care at the right time for all patients.”

Through joint strategic planning and an expansion of services, both organizations will leverage existing expertise at Miller Children’s and complementary specialty and acute care services from UCLA Mattel to bolster existing programs, further grow clinical and research programs and identify opportunities for future growth of community-based facilities and services.

“This is a tremendous opportunity to leverage both organizations’ exceptional strengths in pediatrics while greatly improving the health and health care of children,” said John Bishop, CEO of Miller Children’s & Women’s Hospital Long Beach, Long Beach Memorial and Community Hospital Long Beach. “Through this collaboration, we’ll expand our ability to provide an even wider range of specialized medical care and tap the resources of UCLA, one of the nation’s leading academic medical centers. In turn, UCLA Mattel will have access to our exceptional physicians and programs. It’s a win-win for children and families in our communities.”

By bringing together clinical and research teams, these two leading children’s hospitals and their specialty and outpatient pediatric care centers in communities throughout the region will be better positioned to provide comprehensive pediatric health services to meet the unique and growing needs of Southern California families. They will work closely with community pediatricians and other clinicians and providers to create a network to improve children’s access to care. 

The organizations are among a small number of health care providers nationwide with both children’s and women’s/adult hospitals on the same campus. Both UCLA Mattel and Miller Children’s are uniquely positioned to provide children a lifetime of care in a single location. UCLA Mattel is on the UCLA campus with sister facilities Ronald Reagan UCLA Medical Center and Resnick Neuropsychiatric Hospital at UCLA. Miller Children’s shares a campus with Long Beach Memorial, a major teaching hospital. The two children’s hospitals already have a hematology/oncology cancer partnership at Miller Children’s that embodies their commitment to provide the highest level of research-based clinical care in a supportive, nurturing environment that is convenient for children and families. The new strategic affiliation will form the basis for continued collaboration and enhanced pediatric services across Southern California.

One of the nation’s top children hospitals, UCLA Mattel Children’s Hospital serves the most critically ill children with pediatric clinical practices and research that make it an international model for medical care and innovation. With access to clinical trials and top-ranked clinical care — plus specialists and subspecialists at one of the nation’s leading medical schools, the David Geffen School of Medicine at UCLA — the hospital is consistently ranked by U.S. News and World Report as one of the country’s best children’s hospitals. Programs include transplant and other nationally-recognized medical and surgical services. Research through UCLA's Children's Discovery and Innovation Institute enables physician scientists to pioneer therapies that shape pediatric patient care globally. UCLA Mattel Children's Hospital also has one of country’s largest pediatric telemedicine programs. Specialists offer expert care to remote Southern California locations and internationally through the pediatric Global Health program. 

The 369-bed Miller Children’s & Women’s Hospital Long Beach, part of MemorialCare Health System, is among the country’s 10 largest children’s hospitals. One of only eight free-standing children’s hospitals in California, Miller Children’s treats over 100,000 children annually at its hospital, outpatient specialty and satellite centers—as well as maternity care for expectant mothers—all under one roof. A national pioneer in perinatal and neonatal medicine for high-risk mothers and babies, Miller Children’s is renowned for advances in treating fragile newborns with one of the largest and most respected neonatal intensive care units; for Jonathan Jaques Children’s Cancer Center; pediatric heart, orthopedics and emergency centers; and rated among the best for treating cystic fibrosis, red blood disorders and sickle cell anemia. With sister teaching hospital Long Beach Memorial, it is the West’s second largest hospital campus, providing a lifetime of care for children and adults.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/UCLA+Mattel+Children%27s+Hospital.jpgUCLA Mattel Children’s HospitalUCLA Mattel Children’s Hospital

UCLA Mattel Children’s Hospital

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/UCLA+Mattel+Children%27s+Hospital.jpgUCLA Mattel Children’s Hospital

UCLA Mattel Children’s Hospital

TamiDennis310-267-7007tdennis@mednet.ucla.eduThe two organizations intend to establish a broader collaboration to strengthen their ability to offer the highest-quality care.UCLA Healthhttp://newsroom.ucla.edu/releases/ucla-mattel-childrens-miller-childrens-womens-hospital-affiliationThu, 22 Jun 2017 17:00:00 GMTUCLA-led study highlights the importance of controlling HIV-infection during pregnancy

HIV-positive women with cytomegalovirus, or CMV, in their urine at the time of labor and delivery are more than five times likelier than HIV-positive women without CMV to transmit HIV, the virus that causes AIDS, to their infants, according to a UCLA-led study. The research also found that they are nearly 30 times likelier to transmit cytomegalovirus to their infants.

Dr. Karin Nielsen, a professor of clinical pediatrics in the division of infectious diseases at the David Geffen School of Medicine at UCLA, is the senior author of the study, which was published today in the journal Clinical Infectious Diseases.

“The findings were surprising because prior studies in healthy pregnant women have not shown an association between CMV detection in urine, or even cervical secretions, and congenital CMV infection,” Nielsen said.

UCLA Health Dr. Karin Nielsen

The research also found that women who had gonorrhea when they gave birth were nearly 20 times more likely to pass CMV on to their infants. People with healthy immune systems can stave off illness from the virus, but babies infected through their mothers and people with weakened immune systems, such as those with HIV, can experience serious health problems.

CMV can impair fetal growth, and babies born with the virus can have damage to the brain, liver, lung and spleen, as well as hearing loss. People who are otherwise healthy usually do not experience any symptoms, but it can cause fever, sore throat, fatigue and swollen glands. In people with compromised immune systems, however, CMV can affect the eyes, lungs, liver, esophagus, stomach and intestines, according to the Centers for Disease Control and Prevention.

The researchers evaluated 260 pairs of mothers and infants — 222 from the Americas and 38 from South Africa — who were enrolled in a perinatal study by the National Institute of Child Health and Human Development. None of the mothers had used antiretrovirals prior to labor.

After testing the mothers’ and infants’ urine for CMV, the researchers found that:

  • 9.2 percent of the women had detectable CMV and 3.8 percent of the infants had the virus.
  • 20.8 percent of women with detectable CMV had infants with the virus, as opposed to 2.1 percent of women who did not have detectable CMV.
  • 29.2 percent of women with detectable CMV transmitted HIV to their infant, compared with 8.1 of those who did not have detectable CMV.

Among the study’s limitations: The sample size was determined by the availability of urine samples from the mothers, and women in the overall study from which data was drawn were diagnosed with HIV at the time of labor and delivery, so results of the UCLA-led research are not applicable to pregnant women with HIV who are on antiretroviral treatment during pregnancy.

Still, the study “underscores the importance of controlling HIV-infection during pregnancy through use of antiretrovirals in the prevention of both CMV and HIV transmission from mothers to infants,” said Dr. Kristina Adachi, a postdoctoral researcher in pediatric infectious diseases in the UCLA department of pediatrics and the study’s lead author.

The study’s other UCLA authors are Bonnie Ank, Dr. Yvonne Bryson and Dr. Jeffrey Klausner. Other researchers were from several other institutions in the U.S., Brazil and South Africa.

The study was supported by the National Institute of Child Health and Human Development, the UCLA Children’s Discovery and Innovation Institute through the Harry Winston Fellowship Award, the UCLA AIDS Institute and the UCLA Center for AIDS Research.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Cytomegalovirus.tifCytomegalovirusCytomegalovirus can impair fetal growth, and babies born with the virus can have damage to the brain, liver and lungs.

Cytomegalovirus, or CMV, virions

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Cytomegalovirus.tifCytomegalovirus

Cytomegalovirus, or CMV, virions

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Dr.+Karin+Nielsen.jpgDr. Karin Nielsen

Dr. Karin Nielsen

EnriqueRivero310-267-7120erivero@mednet.ucla.eduThe research also found that women who had gonorrhea when they gave birth were nearly 20 times more likely to pass on CMV to their babies.Enrique Riverohttp://newsroom.ucla.edu/releases/hiv-positive-women-with-cytomegalovirus-likelier-to-pass-virus-that-causes-aids-to-infantWed, 21 Jun 2017 22:55:00 GMTHospital emergency rooms treat more than 170,000 children each year for sports-related traumatic brain injuries. What do parents and coaches need to know to protect their kids and players? UCLA RESEARCH ALERTFINDINGS

A new study by scientists at UCLA found that when mice eat a high-fat diet, the cells in their small intestines respond the same way they do to a viral infection, turning up production of certain immune molecules and causing inflammation throughout the body. The scientists also found that feeding the mice tomatoes containing a protein similar to that in HDL, or “good cholesterol,” along with the generic cholesterol drug Ezetimibe, reversed the inflammation.

The results could lead to new types of drugs, targeting the intestinal cells, to reduce people’s risk of heart attacks and strokes, or to treat other conditions linked to inflammation, including cancer and inflammatory bowel disease.

BACKGROUND

Researchers already knew that prolonged obesity can cause inflammation of the liver and fat tissues, and that this inflammation contributes to the development of diabetes and heart disease. Studies have also shown that higher levels of high-density lipoprotein, or HDL, cholesterol, reduces a person’s risk of heart disease.

The UCLA research team, led by Alan Fogelman, chair of the department of medicine at the David Geffen School of Medicine at UCLA, previously developed genetically engineered tomatoes that contained 6F, a protein resembling the main protein in high-density lipoprotein. In early experiments on 6F, they found that the compound was active in the small intestines of mice, and that it reduced inflammation. But exactly how it did this was unclear.

METHOD

The scientists fed either a standard chow or a high-fat, high-cholesterol Western diet to mice that were especially prone to developing clogged arteries. They also treated some of the mice with either 6F, in the form of a tomato concentrate containing the protein, Ezetimibe, or both. After two weeks, cells from the small intestines of the mice were collected and blood samples were taken. The researchers measured cholesterol levels as well as the levels of inflammatory and immune molecules in both the intestines and throughout the body.

IMPACT

The findings shed light on the molecular details of how high-fat diets cause inflammation in the body, by making the intestines activate the pathway normally triggered by a virus. This suggests that blocking this immune reaction — as 6F and Ezetimibe do — may treat inflammatory diseases and decrease people’s risk of heart attack and stroke.

AUTHORS

The authors of the study are all faculty and researchers at UCLA, affiliated with the Department of Medicine; Department of Molecular and Medical Pharmacology; Department of Human Genetics; Department of Microbiology, Immunology & Molecular Genetics; Department of Pathology and Laboratory Medicine; Department of Obstetrics and Gynecology; Semel Institute for Neuroscience and Human Behavior; and Department of Molecular, Cell and Developmental Biology. The first author is Pallavi Mukherjee; Fogelman is the senior author.

JOURNAL

The study was published June 7, 2017, in the Journal of Lipid Research.

FUNDING

The study was funded by the United States Public Health Service (2P01 HL-30568) and the Castera, Laubisch, and Milt Grey funds at UCLA.  

DISCLOSURES

Alan Fogelman, Mohamad Navab and Srinivasa Reddy are principals in Bruin Pharma, which is working to commercialize apoA-I mimetics, including the 6F peptide studied in this paper; Fogelman is additionally an officer of the company.

DavidOlmos310-267-8276dolmos@mednet.ucla.eduResults of the UCLA study could lead to new types of drugs, targeting the intestinal cells, to reduce people’s risk of heart attacks and strokes, or to treat other conditions linked to inflammation, including cancer. Sarah C.P. Williamshttp://newsroom.ucla.edu/releases/high-fat-diet-leads-to-same-intestinal-inflammation-as-a-virusWed, 21 Jun 2017 17:50:00 GMTResearchers from UCLA helped lead discovery of the first definitive genetic mutations

An international team led by researchers from UCLA and Massachusetts General Hospital has identified the first definitive genes associated with Tourette syndrome, giving scientists a long-sought foothold on the biology of the disease.

The report in the June 21 issue of Neuron describes the discovery of rare mutations — either deletions or duplications of genetic material — in two neurodevelopmental genes, NRXN1 and CNTN6, in people with Tourette syndrome, a disorder characterized by multiple chronic, involuntary motor and vocal tics.

“This is a first, key step in understanding the role of these genes in the disease process and ultimately in pointing the field toward possible therapeutic strategies,” said Dr. Giovanni Coppola, a professor of psychiatry and neurology at UCLA’s Semel Institute for Neuroscience and Human Behavior, and the study’s co-senior author. “All of us in the field have been trying to understand which genes increase the risk of disease.”

There’s no cure for Tourette syndrome, and no one medication that is helpful to all people with Tourette syndrome or suppresses all symptoms.

Previous research has shown Tourette syndrome has a clear genetic component. But genetic risk appears to be very complex, possibly involving different genes in different individuals. Several small studies have identified genes that appear to contribute to Tourette syndrome risk, Coppola said, but none of them met the statistical threshold of significance.

For this study, researchers analyzed data collected by the Tourette Syndrome Association International Consortium for Genetics and the Gilles de la Tourette Syndrome GWAS (genome-wide association studies) Replication Initiative from more than 2,400 people with Tourette syndrome.

Of those people, only two dozen shared rare genetic mutations on NRXN1, which has a role in the development of synapses that transmit signals between neurons, or CNTN6, which is important in the development of neuronal connections involved in movement control.

To test whether these findings were specific to Tourette syndrome and not coincidence, researchers looked for the mutations in 4,100 people without Tourette syndrome. They found that the mutations were vastly predominant in people with Tourette syndrome.

The finding is also relevant to other neuropsychiatric disorders. More than 85 percent of people with Tourette syndrome have attention deficit hyperactivity disorder or obsessive-compulsive disorder, or elevated risk for mood, anxiety, major depressive and autism spectrum disorders. Next, scientists plan to study cells from people with these rare genetic variants to understand more precisely how they are involved in these diseases.

“Tourette syndrome has long been considered a model disorder to study the parts of the brain that function at the intersection of our traditional concepts of neurology and psychiatry,” said Dr. Jeremiah Scharf of the psychiatric and neurodevelopmental genetics unit in the Massachusetts General Hospital departments of psychiatry and neurology and co-senior author. “Identifying additional genes will give us additional points on the map to let us focus in on exactly which cells in the brain are not functioning correctly at which specific times.”

John Miller, president and CEO of the Tourette Association of America, which provided support for the study, called the identification of the two genes “an enormous step forward.” “We congratulate our colleagues on this important discovery and on the real progress it means for individuals with Tourette.”

The study’s first author is Alden Huang, a doctoral student in the UCLA bioinformatics program. Additional co-senior authors of the study are Dr. Carol Mathews of the University of Florida and Peristera Paschou of Purdue University. Other support for the study came from the National Institute of Neurologic Disorders and Stroke grants U01 NS040024, K02 NS085048, P30 NS062691 (Informatics Center for Neurogenetics and Neurogenomics, ICNN) and NS016648; National Institute of Mental Health grants K23 MH085057 and MH096767; and American Recovery and Reinvestment Act grant NS040024-07S.

Coppola said that he is especially grateful to patients who agreed to be part of the study. As a neurologist in Italy, where he trained, people volunteering for genetic studies would ask him, “What is the possible outcome of this?” and he would say, “Most likely, nothing.”

Now, with this study’s results, Coppola can point to a success story: “Next time your doctor asks you to give your DNA for testing, and tells you chances are dim for the result being relevant, keep in mind — sometimes it works. And the more people enrolled, the better it works.”

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Giovanni+Coppola.JPGGiovanni Coppola and Alden HuangTwo of the study’s authors, Dr. Giovanni Coppola, left, professor of psychiatry and neurology at UCLA, and bioinformatics doctoral student Alden Huang.

Dr. Giovanni Coppola, left, is a professor of psychiatry and neurology at UCLA’s Semel Institute for Neuroscience and Human Behavior, and the study’s co-senior author. Also pictured is Alden Huang, a doctoral student in the UCLA bioinformatics program and the study’s first author.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Giovanni+Coppola.JPGGiovanni Coppola and Alden Huang

Dr. Giovanni Coppola, left, is a professor of psychiatry and neurology at UCLA’s Semel Institute for Neuroscience and Human Behavior, and the study’s co-senior author. Also pictured is Alden Huang, a doctoral student in the UCLA bioinformatics program and the study’s first author.

LeighHopper310-267-7149 LHopper@mednet.ucla.eduAn international team led by researchers from UCLA and Massachusetts General Hospital helped lead discovery of the first definitive genetic mutations.Leigh Hopperhttp://newsroom.ucla.edu/releases/rare-genetic-variants-found-to-increase-risk-for-tourette-syndromeWed, 21 Jun 2017 16:00:00 GMTUCLA and other UC medical campuses work together to get more innovative therapeutics to patients

For 12 years, UCLA researcher Dennis Slamon pursued a groundbreaking approach to treating breast cancer: Attack the disease genetically.

The journey was long and filled with obstacles, but his persistence paid off.

Slamon and colleagues conducted laboratory and clinical research that, in collaboration with biotechnology firm Genentech, helped lead to development of the breast cancer drug Herceptin.

UCLA's Dennis Slamon with Harry Connick Jr., who played the professor of medicine in a 2008 television movie.

The drug, which targets a specific genetic alteration found in about 25 percent of breast cancer patients, has saved thousands of women’s lives. Lifetime even made a movie based on Slamon’s struggles, “Living Proof,” starring Harry Connick Jr.

But not all drug discovery efforts have a Hollywood ending.

The odds of developing a blockbuster drug are slim. Thousands of compounds are screened, and only about one in 10 drugs that survive the initial stages to enter clinical trials eventually receives approval. The road from discovery to drug product can take more than a decade and cost more than $2 billion.

How can the drug discovery process be improved?

The newly launched University of California Drug Discovery Consortium aims to tackle that problem by working together as a UC system to speed and increase development of a range of drugs to help patients. This not only could help generate life-saving treatments, but also create significant economic activity from spin-off companies to licenses and collaborations with industry.

University of California Catherine Tralau-Stewart

“The leap from academic discovery to drug product is time-consuming and costly,” said Catherine Tralau-Stewart, UC San Francisco associate professor of therapeutics and campus lead for the consortium. “We’re trying to improve how we support drug discovery across the UC campuses. We’re hopeful that the end result will be more innovative UC therapeutics reaching patients. The development of industrial, philanthropic and investment partnerships will be a key part of the consortium.”

Translating research into therapies

Tralau-Stewart is principal investigator on a $2.2 million, three-year grant from UC’s Multicampus Research Programs and Initiatives focusing on early translation of academic discovery research into therapies. The grant to the Drug, Device, Discovery and Development workgroup of UC Biomedical Research Acceleration, Integration and Development is helping to get the consortium off the ground.

The consortium brings together UC’s five medical center campuses — Los Angeles, Davis, Irvine, San Diego and San Francisco — to share resources and expertise to help develop new drugs.

UCLA Robert Damoiseaux

“We’re trying to change the ecosystem of drug development in California,” said Robert Damoiseaux, UCLA associate professor of pharmacology, director of the Molecular Screening Shared Resource in the California NanoSystems Institute and campus lead for the consortium.

For example, at UCLA, the nation’s No. 1 institution in terms of creating start-up companies rooted in campus research, the UCLA Innovation Fund has been collaboratively created as a means to advance therapeutics, medical devices and diagnostics, and digital health technologies. Each UC campus also recently received $2.2 million from the University of California to further support efforts to move UC research and innovation into the marketplace for public benefit. 

UC researchers have a history of helping to discover drugs that improve the lives of patients, though even the successes illustrate the lengthy process:

  • Xtandi: In 2016, UCLA sold its royalty interest connected with a leading prostate cancer medication, Xtandi, whose development was based on discoveries by campus researchers that began in the early 2000s. UCLA will use its share of the proceeds — approximately $520 million — to support research programs aimed at generating additional discoveries that lead to medications and other products that serve the public good.
  • Ocrevus: A new multiple sclerosis drug approved this year, Ocrevus grew out of research that began 40 years ago by Stephen Hauser, chair of neurology at UC San Francisco. The drug holds new hope for the hundreds of thousands of Americans living with the disease.
  • Semisynthetic artemisinin: Twelve years after a breakthrough discovery in his UC Berkeley lab, chemical engineering professor Jay Keasling began to see results. In 2013, pharmaceutical company Sanofi and nonprofit PATH launched large-scale production of a partially synthetic version of artemisinin, a chemical critical to making today’s front-line anti-malaria drug, based on Keasling’s discovery.
Overcoming obstacles

Damoiseaux has seen the challenges and obstacles to drug discovery. He is developing an online compendium of resources for the UC system to help researchers on each step of the discovery pipeline.

“The drug discovery process can be very complex,” Damoiseaux said. “We’re trying to close the gap.”

UC held its first systemwide drug discovery symposium in February at the California NanoSystems Institute at UCLA, where UC scientists shared stories of their drug discovery efforts and compared notes on best approaches. A panel of industry experts discussed how to best work with industry to translate drug candidates into the clinic.

The consortium will provide a platform for continuing that collaboration, with researchers aiming to find treatments for a range of diseases, from cancer to other unmet needs. For example, the Center for Discovery and Innovation in Parasitic Diseases at UC San Diego targets diseases affecting hundreds of millions of people worldwide, but which are not normally lucrative for traditional drug and vaccine discovery companies because they primarily affect the poor and underserved.

Damoiseaux already has started collaborating with Hartmut Luecke, a UC Irvine professor of molecular biology and biochemistry. They have identified small molecules that could lead to new life-saving treatments to combat the bacterium H. pylori, which is the main cause of stomach cancer and difficult to eradicate with antibiotics.

“We want to help move interesting and innovative ideas along the drug discovery pipeline to help attract other investments, grants, licenses and collaborations with industry, and generate spinoff companies,” Damoiseaux said.

Tralau-Stewart agreed, emphasizing the value in UC-wide collaboration.

“Each campus has its success stories,” Tralau-Stewart said.  At UCLA, 21 start-ups, many based on medical discoveries, were founded during the last fiscal year alone, according to the UCLA Technology Development Group

“It’s the tip of the iceberg of what could be achieved across the UC system. That’s what the UC Drug Discovery Consortium is trying to change.”

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/Elena+Zhukova+-drug+photo.jpgDrugs

Stock art for drug development

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Stock art for drug development

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20159/Slamon+and+Connick.JPGSlamon and Connick

UCLA’s Dennis Slamon with Harry Connick Jr., who played Slamon in a 2008 television movie.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/ucla_damoiseaux_robert_343x229.jpgRobert Damoiseaux

Robert Damoiseaux is a UCLA associate professor of pharmacology, director of the Molecular Screening Shared Resource in the California NanoSystems Institute and campus lead for the University of California Drug Discovery Consortium.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/ucsf_tralau-stewart_catherine_343x229.jpgCatherine Tralau-Stewart

 Catherine Tralau-Stewart is a UC San Francisco associate professor of therapeutics and campus lead for the University of California Drug Discovery Consortium.

MeghanSteele Horan310-206-5488meghan.horan@ucla.eduRebeccaKendall310-825-1176rkendall@support.ucla.eduTamiDennis310-267-7007tdennis@mednet.ucla.eduThe new consortium could not only help generate life-saving treatments, but also create significant economic activity from spin-off companies to licenses and collaborations with industry.Alec Rosenberghttp://newsroom.ucla.edu/stories/uc-consortium-formed-to-speed-up-and-increase-development-of-new-drugsTue, 20 Jun 2017 21:00:00 GMTThe study, led by UCLA professor Jaana Juvonen, surveyed more than 4,300 sixth-graders in Southern and Northern California.UCLA program offers education and certification to physicians who agree to provide services in underserved communities

No one would argue that the United States has a significant shortage of primary care physicians, or that California’s shortage is extreme. A “shortage” is defined by the U.S. Department of Health and Human Services as fewer than one primary care physician for every 3,000 to 3,500 people, and according to the agency’s statistics, California has 607 federally designated shortage areas, impacting a population of some 6.7 million people.

A program at UCLA aims to make a difference in those numbers by helping legal immigrants with physician training — that is, those who have already graduated from a medical school outside of the United States, Puerto Rico or Canada — pass their U.S. licensing exams and obtain U.S. residency training in family medicine. To date, 114 participants have finished the program and gone into family medicine residency programs.

The initiative, called the UCLA International Medical Graduate Program, is unique in that it’s the only program sponsored by an academic medical center that helps both the immigrant physicians and the underserved community. The program provides the educational review in exchange for a promise that participants — once they’ve become residency-trained and licensed — will provide care in underserved communities for two to three years after completing their family medicine residency. Often, after their obligation to serve in underserved communities is complete, doctors choose to stay in those communities.

“Of all the individuals who have graduated from our program, who could go work wherever they wanted to after meeting their requirements, 75 percent of them remained in the underserved communities,” said Dr. Michelle Bholat, executive director and co-founder of the International Medical Graduate Program. “That is a remarkable statistic and is a win-win for the doctors and their patients who so desperately rely on their care.”

Often, for people living in underserved areas, access to primary care physicians can be so limited — regardless of insurance status — that the emergency room in effect becomes the family doctor. For non-English-speaking immigrants, who face additional cultural and linguistic barriers, access is further complicated.

In fact, the U.S. Census Bureau has designated 6.6 million Californians as having limited-English proficiency; 65 percent of those are Hispanic. For them, graduates of the medical program — most of whom are from Spanish-speaking countries in Latin America — provide a level of understanding that other doctors often cannot.

That cultural resonance between underserved communities and the doctors who want to serve them is part of what makes the program, operated by the Department of Family Medicine, to address the physician shortage. “What’s so unique about our program is that it often means immigrant patients, who are typically underserved in medicine, are cared for by doctors who are new immigrants themselves,” Bholat said.

The program directly addresses the issue of “brain waste,” that is, the underutilization of physicians who have immigrated here legally, but are unlicensed and working far below their education levels.

UCLA Health Dr. Michelle Bholat talks with students in the UCLA International Medical Graduate Program.

The program, Bholat said, admits only immigrant physicians born and educated in Latin America and residing in the United States legally into training that lasts six to 24 months. During that time, program instructors help to prepare the would-be U.S. physicians to pass the U.S. medical board exams and be competitive for admission into a three-year family medicine residency program in the state. The program covers all costs and provides a stipend to participants so they can concentrate on their board exams.

In turn, the students agree that, upon their licensing and completion of a residency program, they will care for patients who have very limited access to health care.

In California, those areas are predominantly in rural Northern California, the Inland Empire, the San Joaquin Valley and in the low-income, immigrant and minority communities in Los Angeles County.

After graduating from the program last year, Dr. Jose Javier Hernandez, from Oaxaca, Mexico, is now a first-year resident in the family medicine residency program at Adventist Health in Hanford, which is located in rural Kings County, California. Spanish-speaking migrant farmworkers make up a large portion of the population, and the patient-to-doctor ratio far exceeds the 3,500-to-one ratio that defines a “shortage.”

“The need for medical care here is overwhelming,” Hernandez said. “So many of my patients have avoided the doctor for years because of language and cultural barriers. Now, they know there is someone who can care for them who knows the language, knows the cultures and shares their heritage. It’s so rewarding knowing how much of a difference I am making in their lives.”

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/exam.jpgDr. Jose Javier Hernandez examines Roselle MartinezDr. Jose Javier Hernandez examines Roselle Martinez at the Hanford Family Medicine residency clinic at the Adventist Medical Center in Hanford, California.

Dr. Jose Javier Hernandez examines Roselle Martinez at the Hanford Family Medicine residency clinic at the Adventist Medical Center, in Hanford, CA. Hernandez, a native of Mexico, graduated from the UCLA International Medical Graduate Program. The program prepares foreign-born doctors, who have immigrated here legally, to gain acceptance into a family medicine residency program in California. Upon completion of the three year residency, they, in turn, agree to practice in a designated underserved area in California for two to three years.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/exam.jpgDr. Jose Javier Hernandez examines Roselle Martinez

Dr. Jose Javier Hernandez examines Roselle Martinez at the Hanford Family Medicine residency clinic at the Adventist Medical Center, in Hanford, CA. Hernandez, a native of Mexico, graduated from the UCLA International Medical Graduate Program. The program prepares foreign-born doctors, who have immigrated here legally, to gain acceptance into a family medicine residency program in California. Upon completion of the three year residency, they, in turn, agree to practice in a designated underserved area in California for two to three years.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/group.jpgDr. Michelle Bholat with students

Dr. Michelle Bholat talks with students in the UCLA International Medical Graduate Program. After additional training at UCLA, which prepares them for residency training, these foreign-born doctors are licensed to practice in the state and, in turn, agree to practice in an underserved community in California for two to three years.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Hernandez.jpgDr. Jose Javier Hernandez examines a patient

Dr. Jose Javier Hernandez examines a patient at the Hanford Family Medicine residency clinic in Hanford, CA. Hernandez entered the Hanford Family Medicine program after completing training in the UCLA International Medical Graduate Program. Upon completion of the residency, Dr. Hernandez has agreed to practice in an underserved area of California for two to three years. 

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/xray.jpgDr. Edna Elvira Biddy reviews a patient’s chart

Dr. Edna Elvira Biddy reviews a patient’s chart. Biddy, a native of Mexico, entered the Family Medicine residency at the Riverside County Medical Center after completing the UCLA International Medical Graduate Program. In exchange for the UCLA preparation, she has committed to practice in an underserved area of California for two to three years.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/training.jpgDoctors in UCLA International Medical Graduate Program

Foreign-born doctors prepare for residency training in the United States as part of the UCLA International Medical Graduate Program. Upon completion of a family medicine residency, the newly licensed immigrant doctors agree to practice medicine in an underserved community in California for two to three years.

EnriqueRivero310-267-7120erivero@mednet.ucla.eduThe UCLA International Medical Graduate Program offers education and certification to physicians who agree to provide services in underserved communities. UCLA Healthhttp://newsroom.ucla.edu/releases/immigrant-doctors-help-bridge-physician-shortageTue, 20 Jun 2017 04:00:00 GMTUCLA Luskin School of Public Affairs provides lessons in social work to first-year medical students

Matthew Hing is a first-year medical student at UCLA, but on this April morning he’s a visitor in a nondescript building on Lincoln Boulevard in Venice — the St. Joseph Center, home of the Chronically Homeless Intervention Program.

Hing enters through a back door, weaving through a crowd of homeless people who gather each morning to take advantage of St. Joseph’s services. This isn’t your typical med school classroom, but Hing believes the experience will be a vital part of his training — adding more educational insight to his medical school curriculum.

Thanks to a partnership between the UCLA Luskin School of Public Affairs’ Department of Social Welfare and the David Geffen School of Medicine at UCLA, Hing and 19 other medical students are receiving a lesson in social work.

A month earlier, the students gathered in a classroom in the public affairs building for an orientation session arranged by Todd Franke, the chair of the department of social welfare; Gerry Laviña, director of field education at UCLA Luskin; and Michelle Talley, a member of UCLA Luskin’s field education faculty and a licensed clinical social worker.

“I think this is a fantastic opportunity,” Franke said as he greeted the students. “We hope this is a marvelous success.”

Laviña talked about how much he learned from similar experiences earlier in his career. “I learned so much from the doctors and nurses and social workers,” he said. “Literally, I would not be here today if I hadn’t had that experience.”

Talley told the students about having worked in child welfare, and how she spent time working with public health nurses on adoption cases. “It was very helpful and useful in my role as a social worker, understanding some of the medical issues that a child could be faced with,” she said.

Hing’s day at the homeless center was the “shadowing” piece of the social work lesson. He spent a day observing and debriefing social workers and a psychiatrist, all of whom specialize in tending to the needs of the homeless.

“The psychiatrist, he saw three clients — all very different cases,” Hing said. “One was an intake case, the second time he had seen the client, so he was really getting a sense of what was going on — what had led to this individual becoming homeless, and how they were doing now.

“The second was much more stable — he’s been seen for several months — but there were new stresses in his life,” Hing said. “It was just a lot of things that a psychiatrist knew to ask that I never knew about.”

The third case involved a patient who was struggling with the anti-psychotic medication that she was taking, and how it was making her fall asleep. “So she was worried about her safety on the street,” he said. “This was something for me in a patient interaction that I would never think about, but you can learn from a social worker. Seeing those unique insights at work in this population — that’s what I got from shadowing.”

Hing shadowed those working with the homeless, and his fellow students had a variety of other experiences. One participated in a forensic interview on a child-abuse case — “an intense experience,” Hing said he heard later.

George Foulsham/UCLA Medical students Samantha Mohammad, left, and Abhinaya Narayanan take notes during the social work orientation.  

Hing’s trip to St. Joseph Center was arranged by Laviña, and the two have been the driving forces behind making the partnership a reality. After attending a conference about social medicine in October, Hing emailed a proposal for the program to members of the curriculum committee at the Geffen School. He and his colleagues, fellow medical students Amrita Ayer, Brian Dang, Lyolya Hovhannisyan and Samantha Mohammad, produced a potential syllabus, which led to a formal presentation to the Luskin School.

After emailing Laviña and Franke, Hing received an overwhelmingly positive response.

“Todd thought it was an excellent idea,” Hing said. “He wondered why it hadn’t already happened, and was excited about the possibilities.”

The concept resonated with Laviña, who sees it as a logical extension of what social welfare experts provide to Luskin’s master’s students.

“Social workers have always worked in multidisciplinary settings, so we strive for collaboration with physicians and all other disciplines,” Laviña said “We were happy to work with Matt and his peers, along with our faculty and panelists, to bring very direct feedback as to how they can become doctors who work with their patients and families using cultural humility and truly seeking a holistic approach.”

The orientation session was the first part of the program. In addition to the introductions by Laviña, Franke and Talley, the session included a panel of seven social welfare experts: Rosella Youse, a manager with the Los Angeles County Department of Children and Family Services; Kim Tran, a forensic interviewer with DCFS who is stationed at Harbor-UCLA Medical Center; Deborah Tuckman, a social worker in the emergency department at Cedars-Sinai; Thomas Pier, social worker at the Simms/Mann UCLA Center for Integrative Oncology; Brian Wren, social worker at Providence Health and Services; James Coomes, social worker at the county department of mental health; and Kim Griffin-Esperon, social worker with the Los Angeles Unified School District.

The experts shared stories about dealing with child abuse, testifying in court for child welfare and neglect cases, helping assist children with spina bifida and cancer, providing guidance on home health care and about coping with many other social issues doctors might encounter during their careers.

“You won’t know child welfare social work like we do,” Youse told the medical students. “But I don’t know the medical field like you do. So together we are really the ideal team.”

The program is also supported by those who work with the students in the Geffen School.

“Caring for patients takes a diverse team of experts,” said Dr. Sheila Naghshineh, chair of the doctoring  program for first-year medical students. “Having a social worker on the team is often vital to providing high-quality, customized care for patients in both the outpatient and inpatient setting.”

It is important for health care providers to understand the role of social workers so that they can learn to work together as a team, Naghshineh said. “The social worker shadowing pilot program helps medical students experience first-hand how to effectively work with social workers, and understand how and when to utilize their services, resources and expertise to benefit patients,” she said.

Asked if he thinks social work should be a part of the medical students’ curriculum, Hing’s response was definitive: “Yes, yes, yes.”

“Ideally, this should be part of our curriculum,” said Hing, who was raised in a medical family — his mother is a social worker and his father is a physician. “I think it is important for us to witness the empathy that social workers bring forth for their patients, who are often from the most vulnerable, marginalized parts of our society. I’d love to make sure that all of my classmates have this opportunity to see the incredible work that is going on around this.”

Laviña said he was inspired to witness and experience the students’ openness to the feedback. “I am heartened to think about the type of doctors they will become — and how they will better serve our communities,” he said.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/medstudents.jpg.jpegMatthew Hing and Katie HelgasonFirst-year UCLA medical student Matthew Hing listens as social worker Katie Helgason, program manager at the St. Joseph Center in Venice, describes a typical day trying to help the homeless.

First-year UCLA medical student Matthew Hing listens as social worker Katie Helgason, program manager at the St. Joseph Center in Venice, describes a typical day at the facility where she and others work to address the needs of the homeless.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/medstudents.jpg.jpegMatthew Hing and Katie Helgason

First-year UCLA medical student Matthew Hing listens as social worker Katie Helgason, program manager at the St. Joseph Center in Venice, describes a typical day at the facility where she and others work to address the needs of the homeless.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Med+Students+Students+Orientation+-+1.jpgUCLA med students orientation

Medical students Samantha Mohammad, left, and Abhinaya Narayanan listen and take notes during the social work orientation session.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Med+Students+St+Joseph+Homeless+Center+-+1+%282%29.jpgMatthew Hing and Naaz Mirreghabie

Matthew Hing, right, visits with UCLA Luskin social welfare student Naaz Mirreghabie, during his shadowing visit to the St. Joseph Center. Mirreghabie worked at St. Joseph as an intern this year.

GeorgeFoulsham310-206-0159gfoulsham@luskin.ucla.eduThe UCLA Luskin School of Public Affairs social welfare department provides lessons in social work and a diversity of experiences to first-year medical students.George Foulshamhttp://newsroom.ucla.edu/stories/social-workers-and-medical-students:-the-ideal-teamMon, 19 Jun 2017 22:54:00 GMTBaylor physician-scientist uncovered molecular foundations of neurological disorders

Dr. Huda Zoghbi, a neurologist whose work has revealed the molecular basis of neurological disorders, is the recipient of the 2017 Switzer Prize awarded by the David Geffen School of Medicine at UCLA for excellence in biological and biomedical sciences research.

Zoghbi’s lab at the Baylor College of Medicine identified a gene mutation that causes Rett syndrome, a severe genetic disorder that mostly affects girls. After a short period of apparently normal development, the disorder causes them to lose language and motor skills, typically by 18 months of age. The discovery paved the way for a genetic test to diagnose the disorder. The same gene mutation can also cause autism, juvenile-onset schizophrenia and other neuropsychiatric disorders.

Zoghbi also discovered the molecular mechanism of spinocerebellar ataxia 1, a neurodegenerative disorder in which people’s balance and coordination progressively worsens. Zoghbi and collaborator Harry Orr identified the gene mutation responsible for the disorder.

These and other discoveries by Zoghbi have opened up new areas of inquiry with the potential to advance diagnoses and treatments for Alzheimer’s disease, Parkinson’s disease and other neurological diseases.

“Dr. Zoghbi’s extraordinary work represents a powerful example of the direct impact that biological and biomedical research have on the lives of patients,” said Dr. Kelsey Martin, dean of the Geffen School of Medicine.

Zoghbi is scheduled to deliver the Switzer Prize lecture at UCLA on Feb. 16, 2018. She will receive a $25,000 honorarium and a medallion.

“I’m honored to accept UCLA’s Switzer Prize on behalf of the patients and the families to whom I am committed, and also on behalf of my many research collaborators and trainees,” she said.

Zoghbi is a Howard Hughes Medical Institute investigator, a professor at the Baylor College of Medicine and the founding director of the Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital in Houston. She has faculty appointments in the departments of pediatrics, molecular and human genetics, neurology and neuroscience.

A native of Beirut, Lebanon, Zoghbi fled the civil war in her home country in the mid-1970s while a medical student at the American University of Beirut. She earned a medical degree at Meharry Medical College in Nashville and went on to become chief resident in pediatrics at Baylor College of Medicine and Texas Children’s.

After years of treating patients, Zoghbi became fascinated with the origins of disease and committed to a three-year fellowship in molecular genetics to acquire research training.

She is a member of the National Academy of Sciences, the National Academy of Medicine and the American Association for the Advancement of Science.

Zoghbi is the recipient of a number of other prestigious awards, including the Breakthrough Prize in Life Sciences, the Shaw Prize in Life Science and Medicine and the Canada Gairdner International Award.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Zoghbi.Huda_headshot+%28002%29.jpgHuda ZoghbiHuda Zoghbi

Huda Zoghbi

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Zoghbi.Huda_headshot+%28002%29.jpgHuda Zoghbi

Huda Zoghbi

PhilHampton310-267-7014phampton@mednet.ucla.eduDr. Huda Zoghbi, a Baylor University neurologist, has helped uncover the molecular basis of neurological disorders including Rett syndrome.Phil Hamptonhttp://newsroom.ucla.edu/releases/david-geffen-school-of-medicine-at-ucla-names-winner-of-switzer-prize-for-research-excellenceMon, 19 Jun 2017 18:30:00 GMTUCLA RESEARCH ALERTFINDINGS Dr. Tamara Horwich

Stress, especially in women, is increasingly being recognized as a major risk factor for coronary heart disease, a condition in which blood vessels to the heart are blocked by plaque buildup or inflammation.

In a new study, UCLA researchers hypothesized that simple biomarkers — urinary stress hormones dopamine, epinephrine and norepinephrine, and cortisol — would be associated with more calcium buildup in the coronary arteries, which indicates the presence of coronary heart disease, and that this effect would be stronger in women than in men.

However, the researchers found that this relationship was actually similar in women and men: Although women had higher average levels of urine stress hormones than men, the association between stress and having asymptomatic coronary heart disease as measured by coronary calcium was similar in both genders. In particular, urinary cortisol was a strong independent predictor of asymptomatic coronary heart disease.

Researchers were also surprised to learn that one stress hormone — dopamine — was inversely related to heart risk. They found higher levels of dopamine were associated with a lower chance of having any coronary calcium.

Overall, this is the first study to demonstrate a correlation between urinary stress hormones and actual buildup of plaque in the arteries, the researchers said.

BACKGROUND

Heart disease is the leading cause of death in the United States, so preventing the condition is important. Stress increasingly is recognized as a major risk factor for coronary heart disease. Previous studies have shown that stress hormones — urinary catecholamines (dopamine, epinephrine and norepinephrine) and cortisol — are related to psychosocial stress, depression and anxiety. No previous studies have investigated the relationship between urinary stress hormones and coronary calcium, although a previous study found an association between salivary cortisol and plaque buildup in the arteries.

METHOD

The 654 participants in the study (53 percent women) were part of a large, ongoing population-based investigation of cardiovascular risk factors, called the Multi-Ethnic Study of Atherosclerosis. Researchers collected urine for one 12-hour overnight period from the participants and analyzed it for levels of hormones related to stress. The subjects also had images taken of their chests using computed tomography, or CT, scans to determine the amount of calcium visible in their coronary arteries and compute their coronary artery calcium score.

The researchers’ next step is to explore the relationship between urinary stress hormones and actual cardiovascular events, such as heart attacks or strokes.

IMPACT

By showing that stress levels can be quantified by a simple urine test, and that this simple test helps predict coronary heart disease, this work could lead to strategies for prevention of coronary heart disease and heart attacks.

AUTHORS

The authors are Rachel Zipursky, Dr. Marcella Calfon Press, Dr. Preethi Srikanthan, Jeff Gornbein, Dr. Karol Watson and Dr. Tamara Horwich, all from UCLA; and Robyn McClelland from the University of Washington.

JOURNAL

The study is published online in the American Journal of Cardiology.

FUNDING

This study was supported by the National Institutes of Health. The authors have no conflicts of interest to disclose.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/THorwich.jpgDr. Tamara HorwichDr. Tamara Horwich

Dr. Tamara Horwich

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/THorwich.jpgDr. Tamara Horwich

Dr. Tamara Horwich

By showing that stress levels can be quantified by a simple urine test, and that this test helps predict disease, this work could lead to strategies for prevention of coronary heart disease and heart attacks.Amy Albinhttp://newsroom.ucla.edu/releases/study-finds-no-gender-difference-in-stress-as-a-risk-factor-for-coronary-heart-diseaseWed, 14 Jun 2017 16:18:00 GMTUCLA RESEARCH ALERTFINDINGS

UCLA-led researchers have found that Zika viral load and the degree of Zika symptoms during pregnancy were not necessarily associated with problems during pregnancy or fetal abnormalities at birth. They also found that the presence of antibodies to previously acquired dengue fever was not necessarily connected to abnormalities during pregnancy or at birth.

BACKGROUND

Congenital Zika virus syndrome — a pattern of birth defects found among fetuses and babies infected with the virus — is a newly identified condition that occurs when women are infected during pregnancy. It is unknown to what degree the amount of Zika virus in the mother, the extent of Zika symptoms or the presence of prior dengue antibodies contribute to the syndrome. Laboratory studies suggest there is a phenomenon called antibody dependent enhancement, in which the presence of pre-existing dengue antibodies would enhance Zika’s virulence, increasing risk to the fetus. Clinical studies, however, have found no evidence of this. It has also been unclear whether a high viral load, or the presence of Zika symptoms, would be associated with risk of harm to the fetus, or if there is a direct relationship between the amount of virus in the blood and severity of symptoms in the mother.

METHOD

Researchers developed an assessment tool to gauge severity of symptoms based on duration of fever, degree of rash, how many parts of the body were affected and duration of symptoms during Zika infection. Zika viral load was quantified by a molecular assay (polymerase chain reaction) in blood and urine. Dengue antibodies were measured at the time patients presented with Zika symptoms for the first time, as a way of assessing pre-existing immunity to dengue.

The researchers defined adverse outcomes as the death of the fetus or a live infant with severe abnormal clinical or brain imaging findings.

They analyzed possible associations between the amount of Zika in the blood or urine and severity of symptoms; viral load and health of the infant; and severity of symptoms and infant health. Researchers also evaluated the health of babies born to women who had laboratory evidence of prior dengue infection and whether the mothers had more or fewer symptoms of Zika or a higher Zika viral load.

Of 131 pregnant women infected with Zika virus, 4.6 percent had mild disease, 74.8 percent had moderate disease and 20.6 percent had severe manifestations of Zika infection. Of the 125 women who reported for follow-ups 46.4 percent had abnormal pregnancy outcomes with nine fetal deaths.

No associations were found between Zika disease severity and abnormal outcomes, disease severity and viral load, or viral load and adverse outcomes. In addition, though 88 percent of the women had antibodies to prior dengue infection, the researchers found no positive or negative association between prior immunity to dengue with Zika severity score, Zika viral load or poor infant health or death.

IMPACT

The findings demonstrate that the amount of Zika virus identified in a woman does not necessarily correlate with significant symptoms or fetal harm. This is different from many infections, in which more virus may mean more severe symptoms or, in the case of HIV, transmission to the baby. But more studies are needed with a larger sample size of patients without prior dengue infection.

AUTHORS

The study authors are Dr. Umme-Aiman Halai, Dr. Karin Nielsen, Dr. James Cherry, Dr. Kristina Adachi and Dr. Irena Tsui, all of  UCLA; Dr. Maria Elisabeth Moreira, Patricia Sequeira, Dr. Jose Paulo Pereira, Jr., Dr. Jose Henrique Pilotto, Dr. Rita Ribeiro Nogueira, and Dr. Patricia Brasil of Fundação Oswaldo Cruz in Rio de Janeiro, Brazil; Dr. Claudia Raja Gabaglia of Biomedical Research Institute of Southern California; and Dr. Stephanie Gaw of UC San Francisco.

JOURNAL

The study was published by the peer-reviewed journal Clinical Infectious Diseases.

FUNDING

This work was supported by the Departamento de Ciência e Tecnologia do Ministério da Saúde do Brasil and grants from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES/ 88887.116627/2016-01); the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (AI28697 and 1R21AI129534-01) and the Thrasher Research Fund.

EnriqueRivero310-267-7120erivero@mednet.ucla.eduFindings help UCLA-led researchers better understand congenital Zika virus syndrome — a pattern of birth defects found among fetuses and babies infected with the virus.Enrique Riverohttp://newsroom.ucla.edu/releases/pregnancy-problems-not-necessarily-linked-to-zika-viral-load-or-dengue-feverTue, 13 Jun 2017 18:23:00 GMTFDA-approved therapy appears to be effective for some whose condition isn’t improved with medication

Americans spend billions of dollars each year on antidepressants, but the National Institutes of Health estimates that those medications work for only 60 percent to 70 percent of people who take them. In addition, the number of people with depression has increased 18 percent since 2005, according to the World Health Organization, which this year launched a global campaign encouraging people to seek treatment. 

The Semel Institute for Neuroscience and Human Behavior at UCLA is one of a handful of hospitals and clinics nationwide that offer a treatment that works in a fundamentally different way than drugs. The technique, transcranial magnetic stimulation, beams targeted magnetic pulses deep inside patients’ brains — an approach that has been likened to rewiring a computer.

TMS has been approved by the FDA for treating depression that doesn’t respond to medications, and UCLA researchers say it has been underused. But new equipment being rolled out this summer promises to make the treatment available to more people.  

“We are actually changing how the brain circuits are arranged, how they talk to each other,” said Dr. Ian Cook, director of the UCLA Depression Research and Clinic Program. “The brain is an amazingly changeable organ. In fact, every time people learn something new, there are physical changes in the brain structure that can be detected.”

Nathalie DeGravel, 48, of Los Angeles had tried multiple medications and different types of therapy, not to mention many therapists, for her depression before she heard about magnetic stimulation. She discussed it with her psychiatrist earlier this year, and he readily referred her to UCLA.

Within a few weeks, she noticed relief from the back pain she had been experiencing; shortly thereafter, her depression began to subside. DeGravel says she can now react more “wisely” to life’s daily struggles, feels more resilient and is  able to do much more around the house. She even updated her resume to start looking for a job for the first time in years.  

During TMS therapy, the patient sits in a reclining chair, much like one used in a dentist’s office, and a technician places a magnetic stimulator against the patient’s head in a predetermined location, based on calibrations from brain imaging. 

The stimulator sends a series of magnetic pulses into the brain. People who have undergone the treatment commonly report the sensation is like having someone tapping their head, and because of the clicking sound it makes, patients often wear earphones or earplugs during a session.

TMS therapy normally takes 30 minutes to an hour, and people typically receive the treatment several days a week for six weeks. But the newest generation of equipment could make treatments less time-consuming.  

“There are new TMS devices recently approved by the FDA that will allow patients to achieve the benefits of the treatment in a much shorter period of time,” said Dr. Andrew Leuchter, director of the Semel Institute’s TMS clinical and research service. “For some patients, we will have the ability to decrease the length of a treatment session from 37.5 minutes down to 3 minutes, and to complete a whole course of TMS in two weeks.” 

Leuchter said some studies have shown that TMS is even better than medication for the treatment of chronic depression. The approach, he says, is underutilized.

“We are used to thinking of psychiatric treatments mostly in terms of either talk therapies, psychotherapy or medications,” Leuchter said. “TMS is a revolutionary kind of treatment.” 

Bob Holmes of Los Angeles is one of the 16 million Americans who report having a major depressive episode each year, and he has suffered from depression his entire life. He calls the TMS treatment he received at UCLA Health a lifesaver.

“What this did was sort of reawaken everything, and it provided that kind of jolt to get my brain to start to work again normally,” he said.

Doctors are also exploring whether the treatment could also be used for a variety of other conditions including schizophrenia, epilepsy, Parkinson’s disease and chronic pain. 

“We're still just beginning to scratch the surface of what this treatment might be able to do for patients with a variety of illnesses,” Leuchter said. “It’s completely noninvasive and is usually very well tolerated.”

Learn more about the UCLA Brain Research Institute and the Depression Grand Challenge.

Journalists: B-roll, sound bites, web elements, high-resolution still photos and HD video is available for free and unrestricted use by the news media. http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Dr+Andrew+Leuchter.jpgDr Andrew LeuchterDr. Andrew Leuchter talks with a patient who is about to undergo transcranial magnetic stimulation, which treats depression by sending magnetic pulses to a specific area of the brain.

Dr. Andrew Leuchter talks with a patient who is about to undergo transcranial magnetic stimulation (TMS) at the Semel Institute for Neuroscience and Human Behavior at UCLA. TMS treats depression by sending magnetic pulses to a specific area of the brain.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Dr+Andrew+Leuchter.jpgDr Andrew Leuchter

Dr. Andrew Leuchter talks with a patient who is about to undergo transcranial magnetic stimulation (TMS) at the Semel Institute for Neuroscience and Human Behavior at UCLA. TMS treats depression by sending magnetic pulses to a specific area of the brain.

TamiDennis310-267-7007tdennis@mednet.ucla.eduThe Semel Institute for Neuroscience and Human Behavior is one of a handful of hospitals and clinics nationwide that offer a treatment that works in a fundamentally different way than drugs.UCLA Healthhttp://newsroom.ucla.edu/releases/tms-depression-uclaTue, 13 Jun 2017 04:00:00 GMTUCLA researchers observed that mice with a form of autism had an inability to adapt to repeated whisker stimulation

By tickling the whiskers of mice, and recording how they respond, UCLA researchers may be closer to understanding why many children with autism cover their ears when they hear loud sounds or can’t tolerate scratchy wool sweaters.

Scientists report in the June 12 issue of the Journal of Neuroscience that mice genetically engineered to mimic a type of autism in humans, fragile X syndrome, are unable to adapt to, or tune out, repeated stimulation to their whiskers — unlike ordinary mice. The findings have implications for a common symptom — sensory hypersensitivity — in humans with autism.

“If we can understand more about this mechanism, or help push the brain in the direction of adaptation, we could really help children with autism,” said Dr. Carlos Portera-Cailliau, professor of neurology and neurobiology at the David Geffen School of Medicine at UCLA and the paper’s senior author. “Currently, their brains do not mature in a way that allows this adaptation mechanism to work properly.”

Hypersensitivity to touch, sounds, taste and other sensory input is a central feature of autism, a disorder characterized by social interaction difficulties, repetitive behaviors and language impairment. Sensory hypersensitivity that leads to avoidance, or “tactile defensiveness,” is important to understand because it contributes to other characteristics of autism such as anxiety, sleep disturbances and inattention.

To learn more, Portera-Cailliau and his colleagues used a genetic mouse model of fragile X syndrome, the most common genetic cause of autism and learning disabilities in humans, to determine whether mice with fragile X syndrome show the same “tactile defensiveness” seen in people with autism. The scientists studied the behavior of 14-day-old mice and adult mice running on a ball as a wire comb repeatedly touched their whiskers. The neurological development of a 14-day-old mouse roughly corresponds to the months immediately before and after birth in humans — a time when experiences shape the brain circuits involved in processing sensory input.

The researchers found that the young fragile X mice ran in response to whisker stimulation as though they were trying to escape it. By contrast, the ordinary mice ran a little and stopped, even though whisker tweaking continued, like they were able to block out the stimulus. As adults, the fragile X mice ran and changed direction to avoid the whisker stimulator, whereas typical adult mice were able to ignore it.

“Because fragile X syndrome and autism are diseases of abnormal neural development, it’s really important to see what is happening at different developmental ages in the animal model,” said Cynthia He, the study’s first author and a doctoral student in Portera-Cailiau’s lab.

Researchers also used a special microscope, employing a technique called two-photon calcium imaging, to observe signals from individual brain cells that are activated by stimulation like an object touching whiskers.

UCLA Health Neurons firing in the brain of a mouse in response to stimulation of its whiskers.  

An analysis of these observations showed neurons firing equally in both groups of mice in the beginning, then tapering off only in the mice without fragile X. The researchers hypothesize that the fragile X group may lack chemicals that inhibit neuronal activity, a potential therapeutic target.

“You really need a solid understanding of the physiology in order to develop treatments for neurodevelopmental conditions such as autism,” He said. “This is an important step in that direction.”

This study’s other authors are Daniel Cantu, Anubhuti Goel, Shilpa Mantri and William Zeiger, all of UCLA.

The study was funded by a Paul and Daisy Soros Fellowship for New Americans and an NIH NINDS F30 Fellowship (NS093719); UCLA Neural Microcircuits training grant (T32-NS058280); a Eugene V. Cota-Robles Fellowship; the UCLA Medical Scientist Training Program (NIH NIGMS training grant GM08042; and a Developmental Disabilities Translational Research Program grant (20160969) from the John Merck Fund; a SFARI grant from the Simons Foundation (295438); and NIH NICHD grant (RO1 HD054453).

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/cynthia+and+carlos.jpgCynthia He and Dr. Carlos Portera-CailliauGraduate student Cynthia He and Dr. Carlos Portera-Cailliau, professor of neurology and neurobiology at UCLA.

UCLA graduate student Cynthia He and Dr. Carlos Portera-Cailliau, professor of neurology and neurobiology at the David Geffen School of Medicine at UCLA, discuss the findings of their study looking at how mice, which were genetically engineered to mimic hypersensitivity seen in autism, responded to repeated stimulation of their whiskers.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/cynthia+and+carlos.jpgCynthia He and Dr. Carlos Portera-Cailliau

UCLA graduate student Cynthia He and Dr. Carlos Portera-Cailliau, professor of neurology and neurobiology at the David Geffen School of Medicine at UCLA, discuss the findings of their study looking at how mice, which were genetically engineered to mimic hypersensitivity seen in autism, responded to repeated stimulation of their whiskers.

LeighHopper310-267-7149 LHopper@mednet.ucla.eduUCLA researchers observed that mice with a form of autism had an inability to adapt to repeated whisker stimulation.Leigh Hopperhttp://newsroom.ucla.edu/releases/mice-cant-tune-out-stimuli-mimicking-sensory-hypersensitivity-in-humansMon, 12 Jun 2017 17:25:00 GMTFour-year project focuses on increasing preventive dental services for children and adolescents

UCLA will lead a pilot program to expand preventive dental care for 500,000 Los Angeles children enrolled in Medi-Cal, California’s Medicaid health care program.

The UCLA-led project — the largest of 15 such programs recently approved by the state’s Department of Health Care Services — is part of the Medi-Cal 2020 Dental Transformation Initiative and will run through December 2020. 

According to the Centers for Medicare and Medicaid Services, only about one-third of California’s 6.1 million children and adolescents enrolled in Medi-Cal receive preventive dental care each year. Preventive services not only help maintain good oral health, but they also help reduce the need for costly treatment for tooth decay and cavities in hospitals and emergency departments.

The UCLA program will focus on three primary goals: using information technology to enhance the quality and continuity of care; developing new ways to expand preventive services both within clinics and community settings; and integrating oral health care services across dental, medical and community providers.

“The Dental Transformative Initiative provides an incredible opportunity to expand UCLA’s recent work with local community partners to improve the oral health of children at greatest risk for dental disease throughout Los Angeles County,” said Dr. James Crall, the project director, a professor of public health and community dentistry at the UCLA School of Dentistry.

Crall also is director of the UCLA–First 5 LA Oral Health Program, an initiative to improve oral health care for young children and pregnant women that is supported by First 5 LA, an early childhood advocacy organization.

“Our First 5 LA–funded work has demonstrated the power of combining resources from the university and community partners to address challenges that require collaborative solutions,” said Crall, who is also a faculty associate at the UCLA Center for Health Policy Research. “Given that one-quarter of all California children enrolled in Medi-Cal live in Los Angeles County, we clearly need to engage more critical stakeholders to create the meaningful system changes that will truly transform oral health care for children on Medi-Cal.” 

Collaborators in the new pilot program include local dental and medical organizations, Medi-Cal and Denti-Cal plans, early childhood programs, the Altarum Institute, DataStat, the Dental Quality Alliance, RAND Corporation, the Western University of Health Sciences College of Dental Medicine, the UCLA Fielding School of Public Health and other experts in quality improvement.

“This is an excellent opportunity for UCLA Dentistry to further engage the Los Angeles community and improve oral health care for generations to come,” said Dr. Paul Krebsbach, the school’s dean. “This program is on par with our broader vision I have for the dental school to get our student dentists, residents and faculty members providing dental services to underserved Angelenos.”

Crall said that the dental school will also seek partnership with Los Angeles County agencies, organizations and community programs focused on improving the health and well-being of children and families.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Child+at+dentist+UCLA+Dentistry.jpgChild at dentistThe UCLA program will use information technology to enhance the quality of care for young people and develop new ways to expand preventive services at clinics and community settings.

Child receiving dental treatment

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Child+at+dentist+UCLA+Dentistry.jpgChild at dentist

Child receiving dental treatment

BriannaAldrich310-206-0835baldrich@dentistry.ucla.eduThe initiative is “an excellent opportunity for UCLA Dentistry to further engage the Los Angeles community and improve oral health care for generations to come,” said the school’s dean, Dr. Paul Krebsbach. Brianna Aldrichhttp://newsroom.ucla.edu/releases/ucla-dentistry-to-lead-medi-cal-project-to-expand-preventive-dental-care-for-l-a-childrenThu, 08 Jun 2017 16:14:00 GMTThey are among 200 medical students who pledged the Hippocratic Oath

Some 200 UCLA medical students received their diplomas Friday, June 2, in Perloff Courtyard at the Hippocratic Oath Ceremony for the David Geffen School of Medicine at UCLA.

Addressing a sea of black-robed graduates, Dr. John Mazziotta, vice chancellor of the health sciences and CEO of UCLA Health, advised, “Remember that diseases are something you read about in a book or on a computer. But a patient is a human being in trouble. Reach out to each patient as an individual and make a difference in his or her life.”

The UCLA medical student body is as ethnically diverse as Los Angeles, where 70 percent of the recent graduates will remain for training. And while medical school is a tough road for any student, several newly minted physicians earned their M.D.s after overcoming additional hurdles of immigration and adaptation to life in the United States — or witnessing these challenges in their parents’ lives.

Among the jubilant graduates was Razmik Ghukasyan, 27, who emigrated with his family from war-ravaged post-Soviet Armenia to the U.S. when he was 14. No one in his family spoke English. Yet Ghukasyan graduated summa cum laude as a UCLA undergraduate, and, as a medical student, earned a Leader of Tomorrow scholarship covering his entire medical education. He will enter a general surgery residency at UCLA, and plans to pursue a career in surgical oncology in memory of his uncle, who died of cancer.

Courtesy of Erica Tukiainen Erica Tukiainen found that playing basketball helped her connect with American kids. As an undergraduate, the new physician was captain of the UCLA Women's Basketball team.

Erica Tukiainen, 30, moved with her family to the U.S. from Finland when she was 12. She spoke no English, but playing basketball in the U.S. provided her with a universal language and ultimately an athletic scholarship to UCLA. She served as the captain of the Bruin women's basketball team while majoring in French and premedical studies. Tukiainen will enter a family-medicine residency at Kaiser Permanente in Los Angeles, where she will blend her interests in exercise and public health to help fight obesity.  

Born to Iraqi immigrants, Mostafa Al-Alusi, 26, is among the first awardees of the David Geffen Scholarship to graduate this year, debt-free. Funded by philanthropist David Geffen, the $100 million merit-based scholarship program lifts the burden of loan repayment for the top students in each class, covering all of their living and educational expenses. Al-Alusi will enter an internal-medicine residency at Massachusetts General and is interested in exploring entrepreneurial opportunities in medical technology.

Courtesy of Janelle Rodriguez Dr. Janelle Rodriguez 

Janelle Rodriguez, 36, grew up listening to stories about how the Cuban revolution uprooted her parents’ lives and forced them to flee as political refugees before she was born. At 30, she similarly upended her life when she left a successful career as a biostatistician to enroll in medical school. The decision paid off when she earned a prestigious Albert Schweitzer Fellowship to work with teen mothers in East Los Angeles. She will pursue a residency in family medicine at Kaiser Permanente in Los Angeles.

Bryan Lam’s parents were Vietnamese refugees who crossed the ocean on rickety boats after the fall of Saigon in 1975. As a child, he spent weekends working in his mother’s beauty salon to help support the family. At UCLA, he led the Medical Gay and Lesbian Organization, where he mentored LGBT pre-med undergraduate students. Now 26, he recently returned from a global-health trip to Thailand, where he worked in HIV prevention. After completing a residency in internal medicine at Kaiser Permanente in Los Angeles, he aims to focus his practice on providing care for LGBT communities.

The school’s faculty and leaders, Mazziotta emphasized, value each graduate’s differences and support their future plans.

Dr. Kelsey Martin, dean of the medical school, shared her wish for the Class of 2017. “May you find a way of embracing both facts and empathy; always keep an open mind free from preconceptions as you care for your patients; and remain lifelong learners throughout your careers as healers and discoverers.”

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Mostafa+and+family1.jpgMostafa Al-Alusi and his familyBorn to Iraqi immigrants, Mostafa Al-Alusi, 26, was among the first awardees of the David Geffen Scholarship to receive his M.D. on Friday, June 2.

Born to Iraqi immigrants, Mostafa Al-Alusi, 26, is among the first awardees of the David Geffen Scholarship to graduate on Friday, June 2.  The $100 million merit-based scholarship program is funded by philanthropist David Geffen.

 

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Mostafa+and+family1.jpgMostafa Al-Alusi and his family

Born to Iraqi immigrants, Mostafa Al-Alusi, 26, is among the first awardees of the David Geffen Scholarship to graduate on Friday, June 2.  The $100 million merit-based scholarship program is funded by philanthropist David Geffen.

 

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Eric+and+family.jpgErica Tukiainen and her family

Immigrating from Finland, Erica Tukiainen, 30, found that, as a youngster, playing basketball helped her learn English. The new physician was captain of the Bruin women's basketball team.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/janelle+rodriguez+2017.jpgJanelle Rodriguez

Janelle Rodriguez grew up listening to stories about how the Cuban revolution uprooted her parents’ lives and forced them to flee as political refugees before she was born.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Bryan+Lam+and+family+2017.jpgBryan Lam and family

Bryan Lam’s parents were Vietnamese refugees who crossed the ocean on rickety boats after the fall of Saigon in 1975. 

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20175/Razmik+and+family+2017.jpgRazmik Ghukasyan and his family

A new medical school graduate, Razmik Ghukasyan, 27emigrated with his family from war-ravaged post-Soviet Armenia to the U.S. when he was 14. 

ElaineSchmidt310-267-8323eschmidt@mednet.ucla.eduSome 200 UCLA medical students received their diplomas Friday in Perloff Courtyard during the Hippocratic Oath Ceremony for the David Geffen School of Medicine at UCLA. Elaine Schmidthttp://newsroom.ucla.edu/stories/new-ucla-doctors-embody-the-american-dreamWed, 07 Jun 2017 22:27:00 GMTUCLA RESEARCH ALERTFINDINGS

Researchers at UCLA have developed a molecular compound that improves balance and coordination in mice with early stage Parkinson’s disease. Further, the drug, called CLR01, reduced the amount of a toxic protein in the brain that is thought to be one of the prime culprits in the development of the disorder.

BACKGROUND

Parkinson’s disease is a nervous system disorder that affects movement. It’s estimated that as many as 1 million Americans live with Parkinson’s, and that roughly 60,000 are diagnosed with it each year. There is no cure. The disease is chronic and progressive, and over time can worsen from tremors in a person’s hands and slow movements, to impaired balance and coordination and, ultimately, overall rigidity of the body, including difficulty swallowing and speaking.

While the cause is not known, growing evidence points to the protein alpha-synuclein. The protein binds together in “clumps,” called aggregates, becoming toxic and killing brain neurons that produce dopamine, a neurotransmitter needed to send signals among neurons involved in controlling movements.

METHOD

Earlier research by Gal Bitan, an associate professor of neurology at the David Geffen School of Medicine at UCLA, and colleagues led to the development of CLR01, which is known as a molecular tweezer — a complex compound capable of disrupting the formation of toxic protein clumps. Shaped like the letter “C,” CLR01 wraps around chains of lysine, a basic amino acid that is a constituent of most proteins. In the previous work in zebrafish, the scientists showed that the tweezer could decrease the clumping of alpha-synuclein and prevent its negative effects without detectable toxicity or side effects to normal, functioning cells in the brain.

In this study in mice, the UCLA researchers took a more refined approach. It turns out there are two toxic forms of alpha-synuclein. One is the proteins that clump together, forming aggregates. The second is a soluble form that is difficult to detect because it is not very stable. This is the more toxic form and is thought to be the culprit affecting the neurons. In the new study, the researchers used a treatment of CLR01 that did not affect the aggregated form of alpha-synuclein; instead, it only reduced the soluble form. This proved to be sufficient to help improve movements in mice. These findings are important because they suggest that researchers may not need to focus on the aggregates if the toxic soluble form of alpha-synuclein can be reduced or destroyed.

IMPACT

CLR01 previously showed a strong therapeutic effect in a zebrafish model of Parkinson’s. This study is the first to demonstrate CLR01’s effectiveness in a mammal, one of the last important steps before human clinical trials.

The researchers are now working on optimizing the blood-brain barrier penetration of CLR01 and measuring all the pharmacological features necessary for applying to the Food and Drug Administration to begin the first human, clinical trials.

AUTHORS

Bitan and Dr. Marie-Françoise Chesselet, the Charles H. Markham professor of neurology at UCLA, are the senior authors of the study. Franziska Richter, assistant professor at the University of Leipzig in Germany, is the first author.

JOURNAL

The paper was published in the online edition of the journal Neurotherapeutics.

FUNDING

This work was supported by multiple funding agencies, including the National Institutes of Health, RJG Foundation, the Michael J. Fox Foundation, Team Parkinson/Parkinson Alliance, the American Parkinson’s Disease Association, and gifts to the Center for the Study of Parkinson’s Disease at UCLA.

DavidOlmos310-267-8276dolmos@mednet.ucla.eduUCLA HealthMedia Relations310-267-7022UCLAHealthNews@mednet.ucla.eduResearchers at UCLA have developed a molecular compound that improves balance and coordination in mice with the early stage of the disorder.Mark Wheelerhttp://newsroom.ucla.edu/releases/movement-restored-in-animal-model-of-parkinsons-diseaseWed, 07 Jun 2017 21:31:00 GMTA team of UCLA scientists is testing an experimental drug that could one day result in a treatment for osteoporosis, which affects more than 200 million people worldwide.Changes in same genes that clipped the sea bird’s wings cause human bone disorders

The flightless Galapagos cormorant is one of a diverse array of animals that live on the Galapagos Islands, which piqued Charles Darwin’s scientific curiosity in the 1830s. He hypothesized that altered evolutionary pressures may have contributed to the loss of the ability to fly in birds like the Galapagos cormorant.

In a new study unraveling the cormorant’s DNA, UCLA scientists discovered genetic changes that transpired during the past 2 million years and contributed to the bird’s inability to fly. Interestingly, when these same genes go awry in humans, they cause bone-development disorders called skeletal ciliopathies.

Published today in the journal Science, the findings shed light on the genetic mechanisms underlying the evolution of limb size and could eventually lead to new treatments for people with skeletal ciliopathies.

“A number of these iconic, salient evolutionary changes occurred in the Galapagos,” said senior author Leonid Kruglyak, professor of human genetics at the David Geffen School of Medicine at UCLA. “Darwin, just by looking at these changes, inferred the process of evolution by natural selection. We now have sophisticated genetic tools to reexamine these classic examples and uncover what happened at the molecular level.”

The Galapagos cormorant, with its short, scraggly wings, is the only one of 40 cormorant species that cannot fly. It is also the largest of the cormorants, and a strong swimmer that dives for its meals of fish.

Researchers, including Darwin, have proposed two evolutionary paths for the loss of flight. In some cases, changes that lead to flightlessness may help birds survive because they enhance their ability to do something else, like swimming — so-called positive selection.

Alan Schmierer/Flickr The wings of a Brandt’s cormorant are large enough for flight.  

Alternatively, the birds may have lost their ability to fly simply because they didn’t need to migrate or escape from predators. When flying isn’t essential for survival, the mutations that hinder flight can gradually accumulate in the gene pool.

“These two scenarios aren’t mutually exclusive,” said Kruglyak, who is also a Howard Hughes Medical Institute investigator. “You can start down the path because of passive loss of flight but then also have positive selection to keep reducing wings.”

A trip to the Galapagos Islands launched Kruglyak’s interest in the cormorants. Together with first author Alejandro Burga, a postdoctoral fellow in Kruglyak’s lab, they contacted Patricia Parker, a professor of zoological studies at the University of Missouri-St. Louis. She had obtained Galapagos cormorant DNA samples for a previous study and agreed to collaborate on this project.

The researchers sequenced the genomes of flightless cormorants and three other cormorant species to zero in on genetic changes possibly linked to flight. They next used a program capable of determining whether the genetic changes they identified were likely to affect protein structure and function.

Their analyses led them to a gene called CUX1, which was previously linked to shortened wings in chickens. The scientists noticed that Galapagos cormorants possessed a different version of CUX1 than its flying relatives.

“We saw a mutation in this gene that we’ve never seen in other animals,” Burga said. The team confirmed that the changes to the CUX1 gene altered the protein’s function, likely affecting wing size.

The team also found that the flightless cormorants have an abnormally high number of genetic mutations affecting cilia — small, hair-like structures that protrude from cells and regulate everything from normal development to reproduction.

UCLA Health  

Cilia play a critical role in bone growth. People born with skeletal ciliopathies have shorter limbs, narrowed chests and stunted rib cages — as do the Galapagos cormorants. The UCLA results suggest that CUX1 controls many aspects of cilia, some of which influence bone growth. 

Future studies, Kruglyak said, will explore whether other flightless birds, like the ostrich and kiwi, share mutations with the Galapagos cormorant, and whether these genes can help biologists better understand evolution and limb development.

“Loss of flight is something that has taken place in birds frequently,” Kruglyak said. “There’s a pretty rich field trying to understand how all these changes happen and whether common trajectories exist between species.”

The study’s other authors are Weiguang Wang, Karen Lyons and Eyal Ben-David all of UCLA; Paul Wolf of the U.S. Department of Agriculture/Wildlife Services; Andrew Ramey of the U.S. Geological Survey Alaska Science Center; and Claudio Verdugo of the Universidad Austral de Chile.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/Galapagos+Cormorant.jpgGalapagos cormorantThe Galapagos cormorant, with its shortened wings, is the only one of 40 cormorant species that cannot fly.

The flightless Galapagos cormorant.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/Galapagos+Cormorant.jpgGalapagos cormorant

The flightless Galapagos cormorant.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/Brandts+Cormorant.jpgBrandts cormorant

Brandt’s cormorant. Alan Schmierer/Flickr.

ElaineSchmidt310-267-8323eschmidt@mednet.ucla.eduUCLA research findings show changes in same genes that clipped the sea bird’s wings cause human bone disorders.Sarah C.P. Williamshttp://newsroom.ucla.edu/releases/how-the-galapagos-cormorant-lost-its-ability-to-flyThu, 01 Jun 2017 19:30:00 GMTLakers legend Bryon Scott and business leader Charlie Norris share leadership insights with UCLA neurosurgeons

If you want to grow, be willing to fail. That advice, from business executive Charlie Norris and Los Angeles Lakers legend Byron Scott, could be considered a mantra for anyone — except maybe neurosurgeons. Recently, that was precisely the audience.

The two authors of “Slam-Dunk Success: Leading from Every Position on Life’s Court” spoke to capacity crowds in the Charles and Peggy Norris Global Conference Room of the Edie & Lew Wasserman Building at UCLA on May 17, delivering a synopsis of their new book on leadership.

“We are extremely grateful to have Charlie and Byron in the neurosurgery family and to enjoy this rare opportunity to learn from their valuable expertise,” said Dr. Linda Liau, acting chair of neurosurgery at the David Geffen School of Medicine at UCLA. “We want our neurosurgeons to become leaders in their field and help our staff provide exceptional care to our patients, who often come to us during traumatic times in their lives.”

Some of the lessons Norris and Scott mastered in the boardroom and on the basketball court include:

  • You have to be willing to fail in order to grow.
  • Treat everyone with the same level of respect.
  • Take a genuine interest in people and learn their unique stories.
  • Understanding people’s hearts is key to helping them perform their best.
  • Managing down is as important as managing up.

The two men know of what they speak.

Norris has created a career of transforming faltering firms into multimillion-dollar enterprises. He came to California as CEO of McKesson Water, remaking the $200-million company into a thriving corporation that sold for $1.1 billion a decade later. As chairman of the board for Freshpet, he led the start-up from early-stage testing to a publicly traded company with a market value worth more than $350 million.

Now an ESPN analyst, Scott won three NBA championships as the shooting guard for the Lakers before launching a successful coaching career. He steered the New Jersey Nets team to two NBA finals and was named Coach of the Year with the New Orleans Hornets before returning to Los Angeles to coach the Lakers.

Norris and Scott met nine years ago at the gym and quickly became workout partners and close friends who sought each other’s professional advice. The idea for the book crystalized from their recognition that they shared the same leadership philosophy despite hailing from completely different backgrounds.

“How do you motivate people who come from different countries, cultures and ethnicities?” Scott asked. “That’s the question our book aims to answer.”

According to the authors, it boils down to investing the time to get to know people, understanding how they learn and helping them become their best.

They also emphasized the importance of thinking globally and acting locally.

“We can’t afford to think ‘America First,’” Norris cautioned. “Becoming a first-class organization means working with the best people from around the world. To succeed, we need to be part of the global community.”

Dr. Marvin Bergsneider, director of the UCLA neurosurgery residency program, plans to put the authors’ advice into practice.

Repeating a lesson shared by Scott, Bergsneider told the neurosurgical residents, “From now on, each of you will be asked two questions. ‘What’s blocking you from being great?’ and ‘What can I do to help you become great?’”

Neurosurgical trainees who face challenges head-on outside the operating room, Norris and Scott emphasized, will develop into superb neurosurgeons in the operating room. 

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/Slam-Dunk+Success_103.JPGByron Scott and Charlie NorrisByron Scott and Charles Norris share leadership advice with UCLA neurosurgeons.

Former Los Angeles Lakers player and coach Byron Scott and business executive Charlie Norris, co-authors of a book about leadership speaking to an audience of UCLA neurosurgeons.

 

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/Slam-Dunk+Success_103.JPGByron Scott and Charlie Norris

Former Los Angeles Lakers player and coach Byron Scott and business executive Charlie Norris, co-authors of a book about leadership speaking to an audience of UCLA neurosurgeons.

 

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/Slam-Dunk+Success_011.JPGByron Scott and Charlie Norris

Former Los Angeles Lakers player and coach Byron Scott and business executive Charlie Norris, co-authors of a book about leadership, standing in front of a UCLA Neurosurgery sign.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/Slam-Dunk+Success_014.JPGByron Scott and Charlie Norris

Former Los Angeles Lakers player and coach Byron Scott and business executive Charlie Norris, co-authors of a book about leadership, standing in front of a UCLA Neurosurgery sign.

ElaineSchmidt310-267-8323eschmidt@mednet.ucla.eduUCLA neurosurgeons learn leadership insights from Lakers legend Byron Scott and business leader Charlie Norris.Elaine Schmidthttp://newsroom.ucla.edu/stories/two-all-stars-share-secrets-of-success-in-business-and-basketballThu, 01 Jun 2017 18:09:00 GMTProgram funded by entertainment executive, philanthropist helps UCLA attract top prospects

After earning a master’s degree in education and working as a public-school teacher in New York, Mariel Bailey decided to pursue a medical degree.

That concerned her parents in Rhode Island, who were unable to help cover the costs. Bailey had her pick of top medical schools, including UCLA, UC San Francisco, Harvard and Stanford. An all-expenses-paid scholarship from the David Geffen School of Medicine at UCLA “essentially made the decision for me,” she said.

“The scholarship was a godsend that provided the financial freedom to pursue my dream at an amazing program debt-free and without having to repay years of loans,” Bailey said.

On June 2, Bailey will take the Hippocratic Oath with 177 other graduating medical students. Nine of them, including Bailey, are the first to complete their studies as recipients of the David Geffen Medical Scholarship. The $100 million scholarship program – announced in 2012 and funded by entertainment executive and philanthropist David Geffen – is helping UCLA to recruit some of the nation’s best medical students, lifting the burden of debt and facilitating pursuit of career paths aligned with their passions, including dual-degree programs and scholarly research.

So far, 127 students have received a David Geffen Medical Scholarship, which are based entirely on merit. School officials estimate that by 2022, a total of 300 scholarships will have been awarded — a figure equal to about 20 percent of each entering class during the 10-year period.

UCLA’s medical school was named for Geffen in recognition of a $200 million gift in 2002. 

“The David Geffen Medical Scholarships are pivotal to our continued ascent as one of the nation’s premier medical schools — an ascent that’s remarkable because we’re the youngest of the top 10 medical schools,” said Dr. Kelsey Martin, dean of the David Geffen School of Medicine at UCLA. “In less than three-quarters of a century, discoveries made by our researchers have transformed the practice of medicine, and we have trained thousands of physicians, physician-scientists and biomedical researchers who themselves have gone on to positively impact Los Angeles and other communities.”

UCLA’s new home for medical education, Geffen Hall — officially dedicated last month — was named in recognition of Mr. Geffen’s impact on the school, a national leader in research, patient care, medical education and community service.

Like Bailey, Caroline Gross entertained offers from several top medical schools, including UCLA’s. She chose UCLA in part because of the David Geffen Medical Scholarship.

“I found a medical school that allowed me to become the best physician that I could be — a physician who values empathy and compassion as much as clinical acumen, and one who works better with others than alone,” said Gross, 26. “I’ve had an opportunity to explore my greatest passions in medicine, including ethics and the management of critically ill pediatric populations.”

Among other opportunities provided by the scholarship, Gross said it supported travel to Ghana, where she conducted research on the country’s education programs for neonatal resuscitation. After graduating, she will enter a pediatrics residency at Boston Children’s Hospital. Leaving UCLA without debt makes her more comfortable considering a primary care specialty, often less lucrative than other medical specialties.

Studies commissioned by the Association of American Medical Colleges have found that the numbers of new primary care physicians and doctors in certain specialties are not keeping pace with the demands of a growing and aging population. Feeding concerns about doctor shortages, the median debt of medical school graduates rose from $125,000 in 2000 to $190,000 in 2016, according to the AAMC.

Debt can influence what fields medical school graduates pursue and where they develop their professional careers. Reducing debt allows students to make career decisions based on their passions while reducing concerns about going into lower-paying specialties.

Seventy percent of this year’s UCLA medical school graduating class is staying in California for residency training – a figure consistent with prior years. The David Geffen Medical Scholarship recipients headed to out-of-state residencies expressed interest in returning to California at some point in their careers.

For Maclean Sellars, 35, a Glendale, Calif., father of 19-month-old twin boys, the scholarship provided family as well as professional benefits.

“Knowing that I’m leaving medical school with no debt makes it possible to entertain any career path I want without putting my family’s future at risk,” he said. “Mr. Geffen’s generosity not only made my family possible. He made my career with a family possible.”

Sellars, who entered medical school with a Ph.D. in molecular biology, leaves the day after graduation with his family for an internal medicine residency at Massachusetts General Hospital in Boston. His goal is a subspecialty in oncology, driven in part by an interest in research and his mother’s death from cancer.

Mostafa Al-Alusi, 26, also is headed to Mass General for an internal medicine residency. He wants to explore opportunities in medical technology as an entrepreneur.

“The scholarship enables me to earn my medical degree yet still have the financial security to consider starting a company or buying a house,” said Al-Alusi, who grew up in San Diego. “Not having to worry about debt after graduation is a huge weight off my shoulders.”

After graduating, Bailey, 30, will enter a combined internal medicine and pediatric residency at Brigham and Women’s Hospital and Boston Children’s Hospital. She said the debt-free education afforded by the scholarship provides the freedom to carve her preferred career path — return to California and practice internal medicine.

“I want to work on developing effective preventive care campaigns for children and adult populations,” Bailey said. “It won’t be as lucrative as other specialties, but it’s something that truly drives me.”

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/geffen-scholars1.jpgDavid Geffen Medical Scholarship scholarsGraduating David Geffen Medical Scholarship recipients Caroline Gross and Maclean Sellars (center), flanked by fellow recipients William Sheppard, Jr. and Orly Bell.

Graduating David Geffen Medical Scholarship recipients Caroline Gross and Maclean Sellars (center), flanked by fellow recipients William Sheppard, Jr. and Orly Bell.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/geffen-scholars1.jpgDavid Geffen Medical Scholarship scholars

Graduating David Geffen Medical Scholarship recipients Caroline Gross and Maclean Sellars (center), flanked by fellow recipients William Sheppard, Jr. and Orly Bell.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/geffen-scholars2.jpgDavid Geffen Medical Scholarship scholars

David Geffen Medical Scholarship recipients Orly Bell, Maclean Sellars, Caroline Gross and William Sheppard, Jr.

http://cms.ipressroom.com.s3.amazonaws.com/173/files/20174/caroline-gross-geffen-v.jpgCaroline Gross

Caroline Gross, recipient of a David Geffen Medical Scholarship, speaks at the opening ceremony for UCLA's Geffen Hall. 

PhilHampton310-267-7014phampton@mednet.ucla.eduProgram funded by the entertainment executive and philanthropist helps UCLA attract top medical school prospects.Phil Hampton and Elaine Schmidthttp://newsroom.ucla.edu/releases/first-david-geffen-medical-scholarship-students-are-graduatingThu, 01 Jun 2017 17:00:00 GMTTraveling west to east and the number of time zones crossed seem to increase the severity of jet lag, explains Dr. Alon Avidan, who treats circadian rhythm disorders, among other sleep complaints.
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