Health Sciences: UCLA Newsroom

Harley bikers celebrate 20th annual toy run at Mattel Children's Hospital UCLA

Amy Albin — Thu, 19 Nov 2009 20:40:00 GMT

WHAT:

For the 20th consecutive year, approximately 100 motorcyclists and friends from the Southern California Anaheim-Fullerton H.O.G. (Harley Owners Group) chapter will caravan on their bikes to deliver hundreds of holiday gifts for pediatric patients at Mattel Children's Hospital UCLA. Hospital staff and young patients will greet the bikers and get a chance to see and even sit on the Harleys. Bikers will form a "love line" to unload hundreds of toys which will be distributed to pediatric patients during the holiday season and at other special times throughout the year.

WHEN:

9:30 a.m., Sunday, Nov. 22.

WHERE:

Mattel Children's Hospital UCLA (757 Westwood Blvd., Los Angeles 90095). The event is at the Mattel Hospital entrance, located at Gayley Avenue and Charles E. Young Drive.

PARKING:

Media trucks may park in the yellow loading zone on Gayley Avenue. All other vehicles should park in patient parking areas in Lot 1, located on Gayley Avenue. Press should call media contact to arrange a Lot 1 parking pass.

PHOTO | INTERVIEW OPPORTUNITIES:

9:30 a.m.: Motorcyclists begin arriving in waves at Mattel Children's Hospital UCLA; pediatric patients and medical staff will be there to greet them.
10:30 a.m.: Motorcyclists will form a "love line" to unload the toys from a truck.
11 a.m.: Hospital officials and pediatric patients will thank bikers in a presentation.

BACKGROUND:

Joyce Savisky-Chance, whose young son Johnnie was a patient at UCLA, started the annual event in his memory after he died following a long battle with cancer. UCLA's Child Life department distributes the toys to hospitalized children's parents, who often do not have the time or funds to shop for holiday gifts. Gifts are also distributed throughout the year to help celebrate patient's birthdays or after medical procedures.

MEDIA CONTACT:

Amy Albin, UCLA Health Sciences Media Relations, 310-794-8672 (office) or 310-597-5765 (cell)

UCLA study shows brain's ability to reorganize

Mark Wheeler — Wed, 18 Nov 2009 18:05:00 GMT

Visually impaired people appear to be fearless, navigating busy sidewalks and crosswalks, safely finding their way using nothing more than a cane as a guide. The reason they can do this, researchers suggest, is that in at least some circumstances, blindness can heighten other senses, helping individuals adapt.

Now scientists from the UCLA Department of Neurology have confirmed that blindness causes structural changes in the brain, indicating that the brain may reorganize itself functionally in order to adapt to a loss in sensory input.

Reporting in the January issue of the journal NeuroImage (currently online), Natasha Leporé, a postgraduate researcher at UCLA's Laboratory of Neuro Imaging, and colleagues found that visual regions of the brain were smaller in volume in blind individuals than in sighted ones. However, for non-visual areas, the trend was reversed — they grew larger in the blind. This, the researchers say, suggests that the brains of blind individuals are compensating for the reduced volume in areas normally devoted to vision.

"This study shows the exceptional plasticity of the brain and its ability to reorganize itself after a major input — in this case, vision — is lost," said Leporé. "In other words, it appears the brain will attempt to compensate for the fact that a person can no longer see, and this is particularly true for those who are blind since early infancy, a developmental period in which the brain is much more plastic and modifiable than it is in adulthood."

Researchers used an extremely sensitive type of brain imaging called tensor-based morphometry, which can detect very subtle changes in brain volume, to examine the brains of three different groups: those who lost their sight before the age of 5; those who lost their sight after 14; and a control group of sighted individuals. Comparing the two groups of blind individuals, the researchers found that loss and gain of brain matter depended heavily on when the blindness occurred.

Only the early-blind group differed significantly from the control group in an area of the brain's corpus callosum that aids in the transmission of visual information between the two hemispheres of the brain. The researchers suggest this may be because of the reduced amount of myelination in the absence of visual input. Myelin, the fatty sheaf that surrounds nerves and allows for fast communication, develops rapidly in the very young. When the onset of blindness occurs in adolescence or later, the growth of myelin is already relatively complete, so the structure of the corpus callosum may not be strongly influenced by the loss of visual input.

In both blind groups, however, the researchers found significant enlargement in areas of the brain not responsible for vision. For example, the frontal lobes, which are involved with, among other things, working memory, were found to be abnormally enlarged, perhaps offering an anatomical foundation for some of blind individuals' enhanced skills.

Previous studies have found that when walking down a corridor with windows, the blind are adept at detecting the windows' presence because they can feel subtle changes in temperature and distinguish between the auditory echoes caused by walls and windows.

Leporé noted that scientists and others have long been curious about whether or not blind individuals compensated for their lack of vision by developing greater abilities in their remaining senses. For example, the 18th-century French philosopher Denis Diderot wrote of his amazement with some of the abilities shown by blind individuals, in particular a blind mathematician who could distinguish real from fake coins just by touching them.

But it wasn't until the early 1990s that the suspicions of science began to be confirmed with the development of neuroimaging tools.

"That allowed researchers to probe inside the brain in a non-invasive manner, yielding insights into the impressive adaptive capacity of the brain to reorganize itself following injury or sensory deprivation," Leporé said.

Other authors included Caroline Brun, Yi-Yu Chou, Agatha D. Lee, Sarah K. Madsen, Arthur W. Toga and Paul M. Thompson, all of UCLA, and Franco Leporé, Madeleine Fortin, Frédéric Gougoux, Maryse Lassonde and Patrice Voss, of the University of Montreal.

This study was supported by the Canadian Institutes of Health Research, the Canada Research Chairs Program, the National Institute on Aging, the National Library of Medicine, the National Institute of Biomedical Imaging and Bioengineering, the National Center for Research Resources, the National Institute for Child Health and Development, and a grant from the National Institutes of Health.

The researchers report no conflicts of interest.

The UCLA Laboratory of Neuro Imaging, which seeks to improve understanding of the brain in health and disease, is a leader in the development of advanced computational algorithms and scientific approaches for the comprehensive and quantitative mapping of brain structure and function. The laboratory is part of the UCLA Department of Neurology, which encompasses more than a dozen research, clinical and teaching programs. The department has ranked No. 1 among its peers nationwide in National Institutes of Health funding for the last seven years (2002–08).

For more news, visit the UCLA Newsroom or follow us on Twitter.

UCLA researchers create 'fly paper' to capture circulating cancer cells

Rachel Champeau — Wed, 18 Nov 2009 16:00:00 GMT

Just as fly paper captures insects, an innovative new device with nano-sized features developed by researchers at UCLA is able to grab cancer cells in the blood that have broken off from a tumor.

These cells, known as circulating tumor cells, or CTCs, can provide critical information for examining and diagnosing cancer metastasis, determining patient prognosis, and monitoring the effectiveness of therapies.

Metastasis — the most common cause of cancer-related death in patients with solid tumors — is caused by marauding tumor cells that leave the primary tumor site and ride in the bloodstream to set up colonies in other parts of the body.

The current gold standard for examining the disease status of tumors is an analysis of metastatic solid biopsy samples, but in the early stages of metastasis, it is often difficult to identify a biopsy site. By capturing CTCs, doctors can essentially perform a "liquid" biopsy, allowing for early detection and diagnosis, as well as improved treatment monitoring.

To date, several methods have been developed to track these cells, but the UCLA team's novel "fly paper" approach may be faster and cheaper than others — and it appears to capture far more CTCs.

In a study published this month in the journal Angewandte Chemie, the UCLA team developed a 1-by-2-centimeter silicon chip that is covered with densely packed nanopillars and looks like a shag carpet. To test cell-capture performance, researchers incubated the nanopillar chip in a culture medium with breast cancer cells. As a control, they performed a parallel experiment with a cell-capture method that uses a chip with a flat surface. Both structures were coated with anti-EpCAM, an antibody protein that can help recognize and capture tumor cells.

The researchers found that the cell-capture yields for the UCLA nanopillar chip were significantly higher; the device captured 45 to 65 percent of the cancer cells in the medium, compared with only 4 to 14 percent for the flat device.

"The nanopillar chip captured more than 10 times the amount of cells captured by the currently used flat structure," said lead study author Dr. Shutao Wang, a postdoctoral researcher at both the Crump Institute for Molecular Imaging at the David Geffen School of Medicine at UCLA and the California NanoSystems Institute at UCLA.

Wang noted that the nano-size scale and the unique surface topography of the UCLA nanopillar chip may help it interact with nano-size components on cellular surfaces in the blood, enhancing capture efficiency.

The time required for CTC detection using CellSearch, a technology currently approved by the U.S. Food and Drug Administration, is upwards of three to four hours, according to study author Dr. Hao Wang, a postdoctoral researcher at the Crump Institute and the California NanoSystems Institute at UCLA. The UCLA study found an optimal detection time of only two hours using nanopillar chips.

The nanopillar chip uses a common chamber slide, which fits into standard laboratory cell incubators. After the chip has been incubated and immunofluorescence-stained, an automated fluorescence microscope is used to identify and count the CTCs. The very simple device setting on the chamber slide allows multiple CTC detections to occur at the same time.

"We hope that this platform can provide a convenient and cost-efficient alternative to CTC sorting by using mostly standard lab equipment," said senior study author Dr. Hsian-Rong Tseng, associate professor of molecular and medical pharmacology at the Crump Institute and the California NanoSystems Institute.

The next step is more clinical research and possible studies with "break-away" cancer cells in patients' blood, as well as in other body fluids, such as urine and abdominal fluids, according to Tseng, who is also a researcher at UCLA's Jonsson Comprehensive Cancer Center.

The study was funded by the National Cancer Institute's Centers of Cancer Nanotechnology Excellence and the NanoSystems Biology Cancer Center.

Study collaborators included Dr. Hong Wu, of the UCLA Department of Molecular and Medical Pharmacology; Dr. Allan Pantuck, Dr. Robert Reiter, Dr. Matthew Rettig and Dr. David Finley, of the UCLA Department of Urology; and Dr. Jiaoti Huang and Dr. David Seligson, of the UCLA Department of Pathology and Laboratory Medicine.

Additional study authors included Dr. Jing Jiao, Kuan-Ju Chen, Gwen E. Owens, Dr. Ken-ichiro Kamei, Dr. Jing Sun, Dr. David J. Sherman and Christian P. Behrenbruch, of UCLA's Crump Institute for Molecular Imaging, Institute of Molecular Medicine and California NanoSystems Institute.

For more news, visit the UCLA Newsroom or follow us on Twitter.

UCLA Stroke Center to help launch new system of stroke-certified hospitals in Los Angeles

Amy Albin — Mon, 16 Nov 2009 17:15:00 GMT

The UCLA Stroke Center at Ronald Reagan UCLA Medical Center will be part of a new stroke-certified hospital system that has the potential to greatly improve response times, treatments and overall outcomes for those who suffer a stroke in Los Angeles County.

The new Primary Stroke Center system, announced by the American Heart Association's American Stroke Association (ASA), involves the county's Emergency Medical Services agency and nine participating hospitals certified as primary stroke centers. The program launches Nov. 16.

The result of cooperative work between hospitals and other stakeholders — including the Los Angeles County Department of Health Services, EMS and the ASA — the program includes a policy that provides for the transport of select 911 stroke patients to a primary stroke center, rather than to the nearest hospital, in order to optimize care and minimize disability or death.

"We are very proud to be launching this regional system of organized pre-hospital care and designated Primary Stroke Center hospitals in Los Angeles County," said Dr. Jeffrey Saver, director of the UCLA Stroke Center and one of the lead physicians working on the project. "This launch is a great first step toward our objective of ensuring that anyone in Los Angeles who suffers a stroke will have quick access to brain-saving, standard-of-care treatment."

Plans call for the approval of additional hospitals in Los Angeles County over the next one to two years to ensure that anyone suffering stroke symptoms can call 911 and expect there will be a stroke-certified hospital nearby.

"Stroke centers provide a continuum of care, from initial assessment through hospitalization and rehabilitation," said Dr. William Koenig, medical director of Los Angeles County EMS. "Providing a focused approach, with dedicated stroke nursing and hospital beds, benefits stroke patients. Through this collaboration, we anticipate the network of primary stroke centers will grow throughout the county in the months to come."

Stroke, the third leading cause of death in Los Angeles County, is the result of either a bleed (hemorrhagic) or a clot (ischemic) in the brain that damages brain tissue. Because stroke injury worsens with each passing second, early identification and rapid treatment is critical to minimizing morbidity and mortality.

Studies have shown that outcomes improve significantly if patients activate the EMS system early, by calling 911. However, while time to treatment is a critical factor, the type of treatment received is also crucial, which is why it is important to get patients to a primary stroke center. The UCLA Stroke Center was the first hospital in the county to earn certification as a primary stroke center from the Joint Commission.

In addition to the UCLA Stroke Center, the following facilities have been designated as approved stroke centers: Cedars–Sinai Medical Center, Glendale Adventist Medical Center, Long Beach Memorial Medical Center, Northridge Hospital Medical Center, Providence Little Company of Mary Medical Center–San Pedro, Providence Saint Joseph Medical Center in Burbank, Torrance Memorial Medical Center and Los Alamitos Medical Center in Orange County.

"The launch of the network is a proud day for the American Stroke Association in Los Angeles County," said David Ross, immediate past chairman of the ASA's Los Angeles County board of directors. "We are thrilled to bring together so many talented and committed people on behalf of so many different organizations for the shared objective of stopping strokes. We are grateful to the Annenberg Foundation for providing financial support as we work to create the first county-wide system of care for stroke in Los Angeles."

Knowing the warning signs of a stroke can help save lives. Call 911 immediately if you experience, or observe in someone else, one or more of the following signs: sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; and sudden, severe headache with no known cause. Visit www.strokeassociation.org for more information.

The American Stroke Association, a division of the American Heart Association, is working hard in local communities throughout America to prevent, treat and defeat stroke through research, public and professional education programs, and improved emergency care. Stroke is America's No. 3 killer and devastates hundreds of thousands of individuals and families every year. In Los Angeles County and across the country, the American Stroke Association is working with hospitals through its Get With the Guidelines–Stroke program to ensure that stroke treatment meets standards of care that help minimize death and disability.

The UCLA Stroke Center, recognized as one of the world's leading centers for the management of cerebral vascular disease, treats simple and complex vascular disorders by incorporating recent developments in emergency medicine, stroke neurology, microneurosurgery, interventional neuroradiology, stereotactic radiology, neurointensive care, neuroanesthesiology and rehabilitation neurology. The program is unique in its ability to integrate clinical and research activities across multiple disciplines and departments. A center without walls, the UCLA Stroke Center was founded in 1994.

For more news, visit the UCLA Newsroom or follow us on Twitter.

NanoSystems Institute at UCLA to host global symposium on nanobiotechnology

Mike Rodewald — Fri, 13 Nov 2009 17:40:00 GMT

WHAT:

Nanotechnology has shown great promise for applications in the areas of energy, information technology and the environment. In the health and medicine fields, however, its promise has progressed beyond possibility to become reality. Nanoscale research has led to techniques and devices with the potential to revolutionize health care, including imaging tools that detect cancers at the atomic level, nanomachines programmed to release drugs within specific cells, and biosensors that monitor changes from deep within body organs.

The impact of these and other developments on the current state of medicine and their implications for the future will be explored at the third annual Global Symposium on NanoBioTechnology, "New Directions in NanoHealth: Diagnostics, Therapies, Drug Delivery, NanoSafety."

Symposium topics will include: magnetic and light control of nanotherapy; tissue regeneration, cell therapy and cancer therapy; imaging and diagnostics; nanoparticles and nanotherapy; and biosensors and biomanipulations.

WHO:

Participating institutions:

• California NanoSystems Institute (CNSI) at UCLA

• Center for NanoBio Integration at the University of Tokyo

• Nanomedical National Core Research Center at Yonsei University

• Nanosystems Institute Munich, represented by the Technical University of Munich and Ludwig-Maximilians-University

For a complete list of speakers, visit http://cnsi.ctrl.ucla.edu/nanobiotechnology/pages/speakers.

WHEN:

Thursday–Friday, Nov. 19–20

WHERE:

California NanoSystems Institute at UCLA (Building 114)

INFORMATION | REGISTRATION:

For more information and to register for the event, visit http://cnsi.ctrl.ucla.edu/nanobiotechnology/pages/.

BACKGROUND:

The annual symposium, initiated in 2007, alternates locations between the two founding institutions, the CNBI in Japan and the CNSI in America. To expand the global theme of the symposium, this year's speakers will also include participants from Korea and Germany. Special emphasis will be given to breakthrough discoveries from laboratories in Asia, North America and Europe.

MEDIA CONTACTS:

Jennifer Marcus | 310-267-4839 | jmarcus@cnsi.ucla.edu

Mike Rodewald | 310-267-5883 | mrodewald@cnsi.ucla.edu

PARKING:

Parking will be available in Lot 9 on Westwood Plaza. Press should contact media contacts for parking reservations.

People entering their 60s may have more disabilities today than in prior generations

Enrique Rivero — Thu, 12 Nov 2009 21:00:00 GMT

In a development that could have significant ramifications for the nation's health care system, Baby Boomers may well be entering their 60s suffering far more disabilities than their counterparts did in previous generations, according to a new UCLA study. The findings, researchers say, may be due in part to changing American demographics.

In the study, which will be published in the January 2010 issue of the American Journal of Public Health, researchers from the division of geriatrics at the David Geffen School of Medicine at UCLA found that the cohort of individuals between the ages of 60 and 69 exhibited increases in several types of disabilities over time. By contrast, those between the ages of 70 and 79 and those aged 80 and over saw no significant increases — and in some cases exhibited fewer disabilities than their previous cohorts.

While the study focused on groups born prior to the post–World War II Baby Boom, the findings hold "significant and sobering implications" for health care because they suggest that people now entering their 60s could have even more disabilities, putting an added burden on an already fragile system and boosting health costs for society as a whole, researchers say.

If this is true, it's something we need to address," said Teresa Seeman, UCLA professor of medicine and epidemiology and the study's principal investigator. "If this trend continues unchecked, it will put increasing pressure on our society to take care of these disabled individuals. This would just put more of a burden on the health care system to address the higher levels of these problems."

The researchers used two sets of data — the National Health and Nutrition Examination Surveys (NHANES) for 1988–94 and 1999–2004 — to examine how disabilities for the three groups of adults aged 60–69, 70–79, and 80 and older had changed over time. They assessed disability trends in four areas: basic activities associated with daily living, such as walking from room to room and getting into and out of bed; instrumental activities, such as performing household chores or preparing meals; mobility, including walking one-quarter mile or climbing 10 steps without stopping for rest; and functional limitations, which include stooping, crouching or kneeling.

The study focused primarily on trends for the more recent 60–69 age group — those born between 1930 and 1944, just before the start of the Baby Boom, whose data was included in the 1999–2004 NHANES. In particular, researchers felt this group could offer insights into the health of the Boomers following them, who are now entering their 60s.

The researchers found that between the periods 1988–94 and 1999–2004, disability among those in their 60s increased between 40 and 70 percent in each area studied except functional limitations, independent of sociodemographic characteristics, health status and behaviors, and relative weight. The increases were considerably higher among non-white and overweight subgroups.

By contrast, the researchers found no significant changes among the group aged 70 to 79, while the 80-plus group actually saw a drop in functional limitations.

One reason for this uptick, researchers say, is that disabilities may be linked with the changing racial and ethnic makeup of the group that recently reached or will soon be reaching its 60s, with the most rapid growth projected to be among African Americans and Hispanics — groups with significantly higher rates of obesity and lower socioeconomic status, both of which are associated with higher risk for functional limitations and disabilities.

The researchers note that their controls for differences in sociodemographics, health status (such as chronic conditions and biological risk factors) and health behavior do not completely explain the increase in disability trends among the 60- to 69-year olds. Still, the trends within that group "are disturbing," Seeman said.

"Increases in disability in that group are concerning because it's a big group," she said. "These may be people who have longer histories of being overweight, and we may be seeing the consequences of that. We're not sure why these disabilities are going up. But if this trend continues, it could have a major impact on us, due to the resources that will have to be devoted to those people."

Study co-authors included Arun Karlamangla and Sharon Merkin, of UCLA's geriatrics division, and Eileen Crimmins, of the Andrus Gerontology Center at the University of Southern California.

The National Institute on Aging funded this study.

The UCLA Division of Geriatrics within the department of medicine at the David Geffen School of Medicine at UCLA offers comprehensive outpatient and inpatient services at several convenient locations and works closely with other UCLA programs to improve and maintain the quality of life of seniors. UCLA geriatricians are specialists in managing the overall health of people age 65 and older and treating medical disorders that frequently affect the elderly, including falls and immobility, urinary incontinence, memory loss and dementia, arthritis, high blood pressure, heart disease, osteoporosis, and diabetes. UCLA geriatricians can knowledgably consider and address a broad spectrum of health-related factors — including medical, psychological and social — when treating patients.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Why can't chimps speak? Study links evolution of single gene to human capacity for language

Elaine Schmidt — Wed, 11 Nov 2009 18:00:00 GMT

If humans are genetically related to chimps, why did our brains develop the innate ability for language and speech while theirs did not?

Scientists suspect that part of the answer to the mystery lies in a gene called FOXP2. When mutated, FOXP2 can disrupt speech and language in humans. Now, a UCLA–Emory University study reveals major differences between how the human and chimp versions of FOXP2 work, perhaps explaining why language is unique to humans.

Published Nov. 11 in the online edition of the journal Nature, the findings provide insight into the evolution of the human brain and may point to possible drug targets for human disorders characterized by speech disruption, such as autism and schizophrenia.

"Earlier research suggests that the amino-acid composition of human FOXP2 changed rapidly around the same time that language emerged in modern humans," said Dr. Daniel Geschwind, Gordon and Virginia MacDonald Distinguished Chair in Human Genetics at the David Geffen School of Medicine at UCLA. "Ours is the first study to examine the effect of these amino-acid substitutions in FOXP2 in human cells.

"We showed that the human and chimp versions of FOXP2 not only look different but function differently too," said Geschwind, who is currently a visiting professor at the Institute of Psychiatry at King's College London. "Our findings may shed light on why human brains are born with the circuitry for speech and language and chimp brains are not."

FOXP2 switches other genes on and off. Geschwind's lab scoured the genome to determine which genes are targeted by human FOXP2. The team used a combination of human cells and post-mortem brain tissue from both chimps and humans who died of natural causes.

The chimp brain dissections were performed in the laboratory of co-author Todd Preuss, an associate research professor of neuroscience at Emory University's Yerkes National Primate Research Center.

The scientists focused on gene expression — the process by which a gene's DNA sequence is converted into cellular proteins.

To their surprise, the researchers discovered that the human and chimp forms of FOXP2 produce different effects on gene targets in the human cell lines.

"We found that a significant number of the newly identified targets are expressed differently in human and chimpanzee brains," Geschwind said. "This suggests that FOXP2 drives these genes to behave differently in the two species."

The research demonstrates that mutations believed to be important to FOXP2's evolution in humans change how the gene functions, resulting in different gene targets being switched on or off in human and chimp brains.

"Genetic changes between the human and chimp species hold the clues for how our brains developed their capacity for language," said first author Genevieve Konopka, a postdoctoral fellow in neurology at the David Geffen School of Medicine at UCLA. "By pinpointing the genes influenced by FOXP2, we have identified a new set of tools for studying how human speech could be regulated at the molecular level."

The discovery will provide insight into the evolution of humans' ability to learn through the use of higher cognitive skills, such as perception, intuition and reasoning.

"This study demonstrates how critical chimps and macaques are for studying humans," Preuss said. "They open a window into understanding how we evolved into who we are today."

Because speech problems are common to both autism and schizophrenia, the new molecular pathways will also shed light on how these disorders disturb the brain's ability to process language.

The National Institute of Mental Health, the A.P. Giannini Foundation and the National Alliance for Research on Schizophrenia and Depression funded the study.

Co-authors included Jamee Bomar, Giovanni Coppola, Fuying Gao, Sophia Peng, Kellen Winden, James Wohlschlegel and Zophonias Jonsson, all of UCLA.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Statement by Gerald Levey

UCLA Newsroom — Wed, 04 Nov 2009 22:26:12 GMT

Statement from Gerald S. Levey, vice chancellor of medical sciences and dean of the David Geffen School of Medicine at UCLA, on the naming of his successor:

I believe the selection of A. Eugene Washington to serve as the next dean of the David Geffen School of Medicine and vice chancellor of health sciences at UCLA is an inspired choice and signals a strong commitment to the issues of greatest importance to academic medicine in the coming years. Dr. Washington’s distinguished background in medical research, clinical care, public health, and health care disparities taken together means he will be perfectly situated to lead what is already a great institution’s health sciences program to new and even greater accomplishment.

I look forward to working with Dr. Washington during his transition to UCLA and into the future in my emeritus status. He will soon find, as I know, what an incredible group of individuals – faculty, clinicians, and staff -- work in UCLA Health Sciences.

A. Eugene Washington appointed as dean of the David Geffen School of Medicine and Vice Chancellor of Health Sciences at UCLA

UCLA Newsroom — Wed, 04 Nov 2009 22:06:14 GMT

Message to UCLA administrative officers, deans, department chairs, directors, vice chancellors and faculty of the medical echool and medical sciences from Scott Waugh, executive vice chancellor and provost:

Dear Colleagues:

I am very pleased to inform you that Chancellor Block and I have proposed for UC Regents’ approval the appointment of A. Eugene Washington as dean of the David Geffen School of Medicine and vice chancellor of health sciences at UCLA, effective February 1, 2010.

Dr. Washington currently serves as executive vice chancellor & provost and professor of gynecology, epidemiology, and health policy at the University of California, San Francisco (UCSF). A member of the UCSF faculty since 1983, Dr. Washington served as chair of the Department of Obstetrics, Gynecology, and Reproductive Sciences from 1996 to 2004 and director of the UCSF Women’s Reproductive Health Research Career Development Center from 1998 to 2004. He co-founded UCSF’s Medical Effectiveness Research Center for Diverse Populations in 1993 and served as director through July 2005. He also co-founded the UCSF-Stanford Evidence-based Practice Center and served as its first director from 1997 to 2002. Prior to joining the faculty at UCSF, Dr. Washington worked for the Centers for Disease Control and Prevention (CDC) in the U.S. Public Health Service.

A respected clinical investigator and health policy analyst, Dr. Washington has been actively engaged in the training of medical students, residents, fellows and junior faculty at UCSF. He has published extensively in his major areas of research, which include prenatal genetic testing, cervical cancer screening and prevention, non-cancerous uterine conditions management, quality of health care, and racial/ethnic disparities in health outcomes. Over the last two decades, Dr. Washington has been a national leader in assessing medical technologies, developing clinical practice guidelines and establishing disease prevention policies, particularly for women’s health.

Dr. Washington was elected to the Institute of Medicine (IOM) of the National Academy of Sciences in 1997. He also received the Outstanding Service Medal from the U.S. Public Health Service and has been recognized by his peers and staff at UCSF. In 1999, he was named the UCSF School of Medicine Alumnus of the Year, the highest honor awarded by the Alumni-Faculty Association, and in 2002, he received UCSF’s Martin Luther King Jr. Award, in recognition of extraordinary efforts to promote diversity on the campus. During the past 30 years, he has served on a number of professional and governmental boards and committees, and is currently a member of the Board of Trustees of the Robert Wood Johnson Foundation, and the boards of directors for The California Wellness Foundation, Common Sense Media, and the California HealthCare Foundation. He also serves on the Governing Council of the IOM and as a member of the congressionally mandated Scientific Management Review Board for the National Institutes of Health.

Dr. Washington holds an M.D. from the University of California, San Francisco School of Medicine, an M.Sc. from the Harvard University School of Public Health, an M.P.H. from the University of California, Berkeley School of Public Health, and a B.S. from Howard University. He completed residencies in preventive medicine at Harvard University and in gynecology and obstetrics at Stanford University, and was a health policy scholar at UCSF’s Institute for Health Policy Studies.

Chancellor Block and I want to express our sincere appreciation to the search/advisory committee and consultant, who brought enormous expertise, sensitivity and responsibility to the search and who recruited a truly outstanding pool of candidates for this position. Members included: Sherin U. Devaskar – Professor and Vice Chair, Pediatrics; James S. Economou – Professor of Surgery; Jose J. Escarce – Professor of Medicine, UCLA and Senior Natural Scientist, RAND Corporation; David T. Feinberg – CEO and Associate Vice Chancellor, UCLA Hospital System; Judith C. Gasson – Director, Jonsson Comprehensive Cancer Center; Langston T. Holly – Ruth & Raymond Stotter Chair in Neurosurgery; Patricia A. Kapur – Professor and Ronald L. Katz M.D. Chair, Department of Anesthesiology; Linda M. Liau – Professor of Neurosurgery and Director, Comprehensive Brain Tumor Program; Courtney H. Lyder – Dean, School of Nursing; Jeffery F. Miller – Chair, Department of Microbiology, Immunology & Molecular Genetics; Judy D. Olian – Dean and John E. Anderson Chair in Management, UCLA Anderson School of Management; No-Hee Park – Dean, School of Dentistry; David L. Rimoin – Director, Medical Genetics Institute, Cedars-Sinai and Professor of Pediatrics, Medicine and Human Genetics, UCLA; Linda Rosenstock – Dean, School of Public Health; Richard Sherman – CEO, The David Geffen Company; LuAnn Wilkerson – Senior Associate Dean, Medical Education; Phillip L. Williams – Vice Chairman Emeritus, Times-Mirror Company and Chairman, School of Medicine Board of Visitors. The executive search firm, Witt/Kieffer, was represented by Mary Elizabeth Taylor.

We also want to express our deepest gratitude to Jerry Levey for more than 15 years of extraordinary service as dean and vice chancellor.

I am confident that the UCLA health sciences will continue to thrive under Dr. Washington’s capable leadership. Please join me in welcoming him to our campus and into this new post.

Sincerely,

Scott L. Waugh
Executive Vice Chancellor and Provost

A. Eugene Washington appointed dean of the David Geffen School of Medicine and Vice Chancellor of Health Sciences

Wed, 04 Nov 2009 19:21:29 GMT

Astellas, Medivation to develop, commercialize MDV3100 for treatment of prostate cancer

Stuart Wolpert — Wed, 04 Nov 2009 08:00:00 GMT

Astellas Pharma Inc. of Japan and California's Medivation Inc. have announced a global agreement to develop and commercialize MDV3100, a chemical compound developed in UCLA science laboratories that is now Medivation's investigational drug for the treatment of prostate cancer.

MDV3100 is currently being evaluated in the Phase 3 AFFIRM clinical trial in men with castration-resistant prostate cancer who were previously treated with docetaxel-based chemotherapy.

Michael Jung, UCLA professor of chemistry and biochemistry and a researcher at UCLA's Jonsson Comprehensive Cancer Center, and his research group designed and synthesized the molecule that became MDV3100.

The molecule was tested in biology research that was conducted in the UCLA departments of medicine, urology and pharmacology by Charles Sawyers and his research group; Sawyers has since moved to Memorial Sloan-Kettering Cancer Center in New York, where he serves as chair of the human oncology and pathogenesis program. Medivation Inc. tested MDV3100 in clinical trials.

"This pharmaceutical offers the promise of extended life for patients with prostate cancer, and I am proud that it was developed in a collaborative research effort at UCLA by world-class scientists led by Michael Jung and Charles Sawyers," said UCLA Chancellor Gene D. Block. "While treatment is still in the testing phase, the path to approval looks quite promising."

"It is very encouraging that Medivation has decided to collaborate with Astellas on the development of MDV3100 for the treatment of prostate cancer," said Jung, who is also a member of the California NanoSystems Institute (CNSI) at UCLA. "I am hopeful that this new agreement will help the process of approval of this new drug, which potentially could help many men with prostate cancer. This is indeed good news."

The companies will collaborate on a comprehensive development program that will include additional studies to develop MDV3100 for both late- and early-stage prostate cancer. Subject to receipt of regulatory approval, the companies will jointly commercialize MDV3100 in the United States. Astellas will have responsibility for developing and commercializing MDV3100 outside the United States.

Prostate cancer is the most common non-skin cancer among men in the United States, according to the American Cancer Society. More than 2 million American men have prostate cancer — the second leading cause of cancer death among men after lung cancer. In 2009, an estimated 192,000 new cases are expected to be diagnosed, and approximately 27,000 men are expected to die from the disease.

MDV3100, a new generation of oral anti-androgen, which shows different pharmacological profiles from current anti-androgens, has been shown in preclinical studies to provide more complete suppression of the androgen receptor pathway than bicalutamide, the most commonly used anti-androgen. MDV3100 slows growth and induces cell death in bicalutamide-resistant cancers through three complementary actions: It blocks testosterone binding to the androgen receptor, impedes movement of the androgen receptor to the nucleus of prostate cancer cells (nuclear translocation), and inhibits binding to DNA.

Research published in the journal Science earlier this year demonstrated that MDV3100 has shown considerable promise in early clinical trials involving patients with castration-resistant prostate cancer, or CRPC, whose disease has become resistant to current drugs.

In September 2009, Medivation began enrolling patients in a randomized, placebo-controlled, double-blind, multinational Phase 3 clinical trial known as AFFIRM. This trial is evaluating MDV3100 at a dose of 160 mg taken orally once daily versus placebo in men with castration-resistant prostate cancer who were previously treated with docetaxel-based chemotherapy. This trial is expected to enroll approximately 1,200 patients at sites in the United States, Canada, Europe, South America, Australia and South Africa.

Medivation previously announced interim safety and efficacy results from an ongoing Phase 1-2 clinical trial of MDV3100 at the American Society of Clinical Oncology (ASCO) annual meeting in May 2009. The interim results showed that MDV3100 was associated with anti-tumor activity in patients who had become resistant to bicalutamide or other standard anti-androgen treatments, including both patients who had failed prior chemotherapy and patients who were chemotherapy naive. Anti-tumor activity was demonstrated by reductions in prostate-specific antigen (PSA) levels, improvement or stabilization in tumors that had spread to soft tissue or bone, and a decrease in circulating tumor cells, which has been associated in published literature with improved survival in patients with castration-resistant prostate cancer. MDV3100 was generally well tolerated in this trial at doses up to and including 240 mg a day, with fatigue being the most frequently reported adverse event.

In an article published April 9, 2009, in the online edition of the journal Science, Sawyers, Jung and other chemists and biologists at UCLA and colleagues at several other institutions, including Memorial Sloan-Kettering Cancer Center, described the development and testing of two novel compounds, MDV3100 and RD162, which block the androgen receptor in CRPC cells, and reported results from a clinical trial in which MDV3100 was found to lower PSA levels — a marker for tumor growth — in men with CRPC.

The UCLA patents for both compounds were licensed by the pharmaceutical company Medivation Inc., which chose to test MDV3100 in clinical trials.

Prostate cancer becomes resistant to currently approved anti-androgen drugs when cancer cells begin to increase production of the androgen receptor, Sawyers said. When the level of androgen receptors on the cells' surface reaches a certain level, the drugs that originally suppressed the cancer actually begin to stimulate cancer growth. Sawyers and his colleagues therefore set out to design a new generation of drugs that can block the androgen receptor without this unwanted side effect, even when levels of the receptor are high.

In addition to Sawyers' and Jung's teams, researchers from the Oregon Health and Science University, the University of Washington and Medivation contributed to the research.

This research was supported by the National Institutes of Health, the U.S. Department of Defense, the Prostate Cancer Foundation and Medivation and was conducted through the Prostate Cancer Clinical Trials Consortium.

For more information about Jung, visit www.chem.ucla.edu/~jung/home.html.

UCLA is California's largest university, with an enrollment of nearly 38,000 undergraduate and graduate students. The UCLA College of Letters and Science and the university's 11 professional schools feature renowned faculty and offer more than 323 degree programs and majors. UCLA is a national and international leader in the breadth and quality of its academic, research, health care, cultural, continuing education and athletic programs. Five alumni and five faculty have been awarded the Nobel Prize.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Statement on UCLA's organ transplantation program

UCLA Newsroom — Mon, 02 Nov 2009 20:56:19 GMT

CBS's "60 Minutes" ran a story Sunday, Nov. 1, on the Japanese Yakuza that included numerous inaccuracies relating to Ronald Reagan UCLA Medical Center and organ transplants in general. Unfortunately, the program failed to air the complete statement provided by UCLA, which directly refuted a number of the segment's allegations.

The U.S. organ allocation system is completely transparent. In 2008, both federal legislative investigators and Centers for Medicare and Medicaid Services investigative staff conducted in-depth reviews and found that UCLA's liver transplant patients had received the right organ at the right time. No money or donation was offered or paid to anyone at UCLA as a quid pro quo for getting a transplant or moving up on the list.

An individual's place on the transplant list is determined by a complex, federally mandated formula. Thereafter, as livers become available, factors such as the patient's age, weight, blood type, medical condition and physical location, along with the quality of the liver, will determine whether a patient at the top of the list is an appropriate match for the available organ. As such, the list is not static. Although it is a complex system, it is one based on clear, established guidelines and the expertise of dedicated physicians.

UCLA follows all United Network for Organ Sharing (UNOS) guidelines — medical and ethical — as well as federal and state laws governing organ transplantation. UNOS guidelines explicitly prohibit subjecting any transplant candidate to a "background check" or other ethical litmus tests. They state: "Punitive attitudes that completely exclude those convicted of crimes from receiving medical treatment, including organ transplant, are not ethically legitimate."

A doctor's job is to heal, not judge. That is what UCLA transplant doctors strive to do, performing hundreds of transplants every year. Our liver transplant program, which recently celebrated its 25th anniversary, has saved the lives of nearly 5,000 individuals.

For more background on this issue, please read the following piece, which appeared in the Los Angeles Times on June 6, 2008: http://www.newsroom.ucla.edu/portal/ucla/bad-guy-transplants-52028.aspx.

Kaiser Permanente gives $5.2 million to endow Center for Health Equity at UCLA

Sarah Anderson — Thu, 29 Oct 2009 16:25:00 GMT

The UCLA School of Public Health has received a $5.2 million gift from Kaiser Permanente to endow the UCLA Kaiser Permanente Center for Health Equity. The center, formerly known as the Center to Eliminate Health Disparities, is dedicated to improving the health of underserved populations through research, community collaboration and leadership development.

"This generous funding from Kaiser Permanente will enable the center to expand its ability to bring critical resources and attention to communities with the greatest needs," said Linda Rosenstock, M.D., M.P.H., dean of the UCLA School of Public Health. "Until now, the center has lacked the core support necessary to most effectively address the unacceptable gaps in health status among some in our communities."

"Kaiser Permanente is deeply committed to addressing issues of social inequality in all communities," said Raymond J. Baxter, Ph.D., senior vice president for community benefit, research and health policy at Kaiser Permanente. "Our investment in the UCLA Kaiser Permanente Center for Health Equity is designed to foster greater collaboration between academia, health care providers and the community to help ensure that health equity becomes the norm for everyone in our state and across the nation."

The center will support partnerships with community-based organizations to conduct innovative research and develop effective programs and strategies to eliminate health disparities.

"The very health of our communities is now in the spotlight, but the issue of health equity has persisted under the radar for far too long," said Benjamin Chu, M.D., M.P.H., M.A.C.P., president of Kaiser Permanente Southern California. "We must challenge assumptions and open our minds to the possibilities of what focused research and collaboration can mean to the lives of thousands of families who are struggling to preserve their health. This new center has the potential to inspire positive change, and we will be there with them every step of the way."

The center will also expand its training and technical assistance services, including the development and dissemination of multilingual, culturally appropriate materials, distance learning programs and training tools. It will place a heavy focus on attracting and training new talent determined to eliminate disparities. Stable support for the center will allow community leaders and academics to devote sustained efforts toward raising awareness about health disparities, setting priorities and formulating short- and long-range solutions to urgent health issues.

The center was established in 2004 by co-directors Roshan Bastani, Ph.D., professor of health services and associate dean of research at the UCLA School of Public Health, and Antronette K. (Toni) Yancey, M.D., M.P.H., professor of health services, as a collaborative "center without walls," with members from academia, government and private and nonprofit organizations, to address the increasing disparities in health status and health care in Los Angeles County caused by poverty, lack of health insurance and unhealthy home and work environments.

The center conducts population-based intervention research for health promotion and disease prevention, including developing effective strategies to increase uptake of the recently approved human papillomavirus vaccine among young girls, increasing cancer screening in diverse populations, integrating physical activity and healthy eating into the workplace and preventing chronic disease among farmworker housing communities. Many of these programs have now been replicated in cities, counties and states throughout the country.

Kaiser Permanente, America's leading health care provider and not-for-profit health plan, is shaping the future of health care. Founded in 1945, Kaiser Permanente's mission is to provide high-quality, affordable health care services to improve the health of its members and the communities it serves. Kaiser Permanente currently serves 8.6 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health.

The UCLA School of Public Health is dedicated to enhancing the public's health by conducting innovative research; training future leaders and health professionals; translating research into policy and practice; and serving local, national and international communities.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Pediatric patients experience Halloween fun at Mattel Children's Hospital UCLA

Amy Albin — Tue, 27 Oct 2009 22:55:00 GMT

WHAT:

Despite being in the hospital, pediatric patients at Mattel Children's Hospital UCLA will still get to celebrate Halloween by dressing up in costumes, face-painting and watching a magic show. In addition, five canine teams from UCLA's People-Animal Connection (PAC), an animal-assisted therapy program, will don costumes and accompany the kids while they trick-or-treat through the hospital hallways.

WHEN:

11:30 a.m.–1:30 p.m., Friday, Oct. 30

11:30 a.m.

Creative arts, including crafts and face-painting

Noon

Magic show

12:30 p.m.

PAC dogs greet kids, trick-or-treat parade begins

WHERE:

Child Life Playroom, on the fifth floor of Mattel Children's Hospital UCLA

(757 Westwood Blvd., Los Angeles)

BACKGROUND:

The annual Halloween party is hosted by the hospital's Child Life/Child Development department in an effort to make sure the young patients experience a memorable celebration. For the third year, Spirit Halloween, the country's largest seasonal Halloween retailer, has generously donated all costumes and accessories for pediatric families at UCLA's Westwood and Santa Monica hospitals. Art of Elysium, a nonprofit organization that facilitates creative arts activities with pediatric patients and their families, will organize Halloween face-painting, and Pun the Magician will host his annual magic show.

MEDIA CONTACT:

Amy Albin, UCLA Health Sciences Media Relations, 310-794-8672

R.S.V.P. & PARKING:

Please call media contact to R.S.V.P. and arrange parking.

Ronald Reagan UCLA Medical Center receives award for excellence in heart care

Rachel Champeau — Wed, 21 Oct 2009 07:00:00 GMT

Ronald Reagan UCLA Medical Center has been honored by the American College of Cardiology and the American Heart Association for its commitment to and success in implementing a higher standard of care for heart attack patients.

The medical center was one of only 121 hospitals nationwide to be recognized for achieving the aggressive goal of treating acute myocardial infarction patients with high compliance to levels of care outlined by these two leading national organizations dedicated to promoting quality cardiovascular care and reducing mortality from heart disease.

The honor, known as the American College of Cardiology Foundation's NCDRACTION Registry–GWTG Gold Performance Achievement Award, was created through the merger of the American College of Cardiology Foundation's registry and the American Heart Association's Get With the Guidelines–Coronary Artery Disease program.

"The time is right for us to be focused on improving the quality of cardiovascular care," said Dr. Gregg C. Fonarow, director of the Ahmanson–UCLA Cardiomyopathy Center at Ronald Reagan UCLA Medical Center. "The number of acute myocardial infarction patients eligible for treatment is expected to grow over the next decade due to increasing incidence of heart disease and a large aging population."

To receive the award, the hospital consistently followed the treatment guidelines in the ACTION Registry–GWTG for 24 consecutive months. These included aggressive in-hospital use of medications like cholesterol-lowering drugs, beta-blockers, ACE inhibitors, aspirin and anticoagulants.

"We are dedicated to providing the highest level of care for our patients, including coronary care after a heart attack," said Dr. J. Thomas Rosenthal, chief medical officer and associate vice chancellor of the UCLA Health System. "We are pleased to receive this prestigious recognition."

"The American College of Cardiology Foundation and the American Heart Association commend the Ronald Reagan UCLA Medical Center for its success in implementing standards of care and protocols," said ACTION Registry–GWTG steering committee chair Dr. Christopher Cannon, an associate professor of medicine at Harvard Medical School and an associate physician in the cardiovascular division of Brigham and Women's Hospital in Boston.

Fonarow, who is vice chair of the ACTION Registry–GWTG steering committee, noted that the full implementation of guideline-recommended acute and secondary prevention therapy is a critical step in saving the lives and improving outcomes of heart attack patients.

The merger of the ACTION Registry and the Get With the Guidelines–Coronary Artery Disease program combines the best of both in a single, unified national registry, bringing together the robust data collection and quality reporting features of the registry with the collaborative models, unique tools and quality improvement techniques of the GWTG program.

With the collective strengths of these two programs, the ACTION Registry–GWTG empowers health-care provider teams to consistently treat heart attack patients according to the most current science-based guidelines and establishes a national standard for understanding and improving the quality, safety and outcomes of care provided for patients with coronary artery disease, specifically high-risk STEMI and NSTEMI myocardial infarction patients.

The UCLA Health System has been a leader in patient care, medical research and teaching for more than 50 years. Today, our physicians provide an array of cutting-edge and research-based primary and specialty services in four hospitals on two campuses, and in numerous outpatient clinic locations. Composed of the UCLA Hospital System and the UCLA Medical Group and its affiliates, the UCLA Health System has provided the best in health care and the most advanced treatment options to the people of Southern California, the U.S. and the world. UCLA's preeminence in health care — a strength that comes from the union of research, teaching and excellence in patient care — continues to be recognized nationally and internationally. The clinical programs of Ronald Reagan UCLA Medical Center, Santa Monica–UCLA Medical Center and Orthopaedic Hospital, the Resnick Neuropsychiatric Hospital at UCLA, and Mattel Children's Hospital UCLA constitute a system of hospital care that has been ranked among the best in the nation. UCLA physicians and hospitals continue to be world leaders in the full range of care, from maintaining the health of families to the diagnosis and treatment of complex illnesses.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Feelings of stigmatization may discourage HIV patients from proper care, study finds

Enrique Rivero — Wed, 21 Oct 2009 07:00:00 GMT

The feeling of stigmatization that people living with HIV often experience doesn't only exact a psychological toll — new UCLA research suggests it can also lead to quantifiably negative health outcomes.

In a study published in the October issue of the Journal of General Internal Medicine, researchers from the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA found that a large number of HIV-positive individuals who reported feeling stigmatized also reported poor access to care or suboptimal adherence to antiretroviral therapy (ART).

In fact, individuals who experienced high levels of internalized stigma were four times as likely as those who didn't to report poor access to medical care; they were three times as likely to report suboptimal adherence to HIV medications.

These findings were due, at least in part, to the poor mental health found among many of the participants. Researchers found that HIV stigma was one of the strongest predictors of poor access to medical care and that both HIV stigma and poor mental health predicted suboptimal adherence to medication. Adherence to HIV medications is already known to lead to better health outcomes, including survival, among people living with HIV.

"We were surprised to find that in our models, experiencing high levels of internalized HIV stigma was one of the strongest predictors of poor access to medical care, even after controlling for sociodemographics such as gender, race and ethnicity, income, insurance status, and clinical variables such as T-cell count and years since HIV diagnosis," said the study's lead investigator, Dr. Jennifer Sayles, an assistant professor of medicine at the David Geffen School of Medicine at UCLA and medical director of the Los Angeles County Department of Public Health's Office of AIDS Programs and Policy.

The study — one of the first to quantify how internalized feelings of stigmatization among people living with HIV negatively influence health outcomes — is available online at www.springerlink.com/content/71h5331844161x75/fulltext.pdf.

The findings demonstrate the urgent need for more community dialogue, education and awareness about HIV and the stigma that surrounds the disease, according to Sayles.

"It also highlights the need to address some of the social and contextual aspects of HIV for those living with the disease and to develop interventions that reduce internalized HIV stigma as a barrier to care and treatment," Sayles said.

The two-year study focused on 202 HIV-positive men and women in Los Angeles County, many of them minorities and many with limited incomes and limited education. Study participants completed anonymous surveys assessing internalized HIV stigma, self-reported access to medical care, their regular source of HIV care and ART adherence.

Overall, one-third of the participants reported experiencing high levels of stigma, and, on average, participants described experiencing or perceiving stigma slightly less frequently than "some of the time." Additionally, 77 percent of participants said they had poor access to care, 42.5 percent reported suboptimal adherence to ART and 10.5 percent reported having no regular source of HIV care.

The researchers point to some limitations in the study. They could not establish causality between internalized HIV stigma and negative outcomes — only a strong association between them. Also, the study did not directly measure social inequality, social support, self-efficacy and other similar covariates that may be related to HIV stigma. The study may also have missed people who do not access care or HIV services at all, given that study participants were recruited from community organizations providing outreach and social services to people living with HIV and from HIV clinical care sites. Finally, non-English speakers such as Latinos and Asian Americans were underrepresented in the sample.

Study co-authors include Mitchell D. Wong, Janni J. Kinsler and William Cunningham, all of UCLA, and David Martins of Charles R. Drew University of Medicine and Science.

Grants from the American Foundation for AIDS Research, the California HIV Research Program Network for AIDS Research in Los Angeles, the National Institute of Mental Health, the National Center on Minority Health and Health Disparities, and the National Institute on Aging supported this research.

The General Internal Medicine and Health Services Research Division in the department of medicine at the David Geffen School of Medicine at UCLA provides a unique interactive environment for collaborative efforts between health services researchers and clinical experts with experience in evidence-based work. The division's 100-plus clinicians and researchers are engaged in a wide variety of projects that examine issues related to access to care, quality of care, health measurement, physician education, clinical ethics and doctor-patient communication. Researchers in the division have close working relationships with economists, statisticians, social scientists and other specialists throughout UCLA and frequently collaborate with their counterparts at the RAND Corp. and the Charles Drew University of Medicine and Science.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Nearly all Californians would potentially be insured under national health care reform

Gwendolyn Driscoll — Mon, 19 Oct 2009 17:46:00 GMT

If national health care reform is enacted, 93 percent of California's non-elderly population would have access to health insurance — a nearly 13 percentage-point increase in statewide coverage — according to a new fact sheet released today by the UCLA Center for Health Policy Research.

About 4 million of California's 6.4 million non-elderly adults and children who were uninsured for all or part of the year in 2007 would directly benefit through the expanded coverage offered by federal health care reform proposals, according to the fact sheet's author, Shana Alex Lavarreda, the center's director of health insurance studies.

"Just enacting the reforms agreed on in all current proposals would secure access to health insurance for millions of Californians," said Lavarreda. "It would be a dramatic change for the better."

Currently, 80.5 percent of California's estimated 33 million non-elderly residents have health insurance coverage throughout the year. Key changes included in all three of the health care reform proposals considered by Congress would make an additional 4 million uninsured Californians eligible either for public health insurance (in Medi-Cal, California's Medicaid program) or for public subsidies to purchase coverage in a health insurance exchange.

In Los Angeles County alone, the epicenter of uninsurance in California, 1.2 million uninsured adults and children (out of a total 2.1 million) would be helped by national health care reform.

Not every Californian will be covered: The current proposals do not include people who either have incomes too high to qualify for public subsidies or do not qualify because of their citizenship status.

The fact sheet is based upon a data analysis of the California Health Interview Survey (CHIS), the nation's largest state health survey.

Read the fact sheet

First-time Internet users find boost in brain function after just one week

Rachel Champeau — Mon, 19 Oct 2009 17:00:00 GMT

You can teach an old dog new tricks, say UCLA scientists who found that middle-aged and older adults with little Internet experience were able to trigger key centers in the brain that control decision-making and complex reasoning after just one week of surfing the Web.

The findings, presented Oct. 19 at the 2009 meeting of the Society for Neuroscience, suggest that Internet training can stimulate neural activation patterns and could potentially enhance brain function and cognition in older adults.

As the brain ages, a number of structural and functional changes occur, including atrophy, reductions in cell activity and increases in deposits of amyloid plaques and tau tangles, which can impact cognitive function.

Research has shown that mental stimulation similar to that which occurs in individuals who frequently use the Internet may affect the efficiency of cognitive processing and alter the way the brain encodes new information.

"We found that for older people with minimal experience, performing Internet searches for even a relatively short period of time can change brain activity patterns and enhance function," said study author Dr. Gary Small, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA and the author of "iBrain," a book that describes the impact of new technology on the brain and behavior.

The UCLA team worked with 24 neurologically normal volunteers between the ages of 55 and 78. Prior to the study, half the participants used the Internet daily, while the other half had very little experience. Age, educational level and gender were similar between the two groups.

Study participants performed Web searches while undergoing functional magnetic resonance imaging (fMRI) scans, which recorded the subtle brain-circuitry changes experienced during this activity. This type of scan tracks brain activity by measuring the level of cerebral blood flow during cognitive tasks.

After the initial brain scan, participants went home and conducted Internet searches for one hour a day for a total of seven days over a two-week period. These practice searches involved using the Internet to answer questions about various topics by exploring different websites and reading information. Participants then received a second brain scan using the same Internet simulation task but with different topics.

The first scan of participants with little Internet experience demonstrated brain activity in regions controlling language, reading, memory and visual abilities, which are located in the frontal, temporal, parietal, visual and posterior cingulate regions, researchers said. The second brain scan of these participants, conducted after the practice Internet searches at home, demonstrated activation of these same regions, as well as triggering of the middle frontal gyrus and inferior frontal gyrus — areas of the brain known to be important in working memory and decision-making.

Thus, after Internet training at home, participants with minimal online experience displayed brain activation patterns very similar to those seen in the group of savvy Internet users — after just a brief period of time.

"The results suggest that searching online may be a simple form of brain exercise that might be employed to enhance cognition in older adults," said Teena D. Moody, the study's first author and a senior research associate at the Semel Institute at UCLA.

When performing an Internet search, the ability to hold important information in working memory and to extract the important points from competing graphics and words is essential, Moody noted.

Previous research by the UCLA team found that searching online resulted in a more than twofold increase in brain activation in older adults with prior experience, compared with those with little Internet experience. According to Small, the new findings suggest that it may take only days for those with minimal experience to match the activity levels of those with years of experience.

Additional studies may address the impact of the Internet on younger individuals and help identify aspects of online searching that generate the greatest levels of brain activation.

The study was funded by the Parvin Foundation.

Susan Y. Bookheimer, professor of psychiatry and biobehavioral sciences at the Semel Institute at UCLA, was also an author of this study. Himaja Gaddipati, a UCLA neuroscience student, and Jennifer Brace, a UCLA doctoral student in neuroscience, contributed to the work.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Higher resource use at hospitals means reduced mortality among heart patients

Roxanne Moster — Tue, 13 Oct 2009 20:00:00 GMT

Variations in how hospital resources are used across the United States have been a central component of the current discussion on health care reform. A new study by the University of California's five medical centers and Cedars-Sinai Medical Center in Los Angeles that examined variations in medical treatment, cost and patient outcomes between hospitals has some surprising new findings to add to the debate.

The study, "Looking Forward, Looking Back: Assessing Variations in Hospital Resource Use and Outcomes for Elderly Patients With Heart Failure," takes a more in-depth look into the wide variation documented by recent studies on hospital utilization among chronically ill Medicare beneficiaries at the end of life. The findings appear in the early online edition of the journal Circulation: Cardiovascular Quality and Outcomes.

Among the six California teaching hospitals, researchers found lower mortality rates at six months for elderly Medicare heart failure patients hospitalized at hospitals that used more health care resources, compared with those at hospitals that used fewer resources. This finding suggests that more resource-intensive care may improve outcomes among certain patients with heart failure, the most frequent cause of hospitalization and death among Medicare beneficiaries.

The study used a "looking forward" approach that examined all hospitalized heart failure patients; this approach was compared with the "looking back" approach used in prior studies of variation among hospitals — an approach that examined only hospitalized individuals in the last six months of life.

"Two major concerns with the 'looking back' approach are that, one, it cannot identify differences across hospitals in health outcomes, and it ignores the possibility that resource-intensive care may influence survival; and two, it assumes that patterns of resource use among deceased individuals accurately reflect patterns of resource use among all individuals," said Dr. Michael Ong, the study's lead investigator and an assistant professor in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA.

"We found with the 'looking forward' approach that mortality was lower for heart failure patients at the hospitals that had greater resource use," Ong said.

"This positive association between increased resource use and reduced mortality would not be observed with a 'looking back' approach," said Dr. J. Thomas Rosenthal, chief medical officer at Ronald Reagan UCLA Medical Center and one of the study's authors. "In addition, changing to the 'looking forward' approach resulted in nearly half the amount of variation in resource use generated by the 'looking back' approach."

The researchers suggest that focusing only on deceased individuals may overlook important associations between resource utilization and mortality. They believe that acting on variation will require a careful balance between trying to reduce resource use and improving health outcomes. The researchers feel that essential efforts to reduce inefficient use of resources must safeguard against inadvertent reductions of beneficial resources as well.

The study was designed to further examine variations among hospitals and is not a comment on the many studies that have examined variations among geographic areas. However, it highlights the potential complications of ignoring health outcomes in discussions about reducing health care utilization at hospitals.

The study focused on elderly Medicare beneficiaries hospitalized from 2001 to 2005 for heart failure. The six hospitals included UCLA Medical Center (now known as Ronald Reagan UCLA Medical Center); UC San Francisco Medical Center; Cedars-Sinai Medical Center, Los Angeles; UC San Diego Medical Center, UC Irvine Medical Center and UC Davis Medical Center.

The study was funded by the California HealthCare Foundation; in-kind support from the six medical centers included in the study; the Resource Centers for Minority Aging Research/Center for Health Improvement of Minority Elderly (RCMAR/CHIME), which is funded by the National Institutes of Health/National Institute on Aging; and the UCLA Older Americans Independence Center, which is funded by the National Institutes of Health/National Institute on Aging.

Other authors were Carol M. Mangione (UCLA), Patrick S. Romano (UCD), Qiong Zhou (UCLA), Andrew D. Auerbach (UCSF), Alein Chun (Cedars-Sinai), Bruce Davidson (Cedars-Sinai), Theodore G. Ganiats (UCSD), Sheldon Greenfield (UCI), Michael A. Gropper (UCSF), Shaista Malik (UCI), J. Thomas Rosenthal (UCLA) and Jose J. Escarce (UCLA/RAND). The authors report no conflicts of interest.

For more news, visit the UCLA Newsroom or follow us on Twitter.

UCLA gets $4.8M to create Preparedness and Emergency Response Research Center

Sarah Anderson — Tue, 13 Oct 2009 07:00:00 GMT

The UCLA School of Public Health has received a major grant from the U.S. Centers for Disease Control and Prevention to establish a center that will facilitate research to strengthen the ability of federal, state and local public health agencies to prepare for, respond to and recover from natural and human-induced disasters, including terrorism.

The award, which totals $4.8 million over four years, will allow the school's Center for Public Health and Disasters (CPHD) to build on more than two decades of experience in addressing the critical issues faced when a disaster impacts a community. The new Preparedness and Emergency Response Research Center (PERRC) will be directed by Kimberley Shoaf, associate director of the CPHD and an associate professor of community health sciences.

The grant will support three independent research projects designed to explore the interorganizational cooperation necessary to create and sustain a public health system that is resilient to disasters. These research projects will:

Improve collaboration between local school systems and public health agencies to enhance preparedness.
Build effective public health partnerships with community-based and faith-based organizations for disaster readiness.
Conduct community-based participatory research to develop environmental health emergency resilience.

"A coordinated public health system is critical to ensure an effective, timely response to public health emergencies and disasters," Shoaf said. "This new center will enable UCLA to develop evidence-based tools to help local, state and federal entities prepare for, respond to and recover from natural and human-induced disasters."

The UCLA School of Public Health is one of nine accredited U.S. schools of public health to receive CDC funding to conduct research that will evaluate the structure, capabilities and performance of public health systems for preparedness and emergency response activities. The establishment of the new PERRCs is mandated by the Pandemic and All-Hazards Preparedness Act of 2006, which calls for research to improve federal, state, local and tribal public health preparedness and response systems.

The UCLA Center for Public Health and Disasters was established in 1997 to address the critical issues faced when disaster impacts a community. The center facilitates interaction between public health and medicine, engineering, physical and social sciences, and emergency management. The CPHD collaborates with state and local public health agencies, community-based organizations, schools, hospitals and agencies in the public and private sector.

The UCLA School of Public Health is dedicated to enhancing the public's health by conducting innovative research, training future leaders and health professionals, translating research into policy and practice, and serving local, national and international communities.

For more information, visit the UCLA Newsroom or follow us on Twitter.

Breast tenderness during hormone replacement therapy linked to elevated cancer risk

Enrique Rivero — Mon, 12 Oct 2009 20:00:00 GMT

Women who developed new-onset breast tenderness after starting estrogen plus progestin hormone replacement therapy were at significantly higher risk for developing breast cancer than women on the combination therapy who didn't experience such tenderness, according to a new UCLA study.

The research, published in the Oct. 12 issue of the Archives of Internal Medicine, is based on data from more than 16,000 participants in the Women's Health Initiative estrogen-plus- progestin clinical trial. This trial was abruptly halted in July 2002 when researchers found that healthy menopausal women on the combination therapy had an elevated risk for invasive breast cancer.

Researchers do not know why breast tenderness indicates increased cancer risk among women on the combination therapy, said the new study's lead researcher, Dr. Carolyn J. Crandall, a clinical professor of general internal medicine and health services research at the David Geffen School of Medicine at UCLA.

"Is it because the hormone therapy is causing breast-tissue cells to multiply more rapidly, which causes breast tenderness and at the same time indicates increased cancer risk? We need to figure out what makes certain women more susceptible to developing breast tenderness during hormone therapy than other women," Crandall said.

This study compared the daily use of oral conjugated equine estrogens (0.625 mg) plus medroxyprogesterone acetate (2.5 mg), or CEE+MPA, with the daily use of a placebo pill.

Of the participants in the trial, 8,506 took estrogen plus progestin and 8,102 were given placebos. Participants underwent mammography and clinical breast exams at the start of the trial and annually thereafter. Self-reported breast tenderness was assessed at the beginning of the trial and one year later, and invasive breast cancer over the next 5.6 years was confirmed by medical record review.

Women on the combination therapy who did not have breast tenderness at the trial's inception were found to have a threefold greater risk of developing tenderness at the one-year mark, compared with participants who were assigned placebos (36.1 percent vs. 11.8 percent). Among the women who did report breast tenderness at the beginning, the risk at one-year was about 1.26 times that of their counterparts on placebos.

Of the women who reported new-onset breast tenderness, 76.3 percent had been on the combination therapy.

Women in the combination therapy group who did not have breast tenderness at the outset but experienced new-onset tenderness at the first annual follow-up had a 48 percent higher risk of invasive breast cancer than their counterparts on combination therapy who did not have breast tenderness at the first-year follow-up.

"To our knowledge, no prior published studies have addressed whether there is an association between CEE+MPA–induced new-onset breast tenderness and breast cancer risk," Crandall said.

The study does have limitations. The data the researchers used assessed breast tenderness only annually and thus could have underestimated it. Also, the rates of women discontinuing the combination therapy and switching from placebos to active therapy were relatively high, though the researchers believe this could have decreased, rather than increased, the observed association between new-onset tenderness and cancer risk. And the results don't apply to other types of estrogen or progestin therapy.

Study co-authors were Rowan Chlebowski of UCLA; Aaron K. Aragaki, Anne McTiernan and Garnet Anderson of the Fred Hutchinson Cancer Research Center in Seattle; Susan L. Hendrix of Wayne State University–Hutzel Women's Hospital in Detroit; Barbara B. Cochrane of the University of Washington; and Lewis H. Kuller and Jane A. Cauley of the University of Pittsburgh.

Grants from the National Institute on Aging and the Tarlow-Eisner-Moss Research Endowment of the Iris Cantor–UCLA Women's Health Center funded Crandall's research. Funding for the Women's Health Initiative comes through the National Heart, Lung and Blood Institute of the National Institutes of Health.

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Shawn, Larry King to be honored at 'Party on the Pier' benefiting Mattel Children's Hospital

Amy Albin — Wed, 07 Oct 2009 07:00:00 GMT

CNN talk show host Larry King and his wife, Shawn, will be honored at the 10th annual Mattel Party on the Pier, which benefits Mattel Children's Hospital UCLA. The event takes Sunday, Oct. 18, from 11 a.m. to 3 p.m. at Pacific Park on the Santa Monica Pier.

The Kings will each be presented with an honorary white doctor's coat during a special ceremony. In addition, Mattel Inc. will present Shawn with a one-of-a-kind doll made in her image to recognize her dedication to the hospital.

"Larry and I are thrilled to be honored at this year's event, as UCLA has a special place in our hearts," Shawn King said.

The Kings' ties to UCLA date back to Sept. 5, 1997, when the couple wed in Larry's room at UCLA Medical Center (now Ronald Reagan UCLA Medical Center) just before he underwent an angioplasty to unblock an artery in his heart. Their bond with the hospital grew stronger when Shawn returned to UCLA to deliver their two sons, Chance Armstrong King, in 1999, and Cannon Edward King, in 2000.

As a result of his heart illness, the CNN host was inspired to establish the Larry King Cardiac Foundation. The Kings remain dedicated to "saving lives, healing families, strengthening communities, one patient at a time ... a heart a day."

"We are incredibly honored that Larry, Shawn and their children will be helping us celebrate our 10th annual Mattel Party on the Pier," said Dr. Edward R.B. McCabe, physician-in-chief at Mattel Children's Hospital UCLA. "It will truly make a special milestone occasion even more memorable."

Additional celebrities anticipated to attend include David Henrie, David DeLuise and Jennifer Stone ("Wizards of Waverly Place"); Samantha Droke ("Princess Protection Program); recording artist Zoe Myers; Jansen Panettiere ("The Last Day of Summer"); World Wrestling Entertainment's Sgt. Slaughter; and Brandon Mychal Smith ("Sonny With a Chance").

The Mattel Party on the Pier is one of the major annual fundraising events for Mattel Children's Hospital UCLA. As a state-assisted institution, the hospital has increasingly limited funding and must rely on the charitable support of private donors and community partners.

The event sells out each year as guests look forward to highlights that include Pacific Park's thrilling rides, carnival games stocked with prizes donated by Mattel Inc., a silent auction featuring trips, jewelry and collector's memorabilia, arts and crafts booths, great food and more.

General admission tickets are $100 for adults and $50 for children ages 2 to 12; children under 2 are admitted free. Tickets must be purchased in advance. To order tickets, or for sponsorship opportunities, contact Erica Edwards at 310-267-1836 or visit www.partyonthepier.ucla.edu.

Mattel Inc. is the event's title sponsor. Additional major sponsors include the Thomas Spiegel Family Foundation, Beth and Dr. Neal Cutler, Disney Consumer Products, Shawn and Larry King, the Milken Family Foundation, Ellen and Richard Sandler, Liz and Evan Greenspan, Cognizant Technology Solutions, Maxine Dunitz, Four Seasons Resort Maui at Wailea, Alexandra and Scott Lambert, Jonathan and Nancy Littman, Rosanne and Ed Rosen, the Ray and Janet Scherr Foundation, the UCLA Department of Pathology and Laboratory Medicine, Feet First Eventertainment, and L.A. Parent magazine.

Mattel Children’s Hospital UCLA, one of the highest-rated children's hospitals in Southern California, is a vital component of Ronald Reagan UCLA Medical Center, ranked the third best hospital in nation and best in the western United States by U.S. News & World Report. Mattel Children's Hospital offers a full spectrum of primary and specialized medical care for infants, children and adolescents. The hospital's mission is to provide state‑of-the-art treatment for children in a compassionate atmosphere and to improve the understanding and treatment of pediatric diseases.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Insured African Americans more likely to use emergency room than other insured groups

Gwendolyn Driscoll — Wed, 07 Oct 2009 07:00:00 GMT

Health insurance, and the access it provides to a primary care physician, should reduce the use of a major driver of health care costs: the emergency room.

Yet in a policy brief released today by the UCLA Center for Health Policy Research, researchers found that in California, privately insured African Americans enrolled in HMOs are far more likely to use the ER and to delay getting needed prescription drugs than HMO-insured members of other racial and ethnic groups. The research was funded by the California Office of the Patient Advocate.

It's not that African Americans fail to see their doctors, researchers say. In fact, of all HMO enrollees, African Americans were the most likely to report seeing a doctor in the past year, according to the authors of the brief, "African-Americans in Commercial HMOs Are More Likely to Delay Prescription Drugs and Use the Emergency Room."

Patient income and illness did not predict ER or prescription drug use either. Researchers found greater ER use and delays in getting prescription drugs even among African American HMO enrollees who were generally healthy and had higher incomes.

While the reasons behind the ER use and drug delays among African Americans are the subject of future research, lead author Dylan Roby, a research scientist with the UCLA Center for Health Policy Research, said the data suggests that the way health maintenance organizations or their contracted physicians provide care — and the way patients respond to that care — may create obstacles to timely primary care, as well as foster excessive use of the emergency room and delays in getting needed medications.

African Americans Depend on HMOs

More than two-thirds of insured African Americans in California are enrolled in HMOs (67.3 percent, or 1.35 million), compared with 64.7 percent (4.5 million) of insured Latinos and 51.6 percent (8 million) of whites.

Using data from the 2007 California Health Interview Survey (CHIS), researchers found that African American patients enrolled in commercial HMO plans were more likely to delay getting needed prescription drugs. Those enrolled in commercial Kaiser Permanente plans were more likely to use the ER, they said.

"It's troubling, because it suggests that even if you are insured and well-off, you still may not be getting the care you need," Roby said. "It also suggests that HMOs that are designed to provide preventive care and to make sure people have their medications are not able to do so."

Kaiser Permanente is the most popular HMO among African Americans, with one-fourth of all insured African Americans enrolled in the Oakland-based insurance carrier. Despite HMO emphasis on preventive care, however, more than a quarter (25.4 percent) of all privately insured African Americans enrolled in a Kaiser Permanente plan used the emergency room in the past year — in contrast to 14 percent of Asian American enrollees and 17.5 percent of Latinos.

The reasons could range from the relative affordability of emergency-room services to the ease of accessing those services, Roby said.

"If it takes days or weeks to get an appointment with your doctor and just hours to be seen in the ER, people might make the easier choice, especially if it is convenient and affordable," he said. "On the other hand, if someone knows their local ER is overcrowded and expensive, they may be more likely to wait and see their own doctor."

Delaying Needed Medicine

Privately insured African American HMO enrollees also were notably more likely to delay getting needed prescription drugs. Prescription drug delays were about 10 percent higher for privately insured African Americans enrolled in non-Kaiser commercial HMO plans than for whites in comparable commercial plans.

Costs, geography and the pharmacy benefits offered by a given HMO may all inhibit the timely purchase of prescription drugs.

"We need to think about how the cost of prescriptions and delays in getting needed medications are compromising health status and quality of life," Roby said.

The research helps health advocates in California identify key health and health care issues for African American HMO members, said Sandra Perez, director of the California Office of the Patient Advocate. "This is the first step in understanding how HMOs can close the gaps in the quality of care and access they provide to their members."

Roby recommended an education campaign for both patient and provider that would address appropriate use of the ER and primary care services, as well as the importance of medication adherence and getting prescribed medications and refills.

"African American HMO members need to be empowered to find a doctor they are comfortable with, while health plans need to make a greater effort to connect patients with that doctor," Roby said.

The policy brief was supported by a grant from the California Office of the Patient Advocate as part of a targeted educational outreach program.

The California Health Interview Survey is the nation's largest state health survey and one of the largest health surveys in the United States.

The California Office of the Patient Advocate is a state office established to inform and educate consumers about their rights and responsibilities as health plan enrollees and to teach them how to make best use of the services offered by their health plans.

The UCLA Center for Health Policy Research is one of the nation's leading health policy research centers and the premier source of health-related information on Californians.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Cardiologist honored for research on effect of air pollution on heart health

Rachel Champeau — Wed, 07 Oct 2009 00:25:00 GMT

Thanks to the work of Dr. Jesus Araujo, director of environmental cardiology at the David Geffen School of Medicine at UCLA, patients with high cholesterol and those at risk for heart disease may one day be told by their doctors to avoid not only fatty foods and smoking but air pollution too.

Araujo's ongoing research on the effect of air pollution on cardiovascular health has revealed that the smallest particles from vehicle emissions may be the most damaging components of pollution in triggering plaque buildup in the arteries, which can lead to heart attack and stroke.

His team has discovered that these emission particles promote hardening of the arteries by inactivating the protective qualities of high-density lipoprotein (HDL), known as "good" cholesterol.

In recognition of his innovative environmental and biological research, the National Institute of Environmental Health Sciences, part of the National Institutes of Health, has honored Araujo with a 2009 Outstanding New Environmental Scientist (ONES) grant award to establish a UCLA program for the study of air pollution's impact on the heart.

Araujo is one of only six researchers across the country to receive the highly competitive award, which recognizes scientists in the early stages of their careers who are dedicated to launching unique research programs focusing on environmental exposures and their impact on human biology and disease development. Each ONES awardee was put forward as the sole candidate from their respective school or institution; Araujo was nominated by the David Geffen School of Medicine at UCLA.

The $2.6 million grant award, which was announced Oct. 1, will allow Araujo to establish an ambitious program to further his research with co-investigators from UCLA and collaborating academic centers, including the University of Washington, the University of Michigan and the Cleveland Clinic Foundation.

The program will aim to further investigate and understand the biological changes that occur as a result of these air pollutant particles and to develop therapeutic strategies that could inhibit their toxic effects in the future. Scientists will focus on identifying the mechanisms behind how exposure to air pollution induces alterations in HDL lipoproteins in the blood and plaque buildup in the arteries, known as atherosclerosis.

Araujo, an assistant professor of medicine and cardiology who holds both M.D. and Ph.D. degrees, is also a faculty member of the UCLA Molecular Toxicology Interdepartmental Program and an associate member of the UCLA Molecular Biology Institute.

The David Geffen School of Medicine at UCLA, which graduated its first class in 1955, is the youngest medical school to be ranked among the top 11 in the nation by U.S. News & World Report. The school has more than 2,000 full-time faculty members, including recipients of the Nobel Prize, the Pulitzer Prize and the National Medal of Science.

For more news, visit the UCLA Newsroom or follow us on Twitter.

UCLA Medical Group ranks among top physician organizations in state

Roxanne Moster — Fri, 02 Oct 2009 17:27:28 GMT

In the midst of the national debate about the future of health care, the Integrated Healthcare Association has announced that for the fifth consecutive year, the UCLA Medical Group has been rated one of California's top-performing physician organizations.

Rankings were based on four important health care quality measures: clinical quality, patient experience and satisfaction, coordinated diabetes care, and the use of information technology to support safer care.

"UCLA is committed to be at the vanguard of health care measurement to improve care and increase transparency and accountability," said Dr. Samuel A. Skootsky, medical director of the UCLA Medical Group. "UCLA has been justifiably proud of its capacity to treat the most complex illnesses, as well as being proficient in the more usual types of preventive and chronic care reflected in the IHA award. We are committed to continuously improve on the care being provided to patients, and we work hard on behalf of our patients to achieve these results."

The best performers — those who scored in the top 20 percent overall — were selected from among more than 225 physician groups participating in the association's Pay-for-Performance (P4P) program. UCLA was one of 46 California medical groups chosen and one of only five organizations in the Los Angeles area. Integrated Healthcare's P4P program, the largest physician incentive program in the United States, enables physician groups to receive financial rewards from participating health plans based on their performance on quality measures.

According to the association, the top performing physician groups are leaders in the use of evidence-based health care processes and health information technologies that result in better care for patients.

The Integrated Healthcare Association is a not-for-profit statewide collaborative leadership group made up of California health plans, physician groups and health care systems, as well as academic, consumer, purchaser, pharmaceutical and technology representatives. The association promotes quality improvement, accountability and affordability for the benefit of all California consumers through special projects, policy innovation and education.

The UCLA Medical Group is primarily composed of faculty physicians of the David Geffen School of Medicine at UCLA. Organized in 1987, the medical group is committed to quality and provides services to health plan members in most major HMOs and Medicare Advantage plans, as well as patients enrolled in PPOs, Medicare, state-sponsored and indemnity insurance plans, and patients seen by referral. For more information, visit www.uclahealth.org or call 310-302-1300.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Half-million low-income elderly affected by sweeping cuts to state safety net

Gwendolyn Driscoll — Thu, 01 Oct 2009 18:25:00 GMT

An 81-year-old San Francisco woman with dementia, little money and an equally aged caregiver sister who is suffering from cancer.

A 72-year-old Riverside woman with Alzheimer's who cannot be left safely on her own, forcing her son to cut back his working hours to care for her.

A 78-year-old Los Angeles man with Alzheimer's whose daughter will have to quit her job to take care of him if day care services are cut.

These are some of the hundreds of thousands of low-income seniors who are likely to lose income — and some of the tens of thousands who will also lose some or all of the in-home and supportive care they rely on — as budget cuts resulting from California's 2009 fiscal crisis go into effect starting Oct. 1, according to a new study by the UCLA Center for Health Policy Research.

Among the most vulnerable: seniors with Alzheimer's disease whose families rely on state-funded Alzheimer's centers that will soon lose all of their state funding. Also impacted are low-income seniors with disabilities, who often rely on a web of safety-net programs that both supplement their incomes and give them access to free or subsidized in-home care, say the authors of the new policy brief, "California Budget Cuts Fray the Long-Term Safety Net."

The research — based on recent data, published research and nearly two-dozen interviews with program and services experts — is the first comprehensive analysis of the likely impact of state budget cuts on California's disabled elderly.

"Our research finds that the state cuts to long-term care services are driven primarily by a quest for saving dollars that disregards the human impact of the results," said Steven P. Wallace, associate director of the UCLA Center for Health Policy Research and a co-author of the study. "These kinds of cuts hit our most vulnerable citizens: seniors with disabilities and low incomes who typically have no resources to fall back on and little in the way of additional family support."

Among the programs particularly affected by the cuts:

Alzheimer's day care resource centers to lose all state funding

Centers that provide day care for more than 3,200 mostly low-income or socially isolated seniors with Alzheimer's disease will have to curtail hours of service or shut down altogether in response to budget cuts that go into effect Oct. 1.

Supplemental Security Income (SSI/SSP) cut 8 to 10 percent

SSI is a cash assistance program for more than 500,000 very low-income people who are elderly, blind or permanently disabled. California has always supplemented the federally funded benefit using state funds (SSP). Cuts in the state portion will bring total cuts this year of the combined benefit to 8 percent for individuals (from $907 to $830 maximum benefit) and nearly 11 percent for couples (from $1,579 to $1,407).

In-Home Supportive Services Program (IHSS) cut 30 percent

This program aids seniors with incomes above what is needed to qualify for SSI but still not high enough to afford in-home supportive services. IHSS provides a subsidy to help defray the costs of in-home personal care and essential household services that seniors are unable to perform without monitoring or assistance. As of Nov. 1, 30 percent of the 445,584 individuals of all ages enrolled in this program will lose some or all of their benefits; about 60 percent are elderly.

"We need lawmakers to rethink these punishing cuts," said Bruce Chernof, president of the SCAN Foundation, which funded the research. "With a rapidly growing older population, we need to make our publicly funded long-term care system more efficient and effective, and this report shows that the cuts do neither."

The state's adult day health care centers, which serve more than 37,000 seniors, were also scheduled for Oct. 1 cuts until a federal judge issued an injunction Sept. 11 preventing California from cutting services until its poor, elderly and disabled clients are provided other Medi-Cal services to prevent their institutionalization. However, many of the seniors who patronize these centers will still endure cuts to their SSI checks.

"It means the meal seniors get at an adult day health care center may be the only meal of the day," Wallace said. "They won't have the income they need to pay for all of their basic necessities."

The cuts to long-term care programs that support the low-income or disabled elderly are expected to shave about $500 million from California’s budget. However, Wallace said the cuts may ultimately have the reverse effect, by forcing seniors further into poverty and, ultimately, forcing some into Medi-Cal supported nursing homes.

"As a state, we have two choices," Wallace said. "We can either help seniors live with dignity in their own homes, or we can reduce them to destitution and force them into nursing homes. Either way, the state of California is going to pick up the tab."

Read the policy brief.

The SCAN Foundation's mission is to advance the development of a sustainable continuum of quality care for seniors.

The UCLA Center for Health Policy Research is one of the nation's leading health policy research centers and the premier source of health-related information on Californians.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Where religious belief and disbelief meet in the brain

Mark Wheeler — Thu, 01 Oct 2009 00:00:00 GMT

When it comes to religion, believers and nonbelievers appear to think very differently. But at the level of the brain, is believing in God different from believing that the sun is a star or that 4 is an even number?

While religious faith remains one of the most significant features of human life, little is known about its relationship to ordinary belief. Nor is it known whether religious believers differ from nonbelievers in how they evaluate statements of fact.

In the first neuroimaging study to systematically compare religious faith with ordinary cognition, UCLA and University of Southern California researchers have found that while the human brain responds very differently to religious and nonreligious propositions, the process of believing or disbelieving a statement, whether religious or not, seems to be governed by the same areas in the brain.

The study also found that devout Christians and nonbelievers use the same brain regions to judge the truth of religious and nonreligious propositions. The results, the study authors say, represent a critical advance in the psychology of religion. The paper appears Sept. 30 in the journal PLoS ONE (www.plosone.org).

Sam Harris, who recently completed his doctoral dissertation in the lab of Mark Cohen, a professor of psychiatry at the UCLA Staglin Center for Cognitive Neuroscience, was a lead author on the study. Jonas Kaplan, a research assistant professor at the USC's Brain and Creativity Institute, was the co-lead author.

The study involved 30 adults — 15 committed Christians and 15 nonbelievers — who underwent three functional MRI (fMRI) scans while evaluating religious and nonreligious statements as "true" or "false." The statements were designed to produce near perfect agreement between the two groups during nonreligious trials (e.g., "Eagles really exist") and near perfect disagreement during religious trials (e.g., "Angels really exist").

Contrasting belief and disbelief yielded increased activity in the ventromedial prefrontal cortex (VMPFC), an area of the brain thought to be involved in reward and in judgments of self-relevance.

"This region showed greater activity whether subjects believed statements about God, the Virgin Birth, etc., or statements about ordinary facts," the authors said.

The case for belief being content-independent was further bolstered by the fact that while the trial statements accepted by religious believers were rejected by nonbelievers, and vice versa, the brains of both showed the same pattern of activity for belief and disbelief.

A comparison of all religious with all nonreligious statements suggested that religious thinking is more associated with brain regions that govern emotion, self-representation and cognitive conflict in both believers and nonbelievers, while thinking about ordinary facts is more reliant upon memory retrieval networks. Activity in the brain's anterior cingulate cortex, an area associated with cognitive conflict and uncertainty, suggested that both believers and nonbelievers experienced greater uncertainty when evaluating religious statements.

The study raises the possibility that the differences between belief and disbelief may one day be reliably distinguished by neuroimaging techniques.

"Despite vast differences in the underlying processing responsible for religious and nonreligious modes of thought," the authors write, "the distinction between believing and disbelieving a proposition appears to transcend content. These results may have many areas of application — ranging from the neuropsychology of religion, to the use of 'belief-detection' as a surrogate for 'lie-detection,' to understanding how the practice of science itself, and truth-claims generally, emerge from the biology of the human brain."

Harris is the author of two New York Times best-sellers, "The End of Faith" and "Letter to a Christian Nation," which have been published in more than 15 languages, and is the co-founder and CEO of the The Reason Project. His writing has appeared in Newsweek, the New York Times, the Los Angeles Times, the Times of London, the Boston Globe, the Atlantic and many other journals.

Other authors on the study included Cohen, Susan Y. Bookheimer and Marco Iacoboni, of UCLA, and Ashley Curiel, of Pepperdine University. The authors report no conflict of interest.

Work in Dr. Cohen's lab is funded by grants from the National Institutes of Health.

The UCLA Staglin Center for Cognitive Neuroscience is part of the Semel Institute for Neuroscience and Human Behavior at UCLA, an interdisciplinary research and education institute devoted to the understanding of complex human behavior, including the genetic, biological, behavioral and sociocultural underpinnings of normal behavior, and the causes and consequences of neuropsychiatric disorders. In addition to conducting fundamental research, the institute's faculty seeks to develop effective treatments for neurological and psychiatric disorders, improve access to mental health services, and shape national health policy regarding neuropsychiatric disorders.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Jonsson Cancer Center joins statewide UC collaboration to target breast cancer

Kim Irwin — Wed, 30 Sep 2009 00:20:00 GMT

UCLA's Jonsson Comprehensive Cancer Center is taking part in an unprecedented statewide University of California collaboration to revolutionize care for breast cancer patients by designing and testing systemwide new approaches to research, technology and health care delivery.

Called the ATHENA Breast Health Network, the groundbreaking project will initially involve 150,000 California women, who will be screened for breast cancer and followed for decades through the five UC cancer centers. The ATHENA project is supported by a $5.3 million University of California grant and by a $4.8 million grant from the Safeway Foundation.

The project is expected to generate a rich collection of data and knowledge that will shape breast cancer care the way the renowned Framingham heart study changed the care of patients with heart disease.

"ATHENA is a model of multi-institutional collaboration and demonstrates the enormous potential in shared systems," said Dr. John D. Stobo, UC senior vice president for health sciences and services. "This is a great example of the power of our statewide university network of academic medical centers; this initiative will demonstrate that the total of what can be accomplished by UC functioning as an integrated system can far exceed the sum of contributions by the individual campuses. ATHENA represents an unprecedented opportunity to play a leadership role in driving critical changes in health care. The public nature of the UC institutions makes them uniquely positioned to study the appropriateness and effectiveness of treatment. It also allows for the applied use of new scientific evidence, much of which has been developed in the UC medical centers, to truly change the delivery of care."

Dr. Arash Naeim, principal investigator for the Jonsson Cancer Center's part in the project, said the primary goal of ATHENA is to accelerate research, "effectively translating it into innovative clinical care and demonstrating the value that can be leveraged when institutions share knowledge and technology."

"Breast cancer is the most common cancer in women, and innovative efforts aimed at preventing and treating breast cancer require significant financial, intellectual and organizational resources to improve survival and reduce suffering from the disease," Naeim said. "If the University of California cancer centers, their researchers and health care providers work together in an organized and cohesive way as equal partners, there will be a tremendous opportunity to leverage research to improve prevention, diagnosis, treatment and survivorship for all women developing breast cancer."

In addition to the Jonsson Cancer Center, the centers involved in the large-scale demonstration project include UC San Francisco, as the host campus; UC Davis; UC San Diego; and UC Irvine. Also participating in the collaboration are the UC Berkeley School of Public Health, the Northern California Cancer Center, Quantum Leap Healthcare Collaborative, the National Cancer Institute's BIG Health Consortium and the Center for Medical Technology Policy.

"We are excited to be supporting this innovative collaboration that, to date, has the clearest potential to produce groundbreaking research that will bring us closer to a cure," said Larree Renda, executive vice president, chief strategist and administrative officer of Safeway Inc. and chairman of the Safeway Foundation.

Breast cancer, the most common cancer in women, is a devastating and costly disease, striking more than 200,000 women annually and killing more than 40,000 each year, according to the American Cancer Society. In the United States, more than $20 billion is spent annually screening and treating the disease.

ATHENA is designed to more efficiently integrate financing, technology, research and clinical care, creating an infrastructure model that could be utilized for many medical conditions.

"Our goal is to improve survival and reduce suffering from breast cancer, to accelerate research, and compress the time to implement innovations in clinical practice," said ATHENA principal investigator Dr. Laura Esserman, UCSF professor of surgery and radiology, director of the UCSF Carol Franc Buck Breast Care Center and co-leader of the breast oncology program at the UCSF Helen Diller Family Comprehensive Cancer Center.

"By working together as a community, the University of California centers, their affiliates, primary care and specialty physicians, and patient advocates will work to change the options for patients today and create a better future for all women at risk for developing breast cancer," she added.

The goals of the ATHENA initiative include:

Creating common systems to integrate clinical research and care across the UC campuses to advance the science of prevention, screening, diagnosis and treatment of breast cancer.

Driving innovation across the UC system to deliver and finance more effective and efficient systems for personalized and biologically targeted care, using breast cancer as a prototype.

Creating a biospecimen repository that has broad racial and ethnic representation.

Reducing morbidity and mortality by gaining a molecular understanding of breast cancer and factors that fuel breast cancer risk.

Improving understanding of who is at risk for what kind of cancer and whether the risk of that cancer is significant or minimal.

Generating the evidence for developing more effective and less toxic treatments and to drive innovation in prevention, diagnosis and treatment.

Providing tools to change the way patients and providers interact to prevent and manage the disease.

The science fueling personalized medicine currently is experiencing explosive growth. Molecular tests are now available that can analyze a breast cancer tumor and categorize the risk of breast cancer recurrence with and without treatments, according to Esserman.

"Giving doctors sophisticated tools to tailor treatments to the individual tumor will revolutionize care, potentially enabling thousands of women to safely forgo toxic treatments and providing those at high risk of dying from their cancer with more targeted and effective treatments," Esserman said. "Equally, if not more exciting, is the promise of molecular tools to more accurately predict the risk of getting breast cancer, which may ultimately lead to better ways to prevent the disease."

Women who present for breast cancer screening at the five UC centers and their affiliates will be enrolled in the ATHENA Breast Health Network and followed for decades. All women undergoing screening and treatment will be offered the opportunity to collaborate by contributing information about themselves; any risk factors they have, including health status; and other related lifestyle behaviors, such as diet, tobacco and drug use, environmental factors, gynecological history and family risk. This information will be used to help target prevention services now and in the future. Women diagnosed with breast cancer will additionally join a "survivorship cohort" made up of women who have been diagnosed with breast cancer.

"We will be able to create a statewide cohort of women at risk of breast cancer and develop the optimal methods for the early detection of all types of breast cancer," said Dr. Robert Hiatt, professor and co-chairman of the department of epidemiology and biostatistics at UCSF. He is also director of population sciences and deputy director of the UCSF Helen Diller Family Comprehensive Cancer Center, and his research focuses on breast cancer and the environment.

"The size and diversity of the survivorship cohort and the depth and quality of the information we'll have will be unprecedented and will enable the development and testing of robust new models of cancer outcomes and prognosis," Hiatt said.

The UC system is particularly well-positioned for a project of ATHENA's magnitude because the combined centers annually screen as many as 80,000 women and diagnose 2,500 patients with breast cancer. Still, said Esserman, the new project calls for "a reimagining and then a reengineering so that we can continually improve what we do — to improve our current processes, to streamline communication and access to information among care providers and patients, and to improve the efficiency of services."

The potential rewards are significant.

"This project will standardize the collection of structured data from both patients and physicians so that it is computable, interoperable and reusable, and it will integrate molecular profiling at the time of diagnosis and create an unparalleled biospecimen repository. The result will be a network that enables personalized care informed by science and that fuels the accelerated and continuous improvement in treatment options and outcomes," Esserman said. "With ATHENA, wisdom will be waging war against breast cancer and the learning system will continue to evolve until we have cured this disease."

While the ATHENA Breast Health Network focuses on breast cancer, the tools and infrastructure developed for this project are readily transferable to other cancers and conditions. ATHENA has the potential to serve as a transformative model to drive innovation, alter the culture of research and clinical practice, and ultimately change health care delivery.

For further information, please visit www.AthenaCareNetwork.org.

Safeway is a Fortune 50 company and one of the largest food and drug retailers in North America, based on sales. The company operates 1,739 stores in the United States and Canada and had annual sales of $44.1 billion in 2008. The company's stock symbol is traded on the New York Stock Exchange. Safeway supports a broad range of charitable and community programs and in 2008 donated more than $248 million to important causes, such as cancer research, education, hunger relief and programs focused on assisting people with disabilities.

UCLA's Jonsson Comprehensive Cancer Center has more than 240 researchers and clinicians engaged in disease research, prevention, detection, control, treatment and education. One of the nation's largest comprehensive cancer centers, the Jonsson Center is dedicated to promoting research and translating basic science into leading-edge clinical studies. In July 2009, the Jonsson Cancer Center was named among the top 12 cancer centers nationwide by U.S. News & World Report, a ranking it has held for 10 consecutive years.

Study IDs chemicals that could lead to new drugs for genetic disorders, cancer

Elaine Schmidt — Tue, 29 Sep 2009 07:00:00 GMT

UCLA scientists have identified two chemicals that convince our cells to ignore premature signals to stop producing important proteins.

Published in the Sept. 28 edition of the Journal of Experimental Medicine, the findings could lead to new medications for genetic diseases, such as cancer and muscular dystrophy, that are sparked by missing proteins.

"When DNA changes, such as nonsense mutations, occur in the middle rather than the end of a protein-producing signal, they act like a stop sign that tells the cell to prematurely interrupt protein synthesis," said Dr. Richard Gatti, professor of pathology and laboratory medicine and of human genetics at the David Geffen School of Medicine at UCLA. "These nonsense mutations cause the loss of vital proteins, which can lead to deadly genetic disorders."

Gatti's lab specializes in studying ataxia-telangiectasia (A-T), a progressive neurological disease that strikes young children, often killing them by their late teens or early 20s.

For four years, the UCLA Molecular Shared Screening Resource center of the campus's California NanoSystems Institute has screened 35,000 chemicals, searching for those that ignore premature stop signals.

Liutao Du, a postgraduate fellow in the UCLA Department of Pathology and Laboratory Medicine and the first author of the study, developed the screening technology in Gatti's laboratory.

"Of the dozens of active chemicals we discovered, only two were linked to the appearance and function of ATM, the protein missing from the cells of children with A-T," Du said. "These two chemicals also induced the production of dystrophin, a protein that is missing in the cells of mice with a nonsense mutation in the muscular dystrophy gene."

The UCLA team is optimistic that their discovery will aid pharmaceutical companies in creating drugs that correct genetic disorders caused by nonsense mutations. This could affect one in five patients with most genetic diseases, including hundreds of thousands of people suffering from incurable diseases. Because nonsense mutations can lead to cancer, such drugs may also find uses in cancer treatment.

Gatti's lab is funded by the Los Angeles–based Ataxia-Telangiectasia Medical Research Foundation, the National Institutes of Health and the New York–based Ataxia-Telangiectasia Ease Foundation.

The study's co-authors included Robert Damoiseaux, Shareef Nahas, Kun Gao, Hailiang Hu, Julianne Pollard, Jimena Goldstine, Michael Jung, Susan Henning and Carmen Bertoni, all of UCLA.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Record-breaking grants year for UCLA School of Nursing; funding tops $18M

Laura Perry — Thu, 24 Sep 2009 17:30:00 GMT

The UCLA School of Nursing is well on its way to fulfilling one of they key goals Dean Courtney Lyder set when he took the reins a year ago: enhancing the school's research structure. In 2008–09, the school received 26 research grants totaling more than $18 million — a 300 percent increase over the previous year.

Many of the grants, most of which come from the National Institutes of Health, are supporting research in the areas of prevention and care delivery, including major projects on hepatitis and HIV prevention, diet and heart failure, and quality-of-care issues among the elderly in nursing homes.

"From bench to bedside, we are bringing the science of nursing to improving the delivery of care," said Lyder, who is also a prominent and prolific researcher. "Improving care and delivery of services is especially critical in an increasingly strained health care system. Quality patient care begins with evidence-based knowledge of best practices in nursing."

Among the major grant-funded research projects are:

Reducing hepatitis and HIV among homeless parolees

Amount: $3.4 million

Recepient: Adey Nyamathi, A.N.P., Ph.D., F.A.A.N.

Homeless parolees pose a particular challenge for successful reentry into society, as they often have underlying mental health issues, combined with substance use and abuse, and must contend with unstable housing situations, disorganized lives, unemployment and limited access to health care and social services. Consequently, they are at high risk for hepatitis B and C and HIV. The research seeks to protect this population from infection by reducing risky substance abuse and sexual behavior; promoting access to health care and social and employment services; and enabling positive coping and communication skills. Parolee participants in the study will be enrolled in a coaching program that will include nursing case-management, specialized education services, vaccinations for hepatitis and coach-facilitated mentoring by cell phone. The findings will lay the groundwork for health policy decisions that can positively impact hepatitis and HIV risk reduction and behaviors that lead to a high reincarceration rate among parolees.

Improving prevention efforts for homeless at risk for hepatitis and HIV

Amount $3.3 million

Recepient: Adey Nyamathi, A.N.P., Ph.D., F.A.A.N.

In this study, researchers from UCLA and the Friends Community Center will work together to design a program that will help young, homeless, stimulant-using gay and bisexual men to complete the hepatitis vaccine and reduce drug use and risky sexual behavior. As stimulant use threatens to increase homeless individuals' risk of exposure to the hepatitis B and C viruses, the research seeks to to engage this group in treatment until they are suitably protected from hepatitis B and, hopefully, to reduce their risk for hepatitis C and HIV as well.

Can high-protein diets reduce the incidence of heart failure?

Amount: $2.5 million

Recepient: Lorraine Evangelista, R.N., Ph.D.

Looking at advanced cardiac patients, this research focuses on better understanding the specific effects of high-protein diets on heart failure progression. Results from the study will provide evidence for rational recommendations that can be integrated in heart failure management and treatment guidelines.

Determining the relationships between brain structure and heart failure

Amount: two grants totaling $2.1 million

Recepient: Mary Woo, R.N., D.N.Sc.

These grants will enable researchers to examine the relationships among sleep disorders, thiamine (vitamin B1) deficiencies, and brain structure and function in heart failure. The studies will look at both the possible causes and potential treatments for heart failure mortality and symptoms, which dramatically impair quality of life, such as memory loss and depression.

Finding signs of early bedsores on darkly pigmented skin

Amount: $1.25 million

Recepient: Barbara Bates Jensen, R.N., Ph.D., C.W.O.C.N.

Detecting early signs of pressure damage in individuals with dark skin tones is difficult, as early detection is based on visual observation of skin redness. The goal of this study is to improve skin health by developing the use of biophysical measures to better detect pressure ulcers in elderly nursing home residents with darkly pigmented skin. Pressure ulcers, or bedsores, are a quality-of-care issue in all health care settings and are a major focus on the nation's health care agenda, since they are costly and, in many cases, preventable.

"Every day, nurses see the challenges faced by the individuals to whom they provide care," Lyder said. "The research being accomplished by our faculty is providing solutions to real-world problems."

The UCLA School of Nursing is marking its 60th anniversary transforming nursing science through the pursuit of uncompromised excellence in research, education, practice, policy and patient advocacy. The school offers programs for undergraduate (B.S.), postgraduate (M.S.N. and M.E.C.N.) and doctoral (Ph.D.) students.

Rethinking Alzheimer's disease and its treatment targets

Mark Wheeler — Tue, 22 Sep 2009 07:00:00 GMT

The standard explanation for what causes Alzheimer's is known as the amyloid hypothesis, which posits that the disease results from of an accumulation of the peptide amyloid beta, the toxic protein fragments that deposit in the brain and become the sticky plaques that have defined Alzheimer's for more than 100 years.

Billions of dollars are spent yearly targeting this toxic peptide — but what if this is the wrong target? What if the disease begins much earlier, fueled by a natural process? Reporting in the current edition of the journal Neurobiology of Aging, UCLA professor of psychiatry George Bartzokis argues just that and says that a better working hypothesis is the "myelin model."

"The greatest promise of the myelin model of the human brain is its application to the development of new therapeutic approaches," Bartzokis said.

Like insulation around wires, myelin is a fatty sheath that coats our nerve axons, allowing for efficient conduction of nerve impulses. It is key to the fast processing speeds that underlie our higher cognitive functions and encoding of memories.

But the lifelong, extensive myelination of the human brain also makes it uniquely vulnerable to damage. The myelin model's central premise is that it is the normal, routine maintenance and repair of myelin throughout life that ultimately initiates the mechanisms that produce degenerative diseases like Alzheimer's. That is, the amyloid-beta peptide and the tau peptide, which is also implicated in Alzheimer's, as well as the signature clinical signs of the disease, such as memory loss and, ultimately, dementia, are all byproducts of the myelin breakdown and repair processes.

"The pervasive myelination of our brain is the single most unique aspect in which the human brain differs from other species," said Bartzokis, who is a member of the Laboratory of Neuro Imaging in the UCLA Department of Neurology and a member of UCLA's Brain Research Institute. Myelin is produced by oligodendrocytes, specialized glial cells that themselves become more vulnerable with age.

Bartzokis notes that myelination of the brain follows an inverted U-shaped trajectory, growing strongly until our 50s, when it very slowly begins to unravel as we age. The myelin that is deposited in adulthood ensheaths increasing numbers of axons with smaller axon diameters and so spreads itself thinner and thinner, Bartzokis said. As a result, it becomes more susceptible to the ravages of age in the form of environmental and genetic insults and slowly begins to break down faster than it can be repaired.

The exclusive targeting of the amyloid-beta peptide for many years is understandable because the same genes and enzymes involved in controlling myelination and myelin repair are, ironically, also involved in the production of amyloid-beta proteins. Bartzokis' point is that the amyloid beta may actually develop as a result of the natural process of the repair and maintenance of myelin.

"So the breakdown that leads to Alzheimer's and other age-related brain diseases, such as Parkinson's, may begin much earlier, before the formation of the protein deposits that are used to define these diseases," Bartzokis said.

Most drugs being developed for Alzheimer's are targeting amyloid beta, but little if any clinical improvement is being seen. This is, according to Bartzokis, "similar to cleaning up a house that's been flooded by water but never repairing the actual pipe that created the flood.

"For drug development then, the targets should be much further upstream, earlier in the process before the AB plaques even develop," he said.

Instead of focusing on reducing amyloid beta, Bartzokis argues, the myelin model suggests entirely different approaches to treatment and prevention of Alzheimer's disease that precede plaque formation. With modern brain imaging technology, clinicians could track the dynamic changes taking place in the brain and intercede well before any signs of Alzheimer's are seen.

"With earlier intervention," Bartzokis said, "we could reduce and potentially eliminate the increasingly catastrophic burden of dementia on the individual and their family, the health care system, and our society."

The research was supported by the National Institutes of Health, the RCS Alzheimer's Foundation and the U.S. Department of Veterans Affairs. The author reports no conflicts of interest.

The UCLA Department of Psychiatry and Biobehavioral Sciences is part of the Semel Institute for Neuroscience and Human Behavior at UCLA, an interdisciplinary research and education institute devoted to the understanding of complex human behavior, including the genetic, biological, behavioral and sociocultural underpinnings of normal behavior, and the causes and consequences of neuropsychiatric disorders. In addition to conducting fundamental research, the institute faculty seeks to develop effective treatments for neurological and psychiatric disorders, improve access to mental health services, and shape national health policy regarding neuropsychiatric disorders.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Top structural biologists to discuss cryo-electron micoscopy at UCLA symposium

Mike Rodewald — Tue, 22 Sep 2009 07:00:00 GMT

WHAT:

The two-day Advanced Electron Microscopy in NanoMedicine Symposium at the California NanoSystems (CNSI) at UCLA brings together researchers from academia and industry to discuss cryo-electron microscopy, or cryoEM, an important new imaging tool with major applications for nanobiology and nanomedicine, particularly for understanding viruses and other macromolecular complexes. Researchers can use cryoEM to visualize a broad range of assemblies and nanometer-scale structures in three dimensions — from molecular to atomic resolution.

Organized by the Electron Imaging Center for Nanomachines (EICN), a newly established CNSI core lab, the symposium will also serve as a venue for the public unveiling of the top-of-the-line Titan Krios cryoEM and Titan (S)TEM microscopes in the EICN lab. These multimillion-dollar transmission electron microscopes from the FEI Co. have already produced some of the highest-resolution images yet of nanoscale devices and viruses.

WHO:

Conference speakers and participants will include representatives from:

UCLA
Scripps Research Institute
Baylor College of Medicine
Lawrence Berkeley National Laboratory, UC Berkeley
University of Virginia
Columbia University
University of Colorado at Boulder
California Institute of Technology
Max Planck Institute of Biophysics (Germany)
École Polytechnique Fédérale de Lausanne (Switzerland)
National University of Singapore
Osaka University (Japan)
FEI Co.
National Cancer Institute, National Institutes of Health
Florida State University

For a complete list of speakers, visit www.cnsi.ucla.edu/electron-microscopy/speakers.

WHEN:

Friday, Oct. 2—Saturday, Oct. 3

WHERE:

California NanoSystems Institute at UCLA, Building 114 (map)

INFORMATION | REGISTRATION:

For more information and to register for the event, visit www.cnsi.ucla.edu/cryoEM.

BACKGROUND:

Part of the difficulty of creating cures against virus infections is that their assembly mechanism and molecular interactions are poorly understood without atomic resolution structures. The cryoEm technique, by providing valuable structural information for research in cell biology, microbiology, molecular and biomolecular science, medicine, pharmaceuticals, and materials science, is bridging that knowledge gap and could help lead to major advances in structure-based rational drug design, targeted delivery and biology-inspired nanomachines.

MEDIA CONTACTS:

Mike Rodewald | 310-267-5883 | mrodewald@cnsi.ucla.edu

Jennifer Marcus | 310-267-4839 | jmarcus@cnsi.ucla.edu

PARKING:

Parking will be available in Lot 9 on Westwood Plaza. Press should contact media contact for parking reservations.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Study of UCLA hospital relocation provides insights for disaster planning

Roxanne Moster — Mon, 21 Sep 2009 20:00:00 GMT

By restricting elective surgeries, limiting incoming transfers and enhancing the efficiency of the discharge process, Ronald Reagan UCLA Medical Center was able to reduce capacity before its relocation without interrupting emergency or trauma services, according to a report in the September issue of Archives of Surgery, one of the JAMA/Archives journals.

Similar principles could help hospitals absorb patients in the aftermath of a disaster, the report's UCLA authors say. Planning to respond to natural or manmade disasters has become a priority for health care facilities around the world.

"Thorough preparation requires a coordinated effort to determine the appropriate allocation of hospital resources to accommodate an acute influx of patients with needs for various services, including operative and other procedures," the authors write. "Surge capacity is rarely tested, as most disaster drills terminate after triage and immediate treatment in the emergency department and operating rooms."

Surge capacity is the term used to describe this ability to accommodate a sudden arrival of patients. UCLA Medical Center relocated to the new Ronald Reagan UCLA Medical Center site in June 2008, providing a unique opportunity to examine surge capacity issues.

Dr. Howard C. Jen and colleagues at the David Geffen School of Medicine at UCLA analyzed hospital operations for one-week periods beginning two weeks prior to move day. The researchers also analyzed regional hospital and emergency department capacity.

The medical center had an average daily census (point-in-time number of patients) of 525 patients before relocation planning began, and set a target of 350 patients for move day.

"There were three components to our census-management strategy," said Dr. James Atkinson, senior medical director of hospital transition and a professor of surgery. "First, the elective surgery schedule was restricted beginning one week prior to move day, and operative volume was reduced by 45 percent. Second, incoming transfers were limited, leading to a reduction in both urgent and emergent admissions to medical and surgical services without limitation of trauma and emergency department admissions. Finally, a centralized, multidisciplinary discharge team was used to enhance the efficiency of the discharge process."

Through these strategies, hospital census was reduced 36 percent, from 537 two weeks before move day to 345 on move day, with no change in rate of death among patients. Surgical services were reduced more than non-surgical services (46 percent, compared with 30 percent); the number of elective operations decreased significantly while the number of emergency operations did not change. Hospital admissions decreased by 42 percent and discharges per occupied bed increased by 8 percent.

"The majority of our strategies required three to four days to achieve significant census gains and would be particularly useful during disasters such as hurricanes or illness epidemics, with longer lead times," Atkinson said. "When lead times are brief, such as earthquakes, urban bombings or other mass casualty incidents, strategies to bolster emergency department and trauma center preparedness is the first priority. Inpatient capacity for continued hospital care of injured patients must also be generated simultaneously, and our model provides useful tools for this purpose."

The findings are particularly important given results of the analysis of regional capacity, which found that during a period in which the Southern California population increased by 8.5 percent, the number of acute care beds decreased by 3.3 percent. In addition, Los Angeles County emergency departments experienced a 13 percent diversion rate due to overcrowding.

"Hospitals should create an internal plan using these principles of census management, with modifications to reflect local characteristics," the authors conclude. "Finally, as many hospitals are currently operating at capacity, a regional and integrated systems approach to surge capacity creation is needed."

Study authors included lead author Dr. Jonathan R. Hiatt, chief of the division of general surgery; Dr. James Atkinson, senior medical director of hospital transition and professor of surgery; Dr. Tom Rosenthal, chief medical officer and associate vice chancellor of the UCLA Health System; Dr. Stephen Shew, assistant professor of surgery; and Dr. Howard Jen, senior resident in general surgery, all affiliated with the David Geffen School of Medicine at UCLA and Ronald Reagan UCLA Medical Center.

Ronald Reagan UCLA Medical Center is ranked one of the top three hospitals in the nation and has been rated the best hospital in the western United States for 20 consecutive years by U.S. News & World Report, which reviews patient outcomes data, reputation among physicians and other care-related factors. It is the only Southern California hospital to earn a spot on U.S. News' “honor roll” rankings in each of the 20 year the magazine has conducted the survey.

For more news, visit the UCLA Newsroom or follow us on Twitter.

UCLA scientists make paralyzed rats walk again after spinal cord injury

Elaine Schmidt — Sun, 20 Sep 2009 17:00:00 GMT

UCLA researchers have discovered that a combination of drugs, electrical stimulation and regular exercise can enable paralyzed rats to walk and even run while supporting their full weight on a treadmill.

Published Sept. 20 in the online edition of the journal Nature Neuroscience, the findings suggest that the regeneration of severed nerve fibers is not required for paraplegic rats to learn to walk again. The research may hold implications for rehabilitation after human spinal cord injuries.

"The spinal cord contains nerve circuits that can generate rhythmic activity without input from the brain to drive the hind leg muscles in a way that resembles walking, called 'stepping,' " said principal investigator Reggie Edgerton, a professor of neurobiology at the David Geffen School of Medicine at UCLA and professor of physiological sciences at the UCLA College of Letters and Science.

"Previous studies have tried to tap into this circuitry to help victims of spinal cord injury," he added. "While other researchers have elicited similar leg movements in people with complete spinal injuries, they have not achieved full weight–bearing and sustained stepping as we have in our study."

Edgerton's team tested rats with complete spinal injuries that left no voluntary movement in their hind legs. After setting the paralyzed rats on a moving treadmill belt, the scientists administered drugs that act on the neurotransmitter serotonin and applied low levels of electrical currents to the spinal cord below the point of injury.

The combination of stimulation and sensation derived from the rats' limbs moving on a treadmill belt triggered the spinal rhythm–generating circuitry and prompted walking motion in the rats' paralyzed hind legs.

Daily treadmill training over several weeks eventually enabled the rats to regain full weight–bearing walking, including backwards, sideways and at running speed. However, the injury still interrupted the brain's connection to the spinal cord–based rhythmic walking circuitry, leaving the rats unable to walk of their own accord.

In humans, however, neuroprosthetic devices may bridge spinal cord injuries to some extent, so activating the spinal cord rhythmic circuitry as the UCLA team did may help in rehabilitation after spinal cord injuries.

The study was funded by the Christopher and Dana Reeve Foundation, the Craig Nielsen Foundation, the National Institute of Neurological Disorders and Stroke, the U.S. Civilian Research and Development Foundation, the International Paraplegic Foundation, the Swiss National Science Foundation, the National Institute of Biomedical Imaging and Bioengineering, the Roman Reed Spinal Cord Injury Research Fund of California and the Russian Foundation for Basic Research Grants.

For more news, visit the UCLA Newsroom or follow us on Twitter.

UCLA Breathmobile hits the road to help kids with asthma

Amy Albin — Fri, 18 Sep 2009 07:00:00 GMT

Children in Southern California may soon be breathing a little easier, thanks to the UCLA Breathmobile, an asthma clinic on wheels that provides free diagnosis, treatment, medication and education at school sites for children with asthma.

Staffed by a physician, a registered nurse and a patient-service worker, the RV-style UCLA Breathmobile will be visiting some 25 schools in the Long Beach and Wilmington area, with follow-up visits commencing every six to eight weeks. The Breathmobile is expected to begin treating children in the Long Beach Unified School District early next month.

The Breathmobile will receive an official ribbon-cutting launch at Mattel Children's Hospital UCLA on Wednesday, Sept. 23, at 1 p.m., organized by the hospital and the California Chapter of the Asthma and Allergy Foundation of America (AAFA). The project was developed by the California AAFA chapter to address rising morbidity rates from asthma in high-risk, disadvantaged children.

"With our kid-friendly UCLA Breathmobile, we look forward to bringing our services to the community and helping countless children with the diagnosis and management of asthma," said Dr. Maria Garcia Lloret, assistant clinical professor of pediatric allergy and immunology at Mattel Children's Hospital. "We hope these visits will improve the day-to-day lives of families who are coping with this chronic condition."

Evaluation studies have demonstrated dramatic improvement for patients treated by the Breathmobile, including fewer emergency room visits, improved pulmonary function, a decrease in school absenteeism and an improved quality of life.

There are currently 12 Breathmobiles operating throughout Los Angeles, Orange, San Bernardino and Riverside counties. They visit more than 200 elementary, middle and high schools, as well as several comprehensive health clinics in Southern California.

Asthma is the number one cause of school absenteeism among children, accounting for more than 14 million missed days of school. It is the most common chronic condition among children, affecting nearly 5 million kids under the age of 18. Each year, asthma accounts for more than 10 million outpatient visits and 500,000 hospitalizations.

The Asthma and Allergy Foundation of America is a nonprofit national voluntary health charity dedicated to controlling asthma and allergic diseases for millions of sufferers. The California Chapter of the AAFA was established in 1976 and is the largest chapter in the nationwide network. AAFA's mission is to educate individuals and organizations on steps that can be taken to improve sufferers' quality of life; to support medical research and specialized training for the health care community; to increase public awareness of the severity of asthma and allergic diseases; and to provide medication and treatment to the underserved.

Mattel Children's Hospital UCLA, one of the highest-rated children's hospitals in California, is a vital component of Ronald Reagan UCLA Medical Center, ranked by U.S. News & World Report as the third best hospital in nation and best in the western United States. Mattel Children's Hospital offers a full spectrum of primary and specialized medical care for infants, children and adolescents. The hospital's mission is to provide state‑of-the-art treatment for children in a compassionate atmosphere and to improve the understanding and treatment of pediatric diseases.

For more news, visit the UCLA Newsroom or follow us on Twitter.

UCLA School of Dentistry to build new cancer research facility

Sandra Shagat — Mon, 14 Sep 2009 16:00:00 GMT

Federal economic stimulus efforts will soon add muscle to the fight against cancer.

The UCLA School of Dentistry consistently ranks among the country's top dental schools in National Institutes of Health funding. During the past three fiscal years, the school has secured nearly $30 million in grants for oral cancer research and research training. Now, the dental school has received a major infusion of construction funding for the creation of the UCLA Yip Center for Oral/Head & Neck Oncology Research.

As a result of funds made available by the American Recovery and Reinvestment Act of 2009, the NIH's National Center for Research Resources (NCRR) has awarded more than $5 million for the state-of-the-art complex, which will consolidate and expand the school's ongoing translational research in the biology, detection and treatment of oral cancer.

According to the National Institute of Dental and Craniofacial Research, oral cancer is the sixth most common cancer in men and the 14th most common cancer in women in the United States. On average, only half of those diagnosed with the disease will survive more than five years. Oral cancer will kill approximately one person every hour this year.

"This visionary funding will enable the dental school to become a nexus of multidisciplinary, collaborative research," said No-Hee Park, dean of the UCLA School of Dentistry and the principal investigator for the construction grant. "Our goal is to make UCLA the home of the premier head and neck and oral oncology research program in the nation, a place where we find new methods for the early diagnosis and treatment of this devastating disease."

Existing outmoded laboratories within the dental school building in UCLA's Center for the Health Sciences will be demolished to construct a 6,660-square-foot facility comprising a large, open wet laboratory, a central core support facility and a conference room. The new lab will include chemical fume hoods, tissue-culture support and a dark room and will be specifically designed for state-of-the-art genomics and proteomics research.

"This is the second time in the UCLA School of Dentistry's history that it has applied for and won an NIH construction grant," said Steve Olsen, UCLA vice chancellor for finance, budget and capital programs. "The first such grant created the Jane and Jerry Weintraub Center for Reconstructive Biotechnology, which also was established under Dean Park's tenure."

The school's new research facility will be named for Felix and Mildred Yip, noted philanthropists within Southern California's Asian American community who have been generous supporters of UCLA and the School of Dentistry.

In 2004, a pledge of support from the Yips was instrumental in the dental school securing a fundable score for this major construction project. However, the NCRR was unable to provide the necessary matching funds to advance the renovation because of federal budget problems. This spring, one of the Obama administration's economic stimulus initiatives breathed new life into the shelved grant.

"The resurrection of our construction grant application — and now the news of this sizable award — are exciting developments at the dental school," said David Wong, the school's associate dean of research and a pioneer in the field of salivary diagnostics who developed the first standardized saliva-based test for oral cancer.

Wong holds the Felix and Mildred Yip Endowed Professorship in Dentistry and will serve as the director of the UCLA Yip Center for Oral/Head & Neck Oncology Research.

"We are energized thinking about what this research facility will mean for oral cancer research and for translational science," Wong said. "We hope the Yip Center will be the site of many discoveries that better inform our understanding of the diagnosis and treatment of many different types of disease."

"Scientists at the UCLA School of Dentistry have been operating at the vanguard of oral biology research, making significant progress in enhancing our understanding of the mechanisms of cancer growth, as well as the promise of salivary diagnostics," Felix Yip said. "My wife, Mildred, and I have a strong commitment to the Yip Center and to the dental school in their efforts to find new ways to improve oral health that can change people's lives."

Construction planning for the Yip Center has already begun. The demolition phase of the project is expected to start in 2011, with a projected conclusion date for the facility sometime in 2013.

The UCLA School of Dentistry is dedicated to improving the oral health of the people of California, the nation and the world through its teaching, research, patient care and public service initiatives. The school provides education and training programs that develop leaders in dental education, research, the profession and the community; conducts research programs that generate new knowledge, promote oral health and investigate the cause, prevention, diagnosis and treatment of oral disease; and delivers patient-centered oral health care to the community and state.

UCLA is California's largest university, with an enrollment of nearly 38,000 undergraduate and graduate students. The UCLA College of Letters and Science and the university's 11 professional schools feature renowned faculty and offer more than 323 degree programs and majors. UCLA is a national and international leader in the breadth and quality of its academic, research, health care, cultural, continuing education and athletic programs. Four alumni and five faculty have been awarded the Nobel Prize.

For more news, visit the UCLA Newsroom or follow us on Twitter.

UCLA researchers develop biomarker for rapid relief of major depression

Mark Wheeler — Thu, 10 Sep 2009 16:30:00 GMT

It is a long, slow slog to treat major depression. Many antidepressant medications are available, but no single biomarker or diagnostic test exists to predict which one is right for an individual. As a result, for more than half of all patients, the first drug prescribed doesn't work, and it can take months to figure out what does.

Now, based on the final results of a nationwide study led by UCLA, clinicians may be able to accurately predict within a week whether a particular drug will be effective by using a non-invasive test that takes less than 15 minutes to administer. The test will allow physicians to quickly switch patients to a more effective treatment, if necessary.

The study, called the Biomarkers for Rapid Identification of Treatment Effectiveness in Major Depression, or BRITE-MD, measured changes in brain-wave patterns using quantitative electroencephalography (QEEG), a non-invasive, computerized measurement that recognizes specific alterations in brain-wave activity. These changes precede improvement in mood by many weeks and appear to serve as a biomarker that accurately predicts how effective a given medication will be. The study results appear in two articles published in the September issue of the journal Psychiatry Research.

Nine sites around the country collaborated on the study, which enrolled a total of 375 people who had been diagnosed with major depressive disorder (MDD). Each individual was given a baseline QEEG at the beginning of the trial and then prescribed the antidepressant escitalopram, commonly known as Lexapro, one of a class of drugs known as selective serotonin re-uptake inhibitors that are commonly prescribed for depression. After one week, a second QEEG was taken. The researchers examined a biomarker called the antidepressant treatment response (ATR) index — a specific change in brain-wave patterns from the baseline QEEG.

Subjects were then randomly assigned to continue with escitalopram or were given a different drug. A total of 73 patients who remained on escitalopram were tracked for 49 days to see if their results matched the prediction of the ATR biomarker. The ATR predicted both response and remission with an accuracy rate of 74 percent, much higher than any other method available. The researchers also found that they could predict whether subjects were more likely to respond to a different antidepressant, bupropion, also known as Wellbutrin XL.

"Until now, other than waiting, there has been no reliable method for predicting whether a medication would lead to a good response or remission," said Dr. Andrew Leuchter, professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA and lead author of the study. "And that wait can be as long as 14 weeks. So these are very exciting findings for the patient suffering from depression. The BRITE results are a milestone in our efforts to develop clinically useful biomarkers for predicting treatment response in MDD."

Major depressive disorder is a leading cause of disability, costing society in excess of $80 billion annually; approximately two-thirds of these costs reflect the enormous disability associated with the disorder. An estimated 15 million people in the United States experience a depressive episode each year, and nearly 17 percent of adults will experience major depression in their lifetime.

"BRITE study results suggest that the ATR biomarker could potentially provide the greatest clinical benefit for those patients who might be receiving a medication that is unlikely to help them," Leuchter said. "Our results suggest that it may be possible to switch these patients to a more effective treatment quickly. This would help patients and their physicians avoid the frustration, risk and expense of long and ineffective medication trials."

Leuchter noted that research has shown that depression patients who do not get better with a first treatment experience prolonged suffering, are more likely to abandon treatment altogether and may become more resistant to treatment over time.

"So the benefits to the individual and to society are enormous," he said.

An added benefit of the biomarker test, according to Leuchter, is that it is non-invasive, painless and fast — about 15 minutes — and only involves the placement of six electrodes around the forehead and on the earlobes.

Aspect Medical Systems, which developed the ATR biomarker, provided financial support for the study. Aspect also participated in the design and conduct of the study; the collection, management, analysis and interpretation of the data; and the preparation and review of the manuscript. Final approval of the form and content of the manuscript rested with the authors.

Other UCLA authors included Dr. Ian Cook, Dr. Karl S. Burgoyne and Dr. James T. McCracken. Leuchter is chair of Aspect's neuroscience advisory board and has provided scientific consultation to them.

The Semel Institute for Neuroscience and Human Behavior is an interdisciplinary research and education institute devoted to the understanding of complex human behavior, including the genetic, biological, behavioral and sociocultural underpinnings of normal behavior and the causes and consequences of neuropsychiatric disorders. In addition to conducting fundamental research, institute faculty seek to develop effective treatments for neurological and psychiatric disorders, improve access to mental health services and shape national health policy regarding neuropsychiatric disorders.

For more news, visit the UCLA Newsroom or follow us on Twitter.

UCLA hosts conference on successful aging in a high-tech world Oct. 30

Rachel Champeau — Tue, 08 Sep 2009 18:50:00 GMT

While aging affects everyday living in many ways, the latest technological advances in the medical, consumer and lifestyle fields have the potential to help older adults live better for longer.

The UCLA Center on Aging's second annual "UCLA Technology and Aging Conference: Living Better Longer Through Technology" will feature national academic and industry leaders who will explore cutting-edge innovations affecting every aspect of senior life, from driving and home design to health monitoring and medical advances. The one-day symposium takes place Friday, Oct. 30, at the Skirball Cultural Center in Los Angeles.

Designed for seniors, their families and caretakers, the conference will provide information to help enhance quality of life, with a focus on everyday things seniors can do to live and thrive independently longer. Many conference speakers have been featured in the national media for their research and work in the field.

"Building on last year's successful event, we hope to continue sharing the latest cutting-edge advances and exploring how these innovations can help us age more successfully," said Dr. Gary Small, UCLA's Parlow-Solomon Professor on Aging and director of the UCLA Center on Aging.

Small's morning keynote address will explore how frequent use of technologies such as cell phones, video games, BlackBerrys, iPods and computers impact the brain. He will present the latest research demonstrating how surfing the Internet may stimulate and possibly improve brain function in middle-aged and older adults, as well as strategies and tools to help individuals adapt and excel in this modern age.

David H. Murdock, chairman and owner of Dole Food Co. and Castle & Cooke, will deliver a luncheon keynote address discussing successful aging through good nutrition and active living.

A special lifetime achievement award from the UCLA Center on Aging will be presented to Dr. S. Jerome Tamkin and Judith D. Tamkin, whose outstanding contributions to society and active living exemplify the center's motto, "living better longer." The award introduction will be made by Dr. Gerald S. Levey, UCLA vice chancellor for medical sciences and dean of the David Geffen School of Medicine at UCLA, and the presentation will be made by legendary radio and TV personality Art Linkletter.

An afternoon keynote address by Dr. Kathryn A. Atchison, vice provost of intellectual property and industry relations at UCLA, will address the future development and direction of technology for senior living.

Conference breakout sessions will take place throughout the day, designed around two key themes: "Aging in Place" will focus on technologies that will enable older adults to live longer and better in the comfort and safety of their own homes, and "Aging Healthier Longer" will address cutting-edge developments in disease management and treatment, adaptive and assistive devices and techniques, emotional health, and function and sensory enhancements.

Panels will include:

Architecture and Design: Designing for Independence

Panelists discuss home and community design to keep adults independent longer, including new construction and retrofitting and enhancing current homes for independence and safety. (Glen Simmons, Dahlin Group Architects; Jane Regan, HB Building & Design; Valerie Fletcher, Institute for Human Centered Design)

Behind the Wheel: Advances in Transportation and Driving for Seniors

Panelists discuss the effects of aging on driving ability, as well as safety programs and products, including a camera-based early warning system, to enhance awareness and effectiveness behind the wheel. (Dr. Jaime Fitten, UCLA Brain Research Institute; Anita Lorz, Automobile Club of Southern California; Skip Kinford, Mobileye Corp.)

Activity Sensors: Monitoring Behavior for Safety and Peace of Mind

Panelists discuss wireless and "smart" home monitoring technologies, including cellular-based locator systems, that can track behavior and give early warning of potential hazards like falls or accidents. (Charles Hillman, GrandCare Systems; Kellerey Lohman, Ingenium Care; Lisa Brodsky, EmFinders)

The Wired Senior: Computers and Connectivity

Panelists discuss the latest products and services to help seniors work with computers and the Internet — primary sources of information and social connections. (Richard Mander, Big Screen Live; Laura Nuhaan, Famililink; Peter Radsliff, Presto)

Med-Tech: Medical Treatment Technologies

Panelists explore advances in surgery and medical care — including telesurgery, new tumor treatments, long-term delivery of medications and surgical suite techniques — that are changing how care is delivered. (Dr. Neil Martin, UCLA professor and chairman of neurosurgery; Dr. Percy Lee, director of stereotactic body radiation therapy at UCLA's Jonnsson Cancer Center)

Not Science Fiction: Future Health Care Advances

Revolutionary health care technologies may radically change the physical effects of aging in the near future. Panelists examine some promising areas of research, including the use of nanotechnology to treat brain tumors, computer chips to help enhance function in a damaged brain, and stem cells to reverse aging degeneration. (Dr. Benham Badie, director of the brain tumor program at City of Hope; Dr. Irina Conboy, assistant professor of bioengineering and investigator at the Berkeley Stem Cell Center and California Institute for Quantitative Biosciences)

Staying in Balance: Fall Prevention and Recovery

Panelists discuss reducing the occurrence of falls suffered by seniors through balance training, exercise, gait modification and new products, including a "smart cane." (Dr. William Kaiser, UCLA professor of electrical engineering; Chris Otto, Halo Monitoring; Karen Hunt, Cequal Products Inc.)

Tele-Health: Remote Health Monitoring and Diagnosis

Panelists explore technologies that allow doctors to interact with patients and provide checkups without patients having to leave their home or care facility. (Steve Winner, Silverado Senior Living; Kent Dicks, MedApps; Dr. Nitin Nanda, Asana Telehealth)

Designing for Seniors: Consumer Products for Better Living

Panelists discuss how everyday living can be enhanced by products that meet the daily needs of consumers age 55 and older. (Mark Hines, Verizon Wireless; Bud Meyers, FirstStreet for Boomers and Beyond; Jeff Hill, MyGait, LLC)

Mind Games: Preserving and Enhancing Brain Function

"Brain games" and other electronic programs and activities that stimulate the brain and lead to better memory and brain function have surged into the marketplace. Industry panelists, joined by UCLA's Dr. Gary Small, who has been involved in the development of Dakim's brain-training software, will explore these products and the science behind their development. (Jeff Zimman, Posit Science; Dan Michel, Dakim Inc.)

Living Well: Emotional Health and Quality of Life

Panelists discuss improving health and quality of life through the latest products in sports, exercise, entertainment and stress relief that promote, inform and enrich an active lifestyle. (Dr. Ernie Medina, MedPlay Technologies; Bruce Cryer, HeartMath; Charles De Vilmorin, LinkedSenior)

Good Senses: Adapting for Vision and Hearing Loss

Panelists explore device solutions to help improve reduced vision or loss of hearing, which can impact confidence and ability to interact and engage with the world. (Michele Ahlman, Clearsounds Communications; Marc Stenzel, Enhanced Vision)

The Oct. 30 conference runs from 8 a.m. to 5 p.m. at the Skirball Cultural Center. For registration and more information, call 310-794-0676 or visit www.aging.ucla.edu/TechAgingConference.html. A full program description is also available on the website.

The UCLA Center on Aging is a nonprofit organization that aims to enhance and extend productive and healthy life through research and education on aging. Founded in 1991, the center brings geriatrics and gerontology to the forefront of public awareness and support and offers a number of programs to the public, including memory training, the Senior Scholars program and community meetings, as well as conferences on aging and technology and research.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Waist-hip ratio better than BMI for gauging obesity in elderly

Enrique Rivero — Tue, 01 Sep 2009 17:05:00 GMT

Body mass index (BMI) readings may not be the best gauge of obesity in older adults, according to new research from UCLA endocrinologists and geriatricians. Instead, they say, the ratio of waist size to hip size may be a better indicator when it comes to those over 70.

In a new study published online in the peer-reviewed journal Annals of Epidemiology, researchers from the David Geffen School of Medicine at UCLA found that the waist-to-hip circumference ratio was a better yardstick for assessing obesity in high-functioning adults between the ages of 70 and 80, presumably because the physical changes that are part of the aging process alter the body proportions on which BMI is based.

"Basically, it isn't BMI that matters in older adults — it's waist size," said Dr. Preethi Srikanthan, UCLA assistant professor of endocrinology and the study's lead investigator. "Other studies have suggested that both waist size and BMI matter in young and middle-aged adults and that BMI may not be useful in older adults; this is one of the first studies to show that relative waist size does matter in older adults, even if BMI does not matter."

Using data from the MacArthur Successful Aging Study — a longitudinal study of high-functioning men and women between the ages of 70 and 79 — researchers examined all-cause mortality risk over 12 years by BMI, waist circumference and waist-hip ratio. They adjusted for gender, race, baseline age and smoking status. The average age of participants was 74.

Obesity is often associated with premature mortality because it leads to an increased risk of diabetes, heart attack, stroke and other major health problems, the study authors say.

The researchers found no association between all-cause mortality and BMI or waist circumference; the link was only with waist-hip ratio. In women, each 0.1 increase in the waist-hip ratio was associated with a 28 percent relative increase in mortality rate (the number of deaths per 100 older adults per year) in the group sampled. Thus, if the waist-hip ratio rose from 0.8 to 0.9 or from 0.9 to 1.0, it would mean a 28 percent relative increase in the death rate. Put another way, if hip size is 40 inches, an increase in waist size from 32 to 36 inches signaled a 28 percent relative death-rate increase.

The relationship was not graded in men. Instead there was a threshold effect: The rate of dying was 75 percent higher in men with a waist-hip ratio greater than 1.0 — that is, men whose waists were larger than their hips — relative to those with a ratio of 1.0 or lower. There was no such relationship with either waist size or BMI.

The study may have some limitations, the authors noted. For instance, participants' BMI may be underestimated because height and weight were self-reported and older adults tend to report those numbers from their younger, peak years. Also, waist-hip ratios, waist circumference and BMI numbers were based on single measurements, limiting the researchers' ability to gauge how changing body size in old age can affect mortality risk.

Teresa Seeman and Arun S. Karlamangla, both also of UCLA, were co-authors on the study.

The National Institute on Aging funded this research.

The UCLA Division of Geriatrics, within the department of medicine at the David Geffen School of Medicine at UCLA offers comprehensive outpatient and inpatient services at several convenient locations and works closely with other UCLA programs to improve and maintain the quality of life of seniors. UCLA geriatricians are specialists in managing the overall health of people age 65 and older and treating medical disorders that frequently affect the elderly, including falls and immobility, urinary incontinence, memory loss and dementia, arthritis, high blood pressure, heart disease, osteoporosis, and diabetes. UCLA geriatricians can knowledgably consider and address a broad spectrum of health-related factors — including medical, psychological and social — when treating patients.

For more news, visit the UCLA Newsroom or follow us on Twitter.

New 'music therapy on wheels' delivers healing tunes to pediatric patients

Amy Albin — Mon, 31 Aug 2009 21:45:00 GMT

Mattel Children's Hospital UCLA has a new mobile tool to deliver music therapy and help pediatric patients cope with the fear, isolation and pain associated with being in the hospital.

The Music Rx unit is a high-tech, interactive studio on wheels that includes everything necessary for music therapy, both in group settings and one-on-one. It holds a variety of instruments, including drums, keyboards and guitars, as well as Apple GarageBand software for recording music, a custom-built iPod docking station with 10 iPods to loan, and a large LCD screen that plays hundreds of music videos.

The cart will be officially unveiled during a ribbon-cutting ceremony at Mattel Children's Hospital on Wednesday, Sept. 2, at 2 p.m. The media is invited to arrive at 1 p.m. for a special musical demonstration involving pediatric patients and UCLA's music therapist.

The Music Rx cart was donated to UCLA's Child Life/Child Development Services department by the Children's Cancer Association (CCA), with support from the Starlight Children's Foundation. UCLA is one of first hospitals to participate in the CCA's nationwide expansion of the Music Rx program, which began in Portland, Ore.

"We are proud to join hands with our friends at Mattel Children's Hospital and Starlight to bring the healing power of music to thousands of hospitalized children in California," said Mary Turina, president and CEO of the CCA. "The staff have been incredible partners throughout this project, and I have no doubt they will change lives through the Music Rx Program."

Vanya Green, UCLA's board-certified music therapist, who is also a musician and songwriter, will incorporate Music Rx in her work with children.

"The Music Rx cart is very versatile and has really streamlined everything I need to help our patients benefit from music therapy," Green said. "When the kids, nurses and staff see the interactive music video screen and hear the instruments, the mood is lightened and they get really excited!"

The motto of Music Rx is "music is my med." In the hospital setting, music therapy can be used to help alleviate pain, improve a patient's mood, stimulate movement and communication, calm anxieties and fears, promote relaxation, and make the hospital feel more like home. The patient does not need any musical experience or ability to participate in music therapy.

A 2008 CCA study of Music Rx showed that the program had a positive effect on a child's mood, family bonding and pain scores, compared with those who did not receive the music therapy.

A second component of the Music Rx program features a live music element, with professional harpists, cellists, flautists and other community musicians playing soothing music in the pediatric hallways.

Further expanding on the music therapy program at UCLA, the Pediatric Pain Program at Mattel Children's Hospital and Music to Heal are developing a recording studio where patients can compose and record their own music using industry-standard software.

The Children's Cancer Association (CCA): When seriously ill kids and their families need more than medicine, CCA is there with compassion and innovation, creating moments of respite and hope in the hospital and at home. Managed by a professional staff and powered by volunteers, CCA brings soothing music in a time of crisis, friendship in a time of loneliness, resources in a time of turmoil and vital support in the midst of life-threatening illness. CCA brings hope, possibility and a little magic to some of the most difficult days families will ever face.

Mattel Children's Hospital UCLA, one of the highest-rated children's hospitals in Southern California, is a vital component of Ronald Reagan UCLA Medical Center, ranked the third best hospital in nation and best in the western United States by U.S. News & World Report. Mattel Children's Hospital offers a full spectrum of primary and specialized medical care for infants, children and adolescents. The hospital's mission is to provide state-of-the-art treatment for children in a compassionate atmosphere and to improve the understanding and treatment of pediatric diseases.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Insured and in debt: Even with coverage, Californians struggle to pay medical bills

Gwendolyn Driscoll — Mon, 31 Aug 2009 18:15:00 GMT

More than 2.2 million California adults report having medical debt, and two-thirds of those incurred the debt while insured, according to the authors of "The State of Health Insurance in California (SHIC)," a comprehensive new report from the UCLA Center for Health Policy Research.

In total, nearly one in seven non-elderly adults in California (13 percent) have some kind of medical debt, and more than 800,000 Californians have medical debt greater than $2,000.

The state's Northern and Sierra counties are the most affected, with nearly 25 percent of the population having medical debt of some kind. Central Coast counties also had high percentages of debt. (View a breakdown of medical debt by region and county.)

Individuals with medical debt are twice as likely as those without debt to delay or forgo needed health care, the report found.

"That even insured people are forced to take on medical debt to pay for their health care is another glaring inadequacy in our current system of health insurance," said E. Richard Brown, director of the UCLA Center for Health Policy Research and lead author of the SHIC report. "Current policies either do not offer enough coverage or offer full-coverage at a cost that is too expensive for many people to bear.

"The result is that too many people have health insurance plans that leave them financially vulnerable and force them to delay the care they need."

The biennial SHIC report, produced by the UCLA Center for Health Policy Research with support from The California Endowment and The California Wellness Foundation, presents a representative view of the troubled state of health insurance coverage at a crucial moment, as members of Congress debate the merits of national health insurance reform.

The report, based on the latest data from the California Health Interview Survey (CHIS), the nation's largest state health survey, is the most comprehensive examination of health insurance coverage in the nation's most populous and diverse state.

"Heath coverage is supposed to protect Americans from the financial burden of health care costs," said Dr. Robert K. Ross, CEO and president of The California Endowment. "Americans should be outraged that the very system that they depend on for health care no longer offers that protection."

Specifically, the SHIC report found:

Medical debt results in delays in care

Californians with medical debt were much more likely than those without debt to delay getting the care they needed.

Those with debt were twice as likely to report delays in care: 32.3 percent reported delays in getting needed care, compared with 16.1 percent of those without medical debt.

Delays were higher as the amount of debt increased: Among those with more than $8,000 of medical debt, 43 percent reported delays in getting care.

Debt can lead to loans and bankruptcy: Among those with medical debt, more than half (55.4 percent) reported financial consequences ranging from an inability to pay for basic necessities to credit card debt to a declaration of bankruptcy.

High-deductible plans may contribute to medical debt: Nearly 40 percent of individuals with privately purchased insurance coverage chose plans with deductibles of $1,000 or more or, for a family plan, $2,000 or more.

Health insurance coverage is stagnating

In 2007, at the height of an economic expansion, 6.4 million Californians were uninsured for all or part of the year, a number that has changed little since 2001. Specifically:

There has been little change in employment-based insurance: Job-based insurance covered 56.4 percent of the total non-elderly population in 2001; in 2007, coverage was at 55.6 percent.

Employment-based children's coverage has declined: Slightly more than half (52.2 percent) of children in California were covered by their parent's employer's policy in 2007, a rate nearly three percentage points lower than in 2001 (55.1 percent).

Public coverage is flat: Coverage of children and non-elderly adults by Medi-Cal (California's Medicaid program) and Healthy Families (California's State Children's Health Insurance Program) remained flat between 2005 and 2007, at 15.3 percent.

"It raises questions about the effectiveness of the current market-based system of private health insurance," said Dr. Shana Alex Lavarreda, director of health insurance studies and a co-author of the report. "If, at the height of an economic expansion, California's health insurance coverage was still weaker than in the past, then what does that say? It suggests that our health insurance system is at its straining point and millions of people are falling through the cracks."

In 2007, at the peak of this decade's economic expansion, 6.4 million Californians, including 1.1 million children, lacked insurance all or part of the year. Since then, the recession, severe cuts to state programs that insure children and the doubling of the state's unemployment rate have pushed the number of uninsured even higher, the report's authors say.

"With more than 6 million Californians uninsured and more than 1 million who have health insurance in medical debt, the need for comprehensive health care reform is clear," said Gary L. Yates, president and CEO of The California Wellness Foundation. "However, no matter what the outcome of reform efforts, adequate funding for the health care safety net — community clinics, public and nonprofit hospitals — must be maintained to ensure access to care for the state's uninsured and underinsured."

The California Endowment, a private, statewide health foundation, was established in 1996 to expand access to affordable, quality health care for underserved individuals and communities and to promote fundamental improvements in the health status of all Californians.

The California Wellness Foundation's mission is to improve the health of the people of California by making grants for health promotion, wellness education and disease prevention.

The California Health Interview Survey (CHIS) is the nation's largest state health survey and one of the largest health surveys in the United States.

The UCLA Center for Health Policy Research is one of the nation's leading health policy research centers and the premier source of health-related information on Californians.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Dental researchers confirm microRNAs as biomarkers for oral cancer detection

Sandra Shagat — Tue, 25 Aug 2009 20:06:00 GMT

FINDINGS:

A new study published by researchers at the UCLA School of Dentistry substantiates the effectiveness of measuring the microRNAs present in saliva to detect oral squamous cell carcinoma. Like hall monitors in an elementary school, microRNAs are the molecules produced by cells that simultaneously assess the behavior of multiple genes and control their activity.

Dr. David Wong, UCLA's Felix and Mildred Yip Professor of Dentistry, and his colleagues previously demonstrated the usefulness of proteome and transcriptome diagnostics for oral cancer; this new research expands the "diagnostic alphabet" of genetic salivary biomarkers that can yield a diagnosis on the molecular level long before a tumor is present. The scientists' latest results show that while the saliva of healthy individuals contains about 50 microRNAs, two in particular — miR-125a and miR-200a — are present at significantly different levels in the saliva of individuals suffering from oral squamous cell carcinoma.

IMPACT:

Oral squamous cell carcinoma accounts for more than 90 percent of oral cancers worldwide and is the sixth most common cancer in the United States. It is particularly lethal, with a five-year survival rate post-diagnosis that hovers below 50 percent and has not improved in three decades. Enhancements in the area of early diagnosis, therefore, are key to making strides against the disease. This latest research offers another minimally invasive, cost-effective method for early detection of the disease that can be translated to earlier treatment and potential improvement in long-term survival rates.

AUTHORS:

Noh Jin Park, Hui Zhou, Bradley Henson and David Wong of the UCLA School of Dentistry's Dental Research Institute; David Elashoff of the UCLA School of Public Health; Dragana Kastratovic of the Centre for Clinical Pharmacology at the Clinical Centre of Serbia; and Elliot Abemayor of the David Geffen School of Medicine at UCLA.

FUNDING:

The research was supported by grants from the National Institute of Dental and Craniofacial Research.

JOURNAL:

The research appears in the Sept. 1 print edition of the peer-reviewed journal Clinical Cancer Research and is currently available in the journal's advance online edition.

GRAPHICS:

The full paper and corresponding imagery can be viewed online at http://clincancerres.aacrjournals.org/cgi/rapidpdf/1078-0432.CCR-09-0736v1.

For more news, visit the UCLA Newsroom or follow us on Twitter.

UCLA scientists uncover immune system's role in bone loss

Elaine Schmidt — Tue, 25 Aug 2009 19:33:00 GMT

Got high cholesterol? You might want to consider a bone density test.

A new UCLA study sheds light on the link between high cholesterol and osteoporosis and identifies a new way that the body's immune cells play a role in bone loss.

Published Aug. 20 in the journal Clinical Immunology, the research could lead to new immune-based approaches for treating osteoporosis. Affecting 10 million Americans, the disease causes fragile bones and increases the risk of fractures, resulting in lost independence and mobility.

Scientists have long recognized the relationship between high cholesterol and osteoporosis, but pinpointing the exact mechanism connecting the two has proved elusive.

"We've known that osteoporosis patients have higher cholesterol levels, more severe clogging of the heart arteries and increased risk of stroke. We also knew that drugs that lower cholesterol reduce bone fractures too," said Rita Effros, professor of pathology at the David Geffen School of Medicine at UCLA. "What we didn't understand was why."

Effros suspected a clue to the mystery involved oxidation — cell and tissue damage resulting from exposure of the fatty acids in cholesterol to molecules known as free radicals.

In the study, UCLA researchers focused on low-density lipoprotein (LDL), the so-called "bad" cholesterol. They examined how high levels of oxidized LDL affect bone and whether a type of immune cell called a T cell plays a role in the process.

Using blood samples from healthy human volunteers, the team isolated the participants' T cells and cultured them in a dish. Half of the T cells were combined with normal LDL; the rest were combined with oxidized LDL. The scientists stimulated half of the T cells to mimic an immune response and left the other half alone. The T cells exposed to oxidized LDL displayed a striking response.

"Lo and behold, both the resting and the activated T cells started churning out a chemical that stimulates cells whose sole purpose is to destroy bone," Effros said. Called RANKL, the chemical is involved in immune response and bone physiology.

To investigate further how the immune system participates in bone loss, the scientists repeated the experiment in a mouse model. Half the animals were fed a high-fat diet starting at one month of age, while the control group ate a normal diet. At 11 months, the mice on the high-fat diet showed elevated cholesterol and thinner bones.

When Effros and her colleagues tested the T cells of the mice on the high-fat diet, they discovered that the cells acted differently than those of the mice on the normal diet. The T cells switched on the gene that produces RANKL. The chemical also appeared in the animals' bloodstream, suggesting that the cellular activity contributed to their bone loss.

"It's normal for our T cells to produce small amounts of RANKL during an immune response," Effros said. "But when RANKL is manufactured for long periods or at the wrong time, it results in excessive bone damage.

"That's exactly what happened to the mice on the high-fat diet," she said. "The animals' high cholesterol increased their levels of oxidized LDL, which told the T cells to keep generating RANKL. This discovery revealed to us how the immune system might play an entirely new role in bone loss."

The next step will be exploring methods to control T cell response to oxidized LDL in an effort to develop immune-based approaches to prevent or slow bone loss, Effros said.

The study was funded by the National Institute on Aging, the National Institute of Allergy and Infectious Diseases and the National Heart, Lung and Blood Institute. Effros' co-authors were Lucia Graham, Farhad Parhami, Yin Tintut, Christina Kitchen and Linda Demer, all of UCLA.

For more news, visit the UCLA Newsroom or follow us on Twitter.

More obesity blues: Research shows brains of obese people have less tissue

Mark Wheeler — Tue, 25 Aug 2009 07:57:53 GMT

Obesity is on a rampage. The World Health Organization pegs the number of those affected at more than 300 million worldwide, with a billion more overweight. With obesity comes an increased risk of cardiovascular disease, type 2 diabetes and hypertension.

Now there is more discouraging news.

In a study published in the current online edition of the journal Human Brain Mapping, senior author Paul Thompson, a UCLA professor of neurology, lead author Cyrus A. Raji, a medical student at the University of Pittsburgh School of Medicine, and their colleagues compared the brains of elderly people who were obese, overweight and of normal weight to see if they had differences in brain structure — that is, if their brains looked equally healthy.

They found that obese individuals had, on average, 8 percent less brain tissue than people of normal weight, while overweight people had 4 percent less tissue. According to Thompson, who is also a member of UCLA's Laboratory of Neuro Imaging, this is the first time anyone has established a link between being overweight and having what he describes as "severe brain degeneration."

"That's a big loss of tissue, and it depletes your cognitive reserves, putting you at much greater risk of Alzheimer's and other diseases that attack the brain," he said. "But you can greatly reduce your risk for Alzheimer's if you can eat healthily and keep your weight under control."

For the study, researchers used brain images from an earlier study called the Cardiovascular Health Cognition Study. Scans were selected of 94 elderly people in their 70s who were healthy — not cognitively impaired — five years after the scan was taken. To define the weight categories, they used the body mass index (BMI), the most widely used measurement for obesity. Normal-weight people were defined as having a BMI between 18.5 and 25; overweight people between 25 and 30, and obese people more than 30. The researchers then converted the scans into detailed three-dimensional images using tensor-based morphometry, a neuroimaging method that offers high-resolution mapping of anatomical differences in the brain.

In looking at both the gray matter and white matter of the brain, researchers found that the people defined as obese had lost brain tissue in the frontal and temporal lobes, areas of the brain critical for planning and memory, as well as in the anterior cingulate gyrus (attention and executive functions), hippocampus (long-term memory) and basal ganglia (movement). Overweight people showed brain loss in the basal ganglia, the corona radiata, the white matter comprised of axons, and the parietal lobe (sensory lobe).

"The brains of obese people looked 16 years older than the brains of those who were lean, and in overweight people looked eight years older," Thompson said.

"It seems that along with increased risk for health problems such as type 2 diabetes and heart disease, obesity is bad for your brain: We have linked it to shrinkage of brain areas that are also targeted by Alzheimer's," said the University of Pittsburgh's Raji. "But that could mean exercising, eating right and keeping weight under control can maintain brain health with aging and potentially lower the risk for Alzheimer's and other dementias."

The research was funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, the National Center for Research Resources, and the American Heart Association.

Other authors included April J. Ho, Neelroop N. Parikshak, Xue Hua, Alex D. Leow and Arthur W. Toga, all of UCLA; and James T. Becker, Oscar L. Lopez and Lewis H. Kuller, all of the University of Pittsburgh.

The UCLA Laboratory of Neuro Imaging, which seeks to improve understanding of the brain in health and disease, is a leader in the development of advanced computational algorithms and scientific approaches for the comprehensive and quantitative mapping of brain structure and function. The lab is part of the UCLA Department of Neurology, which encompasses more than a dozen research, clinical and teaching programs. The department ranks first among its peers nationwide in National Institutes of Health funding.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Why sleep? UCLA scientist delves into one of science's great mysteries

Mark Wheeler — Thu, 20 Aug 2009 17:50:00 GMT

Bats, birds, box turtles, humans and many other animals share at least one thing in common: They sleep. Humans, in fact, spend roughly one-third of their lives asleep, but sleep researchers still don't know why.

According to the journal Science, the function of sleep is one of the 125 greatest unsolved mysteries in science. Theories range from brain "maintenance" — including memory consolidation and pruning — to reversing damage from oxidative stress suffered while awake, to promoting longevity. None of these theories are well established, and many are mutually exclusive.

Now, a new analysis by Jerome Siegel, UCLA professor of psychiatry and director of the Center for Sleep Research at the Semel Institute for Neuroscience and Human Behavior at UCLA and the Sepulveda Veterans Affairs Medical Center, has concluded that sleep's primary function is to increase animals' efficiency and minimize their risk by regulating the duration and timing of their behavior.

The research appears in the current online edition of the journal Nature Reviews Neuroscience.

"Sleep has normally been viewed as something negative for survival because sleeping animals may be vulnerable to predation and they can't perform the behaviors that ensure survival," Siegel said. These behaviors include eating, procreating, caring for family members, monitoring the environment for danger and scouting for prey.

"So it's been thought that sleep must serve some as-yet unidentified physiological or neural function that can't be accomplished when animals are awake," he said.

Siegel's lab conducted a new survey of the sleep times of a broad range of animals, examining everything from the platypus and the walrus to the echidna, a small, burrowing, egg-laying mammal covered in spines. The researchers concluded that sleep itself is highly adaptive, much like the inactive states seen in a wide range of species, starting with plants and simple microorganisms; these species have dormant states — as opposed to sleep — even though in many cases they do not have nervous systems. That challenges the idea that sleep is for the brain, said Siegel.

"We see sleep as lying on a continuum that ranges from these dormant states like torpor and hibernation, on to periods of continuous activity without any sleep, such as during migration, where birds can fly for days on end without stopping," he said.

Hibernation is one example of an activity that regulates behavior for survival. A small animal, Siegel noted, can't migrate to a warmer climate in winter. So it hibernates, effectively cutting its energy consumption and thus its need for food, remaining secure from predators by burrowing underground.

Sleep duration, then, is determined in each species by the time requirements of eating, the cost-benefit relations between activity and risk, migration needs, care of young, and other factors. However, unlike hibernation and torpor, Siegel said, sleep is rapidly reversible — that is, animals can wake up quickly, a unique mammalian adaptation that allows for a relatively quick response to sensory signals.

Humans fit into this analysis as well. What is most remarkable about sleep, according to Siegel, is not the unresponsiveness or vulnerability it creates but rather that ability to reduce body and brain metabolism while still allowing that high level of responsiveness to the environment.

"The often cited example is that of a parent arousing at a baby's whimper but sleeping through a thunderstorm," he said. "That dramatizes the ability of the sleeping human brain to continuously process sensory signals and trigger complete awakening to significant stimuli within a few hundred milliseconds."

In humans, the brain constitutes, on average, just 2 percent of total body weight but consumes 20 percent of the energy used during quiet waking, so these savings have considerable adaptive significance. Besides conserving energy, sleep invokes survival benefits for humans too — "for example," said Siegel, "a reduced risk of injury, reduced resource consumption and, from an evolutionary standpoint, reduced risk of detection by predators."

"This Darwinian perspective can explain age-related changes in human sleep patterns as well," he said. "We sleep more deeply when we are young, because we have a high metabolic rate that is greatly reduced during sleep, but also because there are people to protect us. Our sleep patterns change when we are older, though, because that metabolic rate reduces and we are now the ones doing the alerting and protecting from dangers."

The Center for Sleep Research is part of the Semel Institute for Neuroscience and Human Behavior at UCLA, an interdisciplinary research and education institute devoted to the understanding of complex human behavior, including the genetic, biological, behavioral and sociocultural underpinnings of normal behavior, and the causes and consequences of neuropsychiatric disorders.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Sexual minorities more likely to seek mental health services, study finds

Sarah Anderson — Fri, 14 Aug 2009 00:15:00 GMT

Lesbians, gays and bisexuals are twice as likely as heterosexual men and women to seek help from mental health professionals, according to a new study by the UCLA School of Public Health.

The study, published today in the journal BMC Psychiatry, examines the relationship of gender and sexual orientation to the use of services to treat psychiatric problems such as mental health and alcohol and drug disorders.

Researchers collected data on 2,074 people, who were first interviewed in the California Health Interview Survey, in a new survey known as the California Quality of Life Survey. They found that 48.5 percent of lesbian, gay and bisexual individuals reported receiving treatment in the past year, compared with 22.5 percent of heterosexuals. Overall, lesbians and bisexual women were most likely to receive treatment, and heterosexual men were least likely.

While men and women, regardless of sexual orientation, who had an alcohol and/or drug disorder showed no significant differences in treatment rates, the study found that lesbian and bisexual women who had not been diagnosed with mental and drug disorders were more likely to seek mental health counseling than heterosexual women. This is consistent with emerging findings from national surveys showing that many individuals who receive mental health treatment do not have a diagnosable disorder but may have other symptoms, such as psychological distress or impairments in functioning, that lead them to seek care.

The researchers considered several factors that may explain these findings. Discrimination, violence and other stressful life events may be greater among sexual and gender minorities, they said, and homosexuality and issues associated with it may be construed as mental health problems — particularly among racial and ethnic minorities — which may encourage people to seek treatment. Further, in gay and lesbian communities, therapeutic services are considered appropriate places for coping with the stresses associated with being a sexual minority.

"It is well known that health services utilization is greater among women generally," said Susan Cochran, professor of epidemiology at the UCLA School of Public Health and one of the study's authors. "Here we have shown that minority sexual orientation is also an important consideration. Lesbians and bisexual women appear to be approximately twice as likely as heterosexual women to report having received recent treatment for mental health or substance use disorders."

However, the study found that ethnic and racial minorities overall were less likely to utilize mental health or substance use–related services. African Americans and Hispanics may underutilize services for mental health and substance use problems for a variety of reasons, including a lack of familiarity with the types of services available, prior negative experiences with service providers, or because of greater stigma attached to use of these services by their families and communities.

According to the study authors, the findings show that minority sexual orientation predisposes individuals to seek out mental health services. The findings also have implications for the allocation of public funding for the provision of public mental health and substance abuse treatment. The authors suggest that service planning and public policy experts interested in cost of care should take into consideration the effects of environmental and life stressors, including experiences of discrimination, violence, and hate crimes, in incurring mental health costs not only to the individual but to society.

Further, the study points to the need to examine how the treatment of individuals who do not have diagnosable disorders may reduce the likelihood that they will develop greater severity of distress, disorders or impairments in functioning in the future. Lastly, a better understanding of the factors that lead sexual minorities, and especially lesbians and gay women, to seek treatment may generate knowledge that can be used to improve delivery of treatment to those who would benefit from it or who currently do not take advantage of mental health resources.

Cochran was joined on this study by her colleagues Vickie M. Mays, also of the School of Public Health, and Christine Grella and Lisa Greenwell of the Integrated Substance Abuse Program at the Semel Institute for Neuroscience and Human Behavior at UCLA.

For more news, visit the UCLA Newsroom or follow us on Twitter.

UCLA researchers determine toxicity levels of Alzheimer's clusters in brain

Mark Wheeler — Thu, 13 Aug 2009 17:15:00 GMT

Scientists have long suspected that Alzheimer's disease is caused by plaques formed when the small protein amyloid-beta (Aβ) binds to itself in clusters and undergoes a chemical change, creating protein deposits in the brain.

However, recent studies have suggested it is not the plaques that cause Alzheimer's but the small, grape-like clusters of Aβ. The clusters vary in size, and the relationship between cluster size and toxicity — the ability to kill nerve cells — has never been determined accurately.

Now, by creating various sizes of Aβ clusters in the laboratory that exactly match what forms in the brains of Alzheimer's patients, UCLA neurologists have determined that toxicity increases dramatically as the clusters increase in size from two to three to four Aβ proteins. The researchers also report that although larger clusters are more toxic than smaller ones, large formations are relatively rare; smaller formations are more numerous and are thus an inviting target for the development of new therapeutic drugs.

In addition, said senior author and UCLA neurology professor David Teplow, developing the ability to make Aβ clusters in a very pure and precise way that duplicates what forms in the Alzheimer's brain will enable scientists to make detailed studies of their structures, aiding future drug development.

The research is currently available in the early online edition of Proceedings of the National Academy of Sciences.

Alzheimer's is the most common form of late-life dementia. More then 5 million Americans have been diagnosed with the disease and 24 million people worldwide — a number that is expected to reach 81 million by the year 2040.

"We now have the best understanding yet of what types of toxic Aβ structures we should target with new classes of therapeutic drugs," Teplow said.

While researchers found that the larger the Aβ cluster, the greater the toxicity, they also discovered that the increase in toxicity with these clusters is not linear.

"Clusters that contain two Aβ molecules are more toxic than a single Aβ molecule, and those with three molecules are more toxic that those with two," Teplow said. But clusters of the Aβ molecule known as dimers (two Aβ molecules forming a cluster) are three times more toxic than simple monomer compounds; trimers (three Aβ molecules) and tetramers (four) are more than 10 times more toxic than monomers, he said.

This suggests that larger, more toxic clusters should be the target for scientists trying to stop the disease. But in the brains of Alzheimer's patients, the larger clusters are relatively rare, Teplow said, and because smaller clusters are found in far greater amounts, they are, taken in total, more toxic to the brain than larger ones.

"Think of the molecules being wrapped in very weak Velcro," Teplow said. "A number of molecules can bind together to form large clusters, but they break apart very easily."

Having developed a process in the lab to make pure forms of these Aβ clusters of specific sizes will enable detailed study of their structures to show where every atom is.

"This will make development of drugs much easier and, likely, more successful," Teplow said.

Other authors included Kenjiro Ono, of UCLA and Japan's Kanazawa University School of Medicine, and Margaret M. Condrona, of UCLA.

Funding was provided by the Japan Human Science Foundation, a Pergolide Fellowship from Eli Lilly Japan, the Mochida Memorial Foundation for Medical and Pharmaceutical Research, the National Institutes of Health, the Alzheimer's Association and the Jim Easton Consortium for Alzheimer's Drug Discovery and Biomarkers at UCLA.

The UCLA Department of Neurology encompasses more than a dozen research, clinical and teaching programs that cover brain mapping and neuroimaging, movement disorders, Alzheimer's disease, multiple sclerosis, neurogenetics, nerve and muscle disorders, epilepsy, neuro-oncology, neurotology, neuropsychology, headaches and migraines, neurorehabilitation, and neurovascular disorders. The department ranks first among its peers nationwide in National Institutes of Health funding.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Study finds no link between cognitive decline, socioeconomic status in elderly

Enrique Rivero — Thu, 06 Aug 2009 19:20:00 GMT

New UCLA research suggests that for seniors age 70 and older, socioeconomic status does not play a major role in the brain's continued ability to function. However, seniors who have never been married and widowers seem to perform more poorly as they age.

Previous studies on age-related cognitive decline have not adequately clarified the role demographics and socioeconomic status might play in the rate of decline. Some small and short-term studies have found small socioeconomic differences in decline rates, while others have shown none at all, leaving the issue murky at best.

In a new national study of older Americans 70-plus years of age (mean age 75) published in the Aug. 1 issue of the American Journal of Epidemiology, researchers from the David Geffen School of Medicine at UCLA and the UCLA School of Public Health found that rates of cognitive decline over a nine-year period were similar across socioeconomic and racial and ethnic groups. The findings indicate that disparities in cognitive functioning among older Americans of different groups are almost entirely due to differences in the cognitive peaks they reached earlier in life, not to differences in rates of decline.

The study is available online at http://aje.oxfordjournals.org/cgi/reprint/170/3/331.

"It has been known that cognitive performance at any given age appears to depend on demographic characteristics; the more educated, for instance, perform better," said lead investigator Dr. Arun Karlamangla, associate professor of medicine in the division of geriatrics at the Geffen School of Medicine. "But though there are differences in the level of performance you start with in your late 60s, this study's surprise is that the rate of decline in your 70s is the same for every group."

The study was based on data from 6,476 adults born prior to 1924 culled from the Study of Assets and Health Dynamics Among the Oldest Old (AHEAD). Participants were tested five times between 1993 and 2002 on various memory and cognition items, including word recall, the "serial sevens" subtraction test, orientation to time, attention, language and knowledge of current affairs.

The study found evidence of a link between socioeconomic status (SES) and cognition, but only at baseline — that is, the first test. Those with high SES performed better on the first assessment than those with middle SES, who in turn performed better than individuals with low SES. These differences, researchers said, could be linked to the effects of education, such as learned test-taking strategies and the possible direct effects of education on brain structure.

Researchers did find some demographic variation in rates of cognitive decline, with older participants declining faster than younger ones, and widows and widowers and those who never married declining faster than married individuals.

"The most consistent predictors of faster declines in cognitive functioning were being old and being single," the researchers wrote.

There are some potential limitations to the study, the researchers noted. Though few associations between socioeconomic status and the rate of cognitive decline were found in the AHEAD total cognition score, an association might emerge in other cognition domains not examined in the study. There was a greater drop-off during the follow-up period among participants with low socioeconomic status and among low-functioning individuals, possibly skewing results. Additionally, the researchers did not control for differences between groups in physical health.

In addition to Karlamangla, study authors included Dana Miller-Martinez, Carol S. Aneshensel, Teresa E. Seeman, Richard G. Wight and Joshua Chodosh, all of UCLA. Chodosh is also affiliated with the Veterans Affairs Greater Los Angeles Healthcare System.

The National Institute on Aging funded the study.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Pharmacology professor named to endowed chair in cancer research

Rachel Champeau — Wed, 05 Aug 2009 19:35:00 GMT

Dr. Hong Wu, a professor of molecular and medical pharmacology at UCLA, has been named the inaugural holder of the David Geffen Chair in Medical Research, a position that will focus on advancing the field of cancer research.

Established with a $1 million allocation from the David Geffen School of Medicine Endowment Fund at UCLA, the permanent position will play an important role in research targeting new methods of cancer diagnosis and treatment and will help educate and train future cancer researchers.

"We are very pleased that Dr. Wu accepted this prestigious chair position that will contribute to our research efforts in preventing and curing cancer," said Dr. Gerald S. Levey, vice chancellor for medical sciences and dean of the Geffen School of Medicine.

Wu, associate director for research at the translational Institute for Molecular Medicine (IMED) at UCLA and a researcher with UCLA's Jonsson Cancer Center, is known for her work with PTEN, the second most frequently mutated tumor suppressor gene.

Using molecular genetics, cell biology and biochemical approaches, Wu's team has revealed the molecular mechanisms of PTEN involved in tumor development and stem cell activity. These studies have led her group to identify cancer stem cells and develop targeted therapies.

"Dr. Wu's scholarship has led to a greater understanding of specific cell communication pathways that can cause normal cells to transform to cancer as part of her relentless efforts to develop new molecular diagnostics and therapeutics," said Michael E. Phelps, UCLA's Norton Simon Professor and chair of molecular and medical pharmacology. "She is also a persistent leader at IMED to integrate basic and clinical scientists with molecular medicine."

Wu is a member of the UCLA Molecular Biology Institute and co-director of the cancer stem cell program area at the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA. In addition, she is the associate director of the genitourinary oncology program area and director of the UCLA ES Cell/Transgenic Mice Shared Resource at the Jonsson Cancer Center.

Wu has published numerous studies and is a dedicated teacher, working closely with the undergraduate, graduate and postdoctoral students in her lab. She received her M.D. from China's Beijing Medical College and her Ph.D. in biological chemistry from Harvard Medical School.

For more news, visit the UCLA Newsroom or follow us on Twitter.

UCLA welcomes startup to new incubator space at Calif. NanoSystems Institute

Jennifer Marcus — Tue, 04 Aug 2009 22:50:00 GMT

UCLA's newly launched on-campus technology incubator at the California NanoSystems Institute (CNSI) has opened lab space to MediSens Wireless, a startup company that develops and manufactures personal body-monitoring systems for medical and health applications.

The incubator program was established in March to nurture early-stage research and accelerate the commercial translation of technologies developed at UCLA.

MediSens Wireless has licensed patented technology from UCLA for wireless sensor systems developed by Majid Sarrafzadeh, a UCLA professor of computer science and engineering, and his team. The technology is for real-time wireless monitoring of pressure and motion in both medical and non-medical products. The technology will be used to develop body monitoring systems with specific applications for use by diabetic patients with peripheral neuropathy — the loss of sensation in the foot — and those with health issues affecting balance who are at high risk of falls.

As part of this arrangement, MediSens Wireless has obtained an exclusive license that will provide the University of California with a royalty on the company's products. MediSens has rented lab space at the CNSI and will move into the incubator space this month, with access to CNSI core lab facilities for research and development.

"We consider ourselves very fortunate to have been selected to join the UCLA incubator program at CNSI," said Eric Collins, president and CEO of MediSens. "The collaborative and innovative environment within the CNSI facility is an important competitive advantage for MediSens in our mission to bring to market products that improve millions of lives."

The UCLA on-campus Technology Incubation Program at the CNSI is an innovative resource with a mission to help accelerate the growth of entrepreneurial startup companies and early-stage technology research projects that originate at UCLA. The incubator offers shared, flexible lab space dedicated to housing eight to 10 early-stage incubation projects for short periods of time.

"The incubator program is an important way for UCLA to make the fruits of our world-class faculty's research available to the public as rapidly as possible," said UCLA Chancellor Gene Block. "California looks to universities like UCLA for innovative technology. It is fitting then to have these startup companies embedded within the CNSI, whose mission is to fuel economic development by nurturing novel technologies and transferring them from the lab to the clinical arena and commercial market."

"We look forward to working with MediSens to move the technology to product development," said Sarrafzadeh. "The collaborative research environment at CNSI is invigorating, and we are delighted to have MediSens in lab space that benefits from UCLA's great resources.

"We hope that this technology will help to reduce the large number of injuries caused by diabetic foot ulcers and by falls each year, both in hospital rehabilitation departments and in at-home care environments," Sarrafzadeh said.

"We anticipate great success for MediSens as it continues to develop products based on the convergence of computer science and engineering technology with medical and health applications," said Leonard H. Rome, interim director of the CNSI and senior associate dean for research at the David Geffen School of Medicine at UCLA. "CNSI is committed to facilitating collaborations with private industry for the rapid commercialization of new innovations, and we are excited to welcome this startup into the incubator space as it carries out its essential R&D."

Sarrafzadeh is also a co-director of the Wireless Health Institute (WHI) at UCLA, which is dedicated to improving the timeliness and reach of health care through the development and application of wireless, network-enabled technologies integrated with current and next-generation medical enterprise computing. The WHI is under the executive direction of Dr. Patrick Soon-Shiong, a UCLA visiting professor of bioengineering and of microbiology, immunology and molecular genetics and founder and chairman of Abraxis BioScience, a founding partner of the CNSI.

The California NanoSystems Institute at UCLA is an integrated research center operating jointly at UCLA and UC Santa Barbara whose mission is to foster interdisciplinary collaborations for discoveries in nanosystems and nanotechnology; train the next generation of scientists, educators and technology leaders; and facilitate partnerships with industry, fueling economic development and the social well-being of California, the United States and the world. The CNSI was established in 2000 with $100 million from the state of California and an additional $250 million in federal research grants and industry funding. At the institute, scientists in the areas of biology, chemistry, biochemistry, physics, mathematics, computational science and engineering are measuring, modifying and manipulating the building blocks of our world — atoms and molecules. These scientists benefit from an integrated laboratory culture enabling them to conduct dynamic research at the nanoscale, leading to significant breakthroughs in the areas of health, energy, the environment and information technology.

For more news, visit the UCLA Newsroom or follow us on Twitter.

New microchip technology performs 1,000 chemical reactions at once

Rachel Champeau — Mon, 03 Aug 2009 16:10:00 GMT

Flasks, beakers and hot plates may soon be a thing of the past in chemistry labs. Instead of handling a few experiments on a bench top, scientists may simply pop a microchip into a computer and instantly run thousands of chemical reactions, with results — literally shrinking the lab down to the size of a thumbnail.

Toward that end, UCLA researchers have developed technology to perform more than a thousand chemical reactions at once on a stamp-size, PC-controlled microchip, which could accelerate the identification of potential drug candidates for treating diseases like cancer.

Their study appears in the Aug. 21 edition of the journal Lab on a Chip and is currently available online.

A team of UCLA chemists, biologists and engineers collaborated on the technology, which is based on microfluidics — the utilization of miniaturized devices to automatically handle and channel tiny amounts of liquids and chemicals invisible to the eye. The chemical reactions were performed using in situ click chemistry, a technique often used to identify potential drug molecules that bind tightly to protein enzymes to either activate or inhibit an effect in a cell, and were analyzed using mass spectrometry.

While traditionally only a few chemical reactions could be produced on a chip, the research team pioneered a way to instigate multiple reactions, thus offering a new method to quickly screen which drug molecules may work most effectively with a targeted protein enzyme. In this study, scientists produced a chip capable of conducting 1,024 reactions simultaneously, which, in a test system, ably identified potent inhibitors to the enzyme bovine carbonic anhydrase.

A thousand cycles of complex processes, including controlled sampling and mixing of a library of reagents and sequential microchannel rinsing, all took place on the microchip device and were completed in just a few hours. At the moment, the UCLA team is restricted to analyzing the reaction results off-line, but in future, they intend to automate this aspect of the work as well.

"The precious enzyme molecules required for a single in situ click reaction in a traditional lab now can be split into hundreds of duplicates for performing hundreds of reactions in parallel, thus revolutionizing the laboratory process, reducing reagent consumption and accelerating the process for identifying potential drug candidates," said study author Hsian-Rong Tseng, a researcher at UCLA's Crump Institute for Molecular Imaging, an associate professor of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA, and a member of the California NanoSystems Institute at UCLA.

Kym F. Faull, director of the Pasarow Mass Spectrometry Lab at UCLA, helped the team with several challenges, including reducing the amount of chemicals needed for reactions on the chip, enhancing test sensitivity and speeding up reaction analysis.

"The system allows researchers to not only test compounds quicker but uses only tiny amounts of materials, which greatly reduces lab time and costs," said Faull, a professor of psychiatry and biobehavioral sciences at the Geffen School of Medicine.

Next steps for the team include exploring the use of this microchip technology for other screening reactions in which chemicals and material samples are in limited supply — for example, with a class of protein enzymes called kinases, which play critical roles in the malignant transformation of cancer.

According to the researchers, the technology may open up many areas for biological and medicinal study.

The study team relied on work in the UCLA labs of Michael E. Phelps, Norton Simon Professor and chair of molecular and medical pharmacology, and Clifton K.F. Shen, assistant professor of molecular and medical pharmacology. Key research contributors included Yanju Wang, Wei-Yu Lin and Kan Liu, who work in Tseng's lab and intend to continue this line of research in independent careers after completing their training with Tseng.

The study was funded by the U.S. Department of Energy and the National Institutes of Health.

Other authors include: Rachel J. Lin of UCLA's Crump Institute for Molecular Imaging; Matthias Selke of the department of chemistry and biochemistry at California State University, Los Angeles; Hartmuth C. Kolb of Siemens Medical Solutions; Nangang Zhang of UCLA's Crump Institute for Molecular Imaging and the department of physics and Center of Nanoscience and Nanotechnology at China's Wuhan University; and Xing-Zhong Zhao of the department of physics and Center of Nanoscience and Nanotechnology at China's Wuhan University.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Crystal ball for brain cancer?

Elaine Schmidt — Thu, 30 Jul 2009 07:01:00 GMT

UCLA scientists have devised a new way to image brain tumors and predict which ones are most likely to benefit from the drug Avastin — before the patient ever takes a single dose.

Published in this month's issue of the journal Radiology, the findings could help patients make better-informed decisions on whether to pursue or avoid therapy with the powerful drug.

The U.S. Food and Drug Administration in May approved the use of Avastin for the treatment of brain cancer. The drug shrinks tumors by choking off their blood supply. But because half of patients don't respond to Avastin, the therapy exposes them to unnecessary side effects and medication costs of up to $10,000 per month.

"Avastin is an expensive drug, yet only 50 percent of patients with recurring brain cancers respond to it," said lead author Dr. Whitney Pope, assistant professor of radiological sciences at the David Geffen School of Medicine at UCLA. "Until now, there has been no good way to identify these patients in advance. Our work is the first to suggest that we can predict which tumors will respond before the patient ever starts therapy."

Pope and his colleagues focused on glioblastoma, the most common and deadly form of adult brain tumor, which strikes 12,000 Americans a year. Despite therapy with surgery, radiation and chemotherapy, the average glioblastoma patient lives only 12 to 15 months after diagnosis.

Survival rates drop even lower if the tumor returns. Conventional therapies produce little benefit; only 8 to 15 percent of patients survive without tumor growth six months after treatment.

The UCLA team studied 82 patients who had undergone surgery and radiation therapy to remove glioblastoma. Half of the patients received infusions of Avastin every two weeks. All underwent monthly brain scans by magnetic resonance imaging (MRI) to monitor change.

The researchers analyzed the MRI scans of the patients whose tumors returned. Explaining what the team saw requires an understanding of how the tumor creates an independent blood supply.

Cancer cells secrete a growth factor called VEGF that spurs the growth of new blood vessels to supply the tumor with oxygen and nutrients. Avastin blocks VEGF, essentially starving the tumor to death.

This process launches a chain of events that is detectable by MRI. Oxygen-starved cells produce more VEGF, which causes blood vessels to leak fluids into the tumor and surrounding tissue. This results in swelling, which boosts water's ability to move freely in the tumor and brain tissue. As cells disintegrate, they no longer pose a physical barrier to water movement.

"We theorized that tumors with more water motion would also have higher VEGF levels," explained Pope. "Because Avastin targets VEGF, it made sense that the drug would work better in tumors with high levels of the growth factor."

By measuring the amount of water motion within the tumor, the researchers were able to predict with 70 percent accuracy which patients' tumors would progress within six months and which would not. They detected greater water movement in the tumors of those persons who later responded best to Avastin.

"When we realized that high levels of VEGF are linked to greater cell death and increased water movement, we were able to predict the patients' response to Avastin before they began treatment," Pope said. "We were correct 70 percent of the time. Previously, identifying which patients would respond was like flipping a coin. This is a huge improvement."

The research finding presents clear clinical benefits to the patient, Pope said. "Knowing this information ahead of time will help doctors personalize therapy for each patient and decrease exposure to side effects," he noted.

Pope and his colleagues plan to confirm their findings in a larger study. The team will also test the new method's ability to identify responsive patients prior to surgical removal of their tumor.

Pope's co-authors included Dr. Timothy Cloughesy, Hyun Kim, Jing Huo, Jeffry Alger, Matthew Brown, David Gjerson, Dr. Victor Sai, Jonathan Young, Leena Tekchandani, Dr. Paul Mischel, Dr. Albert Lai, Dr. Phioanh Nghiemphu, Dr. Syed Rahmanuddin and Dr. Jonathan Goldin. All authors are affiliated with UCLA, which funded the research.

Pope and Cloughesy are consultants for Genentech, which manufactures Avastin, and are collaborating with the company on several research studies.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Study finds significant number of kids experience family homelessness

Amy Albin — Mon, 27 Jul 2009 16:40:00 GMT

A new multisite study by UCLA and RAND Corp. researchers and colleagues has found that 7 percent of fifth-graders and their families have experienced homelessness at some point in their lives and that the occurrence is even higher — 11 percent — for African American children and those from the poorest households.

The study also found that children who had experienced homelessness at some point during their lives were significantly more likely to have an emotional, behavioral or developmental problem; were more likely to have witnessed serious violence with a knife or a gun; and were more likely to have received mental health care.

The research is the first population-based study to describe the lifetime prevalence of family homelessness among children and its association with health and health care.

The findings will be published in the August issue of the American Journal of Public Health and are currently available online by subscription.

"It was unexpected to see such a high prevalence of family homelessness in this sample of fifth-grade students, especially since this number only included children whose parents reported that they were literally homeless — staying in places like shelters, cars or on the streets," said lead author Dr. Tumaini R. Coker, clinical instructor of pediatrics at Mattel Children's Hospital UCLA and an associate natural scientist at RAND. "Our results suggest that in a classroom of 28 fifth-graders, two students would have been homeless at some point in their lives."

Researchers analyzed data from Healthy Passages, a multisite study of 5,147 fifth-grade students funded by the Centers for Disease Control and Prevention. Interviews of students and parents were conducted over the 2004–05 and 2005–06 school years and included children from Birmingham, Ala.; Houston, Texas; and Los Angeles.

After controlling for sociodemographic factors, indicators of general child health were similar for children who had experienced homelessness (ever-homeless) and those who had never been homeless (never-homeless), but indicators of emotional, behavioral and developmental health were not.

"Ever-homeless children were significantly more likely to have a parent report that they had an emotional, behavioral or developmental problem and to have received mental health–related services," Coker said. "Our study is not able to say whether an experience of homelessness caused these problems. Further research will help us understand the relationship between the emotional, behavioral and developmental problems and the episodes of homelessness."

"Clinicians should be aware of the possibility that their patients could be homeless," said senior author Dr. Mark A. Schuster, the William Berenberg Professor of Pediatrics at Children's Hospital Boston and Harvard Medical School. "In addition to helping such families obtain housing services, clinicians may find that their patients also have mental health problems that should be addressed."

The next stage of research will be to use longitudinal data to understand the temporal relationships between emotional, developmental and behavioral problems and episodes of homelessness.

Additional sites involved in the study included the University of Alabama at Birmingham and the University of Texas, Houston.

In addition to Coker and Schuster, study authors included Marc N. Elliott, David E. Kanouse, Jo Anne Grunbaum, Janice Gilliland, Susan R. Tortolero and Paula Cuccaro. The authors have no financial ties to disclose.

For more news, visit the UCLA Newsroom or follow us on Twitter.

Peptide linked to glucose metabolism and neuronal cell survival

Amy Albin — Wed, 22 Jul 2009 00:00:00 GMT

A cellular protein that may prevent nerve cells from dying also helps to improve insulin action and lower blood glucose levels, according to a study by researchers at the Albert Einstein College of Medicine of Yeshiva University in collaboration with scientists at UCLA.

The study, which focuses on diabetic rodents, appears this month in PLoS One and is the first to show a role in glucose metabolism for humanin, a small protein (peptide). The researchers also demonstrated that humanin resembles the peptide leptin by acting on the brain to influence glucose metabolism.

Humanin is found in mitochondria - structures that populate the cytoplasm of cells and provide them with energy. The peptide was first detected in brain nerve cells in 2001, and subsequent studies suggest that it protects nerve cells from death associated with Alzheimer's and other brain disease.

"This new role of humanin in glucose metabolism, in addition to its role in Alzheimer's disease, is very intriguing since scientists have long proposed a link between type 2 diabetes and Alzheimer's disease," says Nir Barzilai, M.D., a co-senior author of the study, the Ingeborg and Ira Leon Rennert Professor of Aging Research, and director of the Institute for Aging Research at Einstein."Humanin could turn out to be a therapeutic option for two common debilitating diseases that affect millions of people. Additionally, humanin may help treat other age-related diseases."

In the study, Dr. Barzilai and his colleagues infused humanin into the brains of diabetic rats to determine the peptide's effect on glucose metabolism. The infused humanin significantly improved overall insulin sensitivity, both in the liver and in skeletal muscle. Furthermore, a single treatment with a highly-potent form of humanin significantly lowered blood-sugar levels in diabetic rats.

"The improvement in insulin sensitivity caused by centrally administered humanin may be one of the main mechanisms through which humanin regulates cell survival," says Dr. Barzilai. "This may provide another potential mechanism by which humanin protects against Alzheimer's disease."

Humanin's possible link to two age-related diseases — Alzheimer disease and Type 2 diabetes — prompted the researchers to investigate whether age-associated changes in humanin levels occur in rodents and in humans. They found that humanin levels in two brain structures (the hypothalamus and the cortex) and in skeletal muscle decreased with age in rodents, and that circulating blood levels of the peptide decreased with age in people.

"From these results, we conclude that the decline in humanin with age could help explain why Alzheimer's disease and type 2 diabetes are more common in older people," says Dr. Barzilai.

Furthermore, "the remarkable activity of this novel peptide proposes a new role for an emerging class of endogenous molecules derived from the mitochondria that have previously been overlooked and can potentially represent a different paradigm for drug development for a variety of diseases," says Dr. Pinchas Cohen, co-senior author, professor and chief of endocrinology at the Mattel Children's Hospital UCLA, and co-director of the UCSD/UCLA Diabetes/Endocrinology Research Center at the David Geffen School of Medicine at UCLA.

The researchers are currently studying the pharmacokinetics and safety profile of humanin and its analogues.

The paper, "Humanin: A Novel Regulator of Peripheral Insulin Action," is published in the July 22, 2009 issue of PLoS One, a journal of the Public Library of Science.

The lead author is Radhika H. Muzumdar, M.D., M.B., assistant professor of pediatrics and of medicine at Einstein. The co-senior authors are Drs. Barzilai and Cohen, with Dr. Barzilai serving as corresponding author. Co-authors include Gil Atzmon, Tamuri Budagov, Linguang Cui, Francine Einstein, Sigal Fishman, and Derek Huffman, Einstein; Aruna Poduval, Children's Hospital Montefiore; Christoph Buettner, Mount Sinai School of Medicine; and Laura Cobb and David Hwang, UCLA.

Funding and Financial Disclosure: This work was supported by grants from the National Institutes of Health. No pharmaceutical or commercial support contributed to this manuscript. There are no conflicts of interests for any of the investigators.

Albert Einstein College of Medicine of Yeshiva University is one of the nation's premier centers for research, medical education and clinical investigation. It is the home to some 2,000 faculty members, 750 M.D. students, 350 Ph.D. students (including 125 in combined M.D./Ph.D. programs) and 380 postdoctoral investigators. Last year, Einstein received more than $130 million in support from the NIH. This includes the funding of major research centers at Einstein in diabetes, cancer, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Through its extensive affiliation network involving five hospital centers in the Bronx, Manhattan and Long Island - which includes Montefiore Medical Center, The University Hospital and Academic Medical Center for Einstein - the College runs one of the largest post-graduate medical training program in the United States, offering approximately 150 residency programs to more than 2,500 physicians in training.

Mattel Children's Hospital UCLA is one of the highest-rated children's hospitals in California, is a vital component of Ronald Reagan UCLA Medical Center, ranked by U.S. News & World Report as the No. 3 hospital in nation and best in the Western United States. Mattel Children's Hospital offers a full spectrum of primary and specialized medical care for infants, children and adolescents. The hospital's mission is to provide state-of-the-art treatment for children in a compassionate atmosphere and to improve the understanding and treatment of pediatric diseases.

UCLA scientists present first genetic evidence for why placebos work

Mark Wheeler — Mon, 20 Jul 2009 21:15:00 GMT

Placebos are a sham — usually mere sugar pills designed to represent "no treatment" in a clinical treatment study. The effectiveness of the actual medication is compared with the placebo to determine if the medication works.

And yet, for some people, the placebo works nearly as well as the medication. How well placebos work varies widely among individuals. Why that is so, and why they work at all, remains a mystery, thought to be based on some combination of biological and psychological factors.

Now, researchers at UCLA have found a new explanation: genetics. Dr. Andrew Leuchter, a professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, and colleagues report that in people suffering from major depressive disorder, or MDD, genes that influence the brain's reward pathways may modulate the response to placebos. The research appears in the August edition of the Journal of Clinical Psychopharmacology (currently available online by subscription).

Placebos are thought to act by stimulating the brain's central reward pathways by releasing a class of neurotransmitters called monoamines, specifically dopamine and norepinephrine. These are the brain chemicals that make us "feel good." Because the chemical signaling done by monoamines is under strong genetic control, the scientists reasoned that common genetic variations between individuals — called genetic polymorphisms — could influence the placebo response.

Researchers took blood samples from 84 people diagnosed with MDD; 32 were given medication and 52 a placebo. The researchers looked at the polymorphisms in genes that coded for two enzymes that regulate monoamine levels: catechol-O-methyltransferase (COMT) and monoamine oxidase A (MAO-A). Subjects with the highest enzyme activity within the MAO-A polymorphism had a significantly lower placebo response than those with other genotypes. With respect to COMT, those with lower enzyme activity within this polymorphism had a lower placebo response.

"Our findings suggest that patients with MDD who have specific MAO-A and COMT genotypes may be biologically advantaged or disadvantaged in mounting a placebo response, because of the activity of these two enzymes," said Leuchter, who directs the Laboratory of Brain, Behavior and Pharmacology at the UCLA Semel Institute.

"To our knowledge, this is the first study to examine the association between MAO-A and COMT polymorphisms and a response to placebo in people who suffer from major depressive disorder," he said.

Leuchter noted that this is not the sole explanation for a response to a placebo, which is likely to be caused by many factors, both biological and psychosocial. "But the data suggests that individual differences in response to placebo are significantly influenced by individual genotypes," he said.

Including the influence of genotype in the design of clinical trials could facilitate more powerful testing of future treatments, Leuchter said.

Funding for the study was provided by the National Center for Complementary and Alternative Medicine of the National Institutes of Health, Eli Lilly and Co., and Pfizer Inc.

Other authors included James McCracken, Aimee Hunter and Ian Cook, all of UCLA, and Jonathan Alpert of Massachusetts General Hospital and Harvard University.

Author disclosure information:

Dr. Andrew Leuchter has provided scientific consultation or served on advisory boards of a number of companies, including Eli Lilly and Co., where he has also served in the speakers bureau. He has received research/grant support from the National Center for Complementary and Alternative Medicine, Eli Lilly and Co., and Pfizer Inc., among others.

Dr. James T. McCracken has served as an adviser and consultant for Eli Lilly and Co. and other companies and receives research support from, among others, Eli Lilly and Co.

Aimee M. Hunter has nothing to disclose financially.

Dr. Ian A. Cook has served in the speakers bureau for Pfizer Pharmaceuticals Inc. and other companies and has received research support from, among others, Eli Lilly and Co. and Pfizer Inc.

Dr. Jonathan E. Alpert has served as an adviser and consultant for Eli Lilly and Co. and other companies and has served in the speakers bureau for Eli Lilly and Co. He receives research support from, among others, Eli Lilly and Co. and Pfizer Inc.

The Semel Institute for Neuroscience and Human Behavior is an interdisciplinary research and education institute devoted to the understanding of complex human behavior, including the genetic, biological, behavioral and sociocultural underpinnings of normal behavior, and the causes and consequences of neuropsychiatric disorders. In addition to conducting fundamental research, institute faculty seek to develop effective treatments for neurological and psychiatric disorders, improve access to mental health services and shape national health policy regarding neuropsychiatric disorders.

For more news, visit the UCLA Newsroom.

Researchers discover new molecular pathway for targeting cancer, disease

Rachel Champeau — Mon, 20 Jul 2009 16:45:00 GMT

A UCLA study has identified a way to turn off a key signaling pathway involved in physiological processes that can also stimulate the development of cancer and other diseases. The findings may lead to new treatments and targeted drugs using this approach.

In the study, which is currently available in the online edition of the journal Molecular Endocrinology, scientists found that by activating a receptor in cells called the liver X receptor (LXR), they were able to inhibit the hedgehog (Hh) signaling pathway, which is involved in the maintenance of tissue integrity and stem cell generation. When stimulated in an unregulated manner, however, the Hh pathway can also cause cancers of the brain, lung, blood, prostate, skin and other tissues.

Blocking such unregulated stimulation of the Hh pathway had previously been shown in animal studies to prevent cancers, according to the researchers. How LXR was able to inhibit tumor cell growth by impeding the Hh pathway was previously unknown.

"Our finding shows that activation of LXR signaling is a novel strategy for inhibiting Hh pathway activity and for targeting various cell types, including cancer cells, which may provide important clues as to how we might be able to intervene with tumor formation," said Farhad Parhami, a professor of medicine at the David Geffen School of Medicine at UCLA and the study's principal investigator.

During the study, researchers performed various tests activating LXR receptors in cells and found that specific gene expression induced by the Hh pathway could be inhibited. This finding was also confirmed in mice.

"Since Hh signaling plays a major role in other physiological and pathological processes, we may be able to impact other diseases as well," Parhami said.

Dr. William Matsui of Johns Hopkins Medical Institute, an expert on Hh signaling in cancer development, noted the importance of the UCLA study and its significance for the next stages of research — finding a pharmaceutical drug or substance molecule to act as an agonist, which would stimulate LXR activity to inhibit aberrant Hh signaling.

"The hedgehog Hh signaling pathway is an important regulator of tumor formation, and these findings suggest that LXR agonists may be novel treatments for a wide variety of human cancers," Matsui said.

According to researchers, utilizing this new treatment pathway could have broad applications in the cancer field.

"This discovery identifies an entirely new and unexpected mechanism of hedgehog pathway modulation," said study author Dr. James A. Waschek, an expert on Hh signaling in brain tumor development and a professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA. "This has great potential in offering other options, because current hedgehog pathway inhibitors have severe side effects which preclude their use in many cancer patients, especially children."

Waschek also noted that this discovery may reveal new details on how Hh signals within the cell, which is currently poorly understood.

The next stage of the research will focus on activating the LXR pathway using various pharmacological molecules to inhibit tumor formation. Matsui will be a collaborator in this follow-up research.

In addition, the team has started a medicinal chemistry program to design and test small molecules that activate the LXR pathway while avoiding the adverse effects that may be caused when LXR is activated in tissues such as the liver.

The study was funded by the National Institutes of Health and the American Heart Association.

Other authors include Woo-Kyun Kim and Vicente Meliton from the UCLA Department of Medicine; Peter Tontonoz from the UCLA Department of Pathology and Laboratory Medicine and the Howard Hughes Medical Institute; Kye Won Park from the department of food science and biotechnology at Korea's Sungkyunkwan University; Cynthia Hong from the Howard Hughes Medical Institute and the David Geffen School of Medicine at UCLA; Pawel Niewiadomski from the UCLA Department of Psychiatry; and Sotirios Tetradis from the UCLA School of Dentistry.

For more news, visit the UCLA Newsroom.

The sounds of learning

Mark Wheeler — Mon, 20 Jul 2009 16:05:00 GMT

In June 2009, newspapers reported that archaeologists in Germany had discovered a 35,000-year-old flute made of bird bone. It represented, one paper said, "the earliest known flowering of music-making in Stone Age culture." And we have been tapping our toes, humming along, singing and dancing ever since.

The power of music affects all of us and has long appealed to our emotions. It is for this reason that UCLA researchers are using music to help children with autism spectrum disorders (ASD), for whom understanding emotions is a very difficult task. This inability robs them of the chance to communicate effectively and make friends and can often lead to social isolation and loneliness.

Thanks to a grant from the NAMM Foundation, the trade association of the international music products association, Istvan Molnar-Szakacs, a researcher at the UCLA Tennenbaum Center for the Biology of Creativity and member of the of the Help Group–UCLA Autism Research Alliance, and colleagues have developed a music education program designed to help children with ASD better understand emotions and learn to recognize emotions in others.

"This is a 'naturalistic study,' in that it takes place not in a lab but in the child's classroom at the Help Group's Village Glen School for children with autism, where they are engaged in music-making," Molnar-Szakacs said.

Specifically, the children are using a method of music education known as the Orff-Schulwerk approach. Developed by 20th-century German composer Carl Orff ("schulwerk" is German for schooling), it is a unique approach to music learning that is supported by movement and based on things that kids intuitively like to do, such as sing, chant rhymes, clap, dance and keep a beat or play a rhythm on anything near at hand. Orff called this music and movement activity "elemental" — basic, unsophisticated and concerned with the fundamental building blocks of music.

The 12-week program uses elements from the Orff method — including games, instruments and teamwork — and combines them with musical games. The idea is to pair emotional musical excerpts with matching displays of social emotion (happy with happy, sad with sad, etc.) in a social, interactive setting.

"Music is a birthright of all children. To be able to listen and appreciate, sing or participate in music-making are as essential to development as mathematical or linguistic learning," Molnar-Szakacs said. "The purpose of this work is to provide a means for awakening the potential in every child for being 'musical' — that is, to be able to understand and use music and movement as forms of expression and, through that, to develop a recognition and understanding of emotions."

In fact, he said, participating in musical activities has the potential to scaffold and enhance all other learning and development, from timing and language to social skills.

"Beyond these more concrete intellectual benefits, the extraordinary power of music to trigger memories and emotions and join us together as an emotional, empathic and compassionate humanity are invaluable," Molnar-Szakacs said.

The goal of the research is to evaluate the effect of the music education program on outcomes in social communication and emotional functioning, as well as the children's musical development, according to Molnar-Szakacs.

"Hopefully this will be a fun, engaging and cost-effective therapeutic intervention to help children with ASD recognize and understand emotions in daily life interactions," he said. "An improved ability to recognize social emotions will allow these children to form more meaningful social relationships and hopefully greatly improve their quality of life."

Molnar-Szakacs is collaborating on the grant with Elizabeth A. Laugeson, a UCLA clinical instructor of psychiatry and director of the Help Group–UCLA Autism Research Alliance. The alliance is an innovative partnership between the Help Group and the UCLA Semel Institute for Neuroscience and Human Behavior that is dedicated to enhancing and expanding clinical research in the education and treatment of ASD and contributing to the development, greater understanding and use of best-practice models by researchers, educators and clinicians.

The investigators report no conflicts of interest.

The NAMM Foundation is a nonprofit organization dedicated to advancing active participation in music-making across the lifespan by supporting scientific research, philanthropic giving and public service programs from the international music products industry.

The Help Group, founded in 1975, serves children with a wide range of special needs and is the largest and most comprehensive nonprofit of its kind in the United States. Recognized as a leader in the field of autism, it offers extensive special education, therapy and assessment services. The Help Group educates more than 850 students between the ages of 3 and 22 on a daily basis in its highly specialized autism day schools.

The UCLA Tennenbaum Center for the Biology of Creativity has as its mission the study of the molecular, cellular, systems and cognitive mechanisms that result in cognitive enhancements and explain unusual levels of performance in gifted individuals, including extraordinary creativity. It is part of the Semel Institute for Neuroscience and Human Behavior, an interdisciplinary research and education institute devoted to the understanding of complex human behavior, including the genetic, biological, behavioral and sociocultural underpinnings of normal behavior, and the causes and consequences of neuropsychiatric disorders.

For more news, visit the UCLA Newsroom.

Ronald Reagan UCLA Medical Center rated one of top three hospitals in the U.S.

Roxanne Moster — Thu, 16 Jul 2009 04:01:00 GMT

Ronald Reagan UCLA Medical Center ranks as one of the top three American hospitals — and the best hospital in the western United States for the 20th consecutive year — according to a U.S. News & World Report survey that reviewed patient-outcomes data, reputation among physicians and other care-related factors.

The 2009–10 multiplatform "America's Best Hospitals" guide is the most extensive hospital ranking to date and can be found in U.S. News & World Report's special August edition. The rankings are currently available online at www.usnews.com/besthospitals. Ronald Reagan UCLA Medical Center is also the only hospital in Los Angeles and the Southern California region that appears on the honor roll.

The magazine put 4,861 U.S. medical centers through an intensive screening process to create the 16 specialty rankings in the 2009–10 edition of the survey, which is now in its 20th year. Just 174 hospitals made it into the rankings, and only 21 entered the honor roll. The honor roll recognizes hospitals that demonstrate excellence across many specialties.

"This is a wonderful tribute to our entire health care team as we celebrate the one-year anniversary in our new hospital, the Ronald Reagan UCLA Medical Center," said Dr. David Feinberg, CEO and associate vice chancellor of the UCLA Hospital System. "It has truly been a momentous year, and we are grateful to our gifted and dedicated medical and support team throughout the UCLA Health System who go the extra mile every day to save lives and deliver compassionate care to patients in our community and from around the world."

Hospitals are ranked in 16 specialties, from cancer and heart disease to neurosurgery and urology. In 12 of the 16 specialties, ranked hospitals must meet standards that are predominantly driven by hard data based on four components: reputation, death rate, patient safety (new this year) and care-related factors such as nursing and patient services. In the four other specialties — ophthalmology, psychiatry, rehabilitation and rheumatology — rankings are based solely on nominations from the three most recent physician surveys.

"To once again be in the company of the nation's best hospitals, when rapid changes in health care constantly challenge our commitment to excellence, makes us extraordinarily proud of our dedicated physicians, scientists, nurses and staff throughout the UCLA Health System," said Dr. Gerald S. Levey, UCLA vice chancellor for medical sciences and dean of the David Geffen School of Medicine at UCLA. "We congratulate each and every one of them for helping UCLA once again earn this well-deserved distinction."

Ronald Reagan UCLA Medical Center was rated one of the top three hospitals in the nation, along with Johns Hopkins Hospital in Baltimore, which ranked first, and the Mayo Clinic in Rochester, Minn., which was second.

Nationally, UCLA ranked in the top 20 in 15 of the 16 specialty areas. In each of the following specialties, UCLA's national rankings are indicated: cancer at UCLA's Jonsson Cancer Center (11); diabetes and endocrine disorders (8); digestive disorders (5); ear, nose and throat (8); geriatrics (1); gynecology (10); heart and heart surgery (10); kidney disorders (7); neurology and neurosurgery (7); ophthalmology at UCLA's Jules Stein Eye Institute (5); orthopedics (13); psychiatry at the Resnick Neuropsychiatric Hospital at UCLA (5); respiratory disorders (17); rheumatology (5); and urology (4).

"When the stakes are high, you want the best care you can get for someone close to you," said U.S. News' health rankings editor Avery Comarow. "These are hospitals that are used to getting the sickest patients."

The UCLA Health System has for more than half a century provided the best in health care and the latest in medical technology to the people of Los Angeles and the world. Comprised of Ronald Reagan UCLA Medical Center, Santa Monica–UCLA Medical Center and Orthopaedic Hospital, the Resnick Neuropsychiatric Hospital at UCLA, Mattel Children's Hospital UCLA and the UCLA Medical Group, with its wide-reaching system of primary care and specialty care offices throughout the region, the UCLA Health System is among the most comprehensive and advanced health care systems in the world. For information about clinical programs or help in choosing a personal physician, call 800-UCLA-MD1 or visit www.uclahealth.org.

For more news, visit the UCLA Newsroom.

L.A. Laker Jordan Farmar to visit kids at Mattel Children's Hospital UCLA

Amy Albin — Wed, 15 Jul 2009 22:50:00 GMT

WHAT:

Los Angeles Lakers player Jordan Farmar will host his second annual reunion luncheon at Mattel Children's Hospital UCLA for approximately 30 pediatric patients and family members who participated in his Making Dreams Come True program during the past two NBA seasons. Farmar will also visit additional pediatric patients at their bedsides and deliver goodie bags.

The Making Dreams Come True program allows patients and family members to attend a Lakers game and participate in a meet-and-greet with Farmar and other players after the game. A former UCLA basketball star, Farmar established the nonprofit Jordan Farmar Foundation to support charitable programs that build values, develop character, create opportunities and promote positive attitudes, with an emphasis on youth sports programs in Southern California. The UCLA Health System is the "official health system of the Los Angeles Lakers."

WHEN:

Thursday, July 23

2 p.m.: Farmar hosts reunion luncheon with pediatric patients and their families.
3:30 p.m.: Farmar visits with patients at bedside, delivers goodie bags.

WHERE:

Mattel Children's Hospital UCLA, 5th floor pediatric terrace

757 Westwood Plaza, Los Angeles, Calif. 90095 (UCLA campus)

MEDIA CONTACT:

Amy Albin, UCLA Health Sciences Media Relations, 310-794-8672

PARKING:

Please call media contact to arrange parking.

Vitamin D, curcumin may help clear amyloid plaques found in Alzheimer's

Rachel Champeau — Wed, 15 Jul 2009 17:25:00 GMT

UCLA scientists and colleagues from UC Riverside and the Human BioMolecular Research Institute have found that a form of vitamin D, together with a chemical found in turmeric spice called curcumin, may help stimulate the immune system to clear the brain of amyloid beta, which forms the plaques considered the hallmark of Alzheimer's disease.

The early research findings, which appear in the July issue of the Journal of Alzheimer's Disease, may lead to new approaches in preventing and treating Alzheimer's by utilizing the property of vitamin D3 — a form of vitamin D — both alone and together with natural or synthetic curcumin to boost the immune system in protecting the brain against amyloid beta.

Vitamin D3 is an essential nutrient for bone and immune system health; its main source is sunshine, and it is synthesized through the skin. Deficiencies may occur during winter months or in those who spend a lot of time indoors, such as Alzheimer's patients.

"We hope that vitamin D3 and curcumin, both naturally occurring nutrients, may offer new preventive and treatment possibilities for Alzheimer's disease," said Dr. Milan Fiala, study author and a researcher at the David Geffen School of Medicine at UCLA and the Veterans Affairs Greater Los Angeles Healthcare System.

Using blood samples from nine Alzheimer's patients, one patient with mild cognitive impairment and three healthy control subjects, scientists isolated monocyte cells, which transform into macrophages that act as the immune system's clean-up crew, traveling through the brain and body and gobbling up waste products, including amyloid beta. Researchers incubated the macrophages with amyloid beta, vitamin D3 and natural or synthetic curcumin.

The synthetic curcuminoid compounds were developed in the laboratory of John Cashman at the Human BioMolecular Research Institute, a nonprofit institute dedicated to research on diseases of the human brain.

Researchers found that naturally occurring curcumin was not readily absorbed, that it tended to break down quickly before it could be utilized and that its potency level was low, making it less effective than the new synthetic curcuminoids.

"We think some of the novel synthetic compounds will get around the shortcomings of curcumin and improve the therapeutic efficacy," Cashman said.

The team discovered that curcuminoids enhanced the surface binding of amyloid beta to macrophages and that vitamin D strongly stimulated the uptake and absorption of amyloid beta in macrophages in a majority of patients.

Previous research by the team demonstrated that the immune genes MGAT III and TLR-3 are associated with the immune system's ability to better ingest amyloid beta. In this earlier work, Fiala noted, it was shown that there are two types of Alzheimer's patients: Type 1 patients, who respond positively to curcuminoids, and Type II patients, who do not.

"Since vitamin D and curcumin work differently with the immune system, we may find that a combination of the two or each used alone may be more effective — depending on the individual patient," he said.

Fiala noted that this is early laboratory research and that no dosage of vitamin D or curcumin can be recommended at this point. Larger vitamin D and curcumin studies with more patients are planned.

The study was funded by the Human BioMolecular Research Institute, the Alzheimer's Association and MP Biomedicals LLC, a global life sciences and diagnostics company dedicated to Alzheimer's disease research. Fiala is a consultant for MP Biomedicals and also served in the company's speakers bureau.

Additional study authors include Ava Masoumi, Ben Goldenson, Hripsime Avagyan, Justin Zaghi, Michelle Mahanian, Martin Hewison, Araceli Espinosa-Jeffrey and Phillip T. Liu, of the David Geffen School of Medicine at UCLA; Senait Ghirami, Ken Abel, Xuying Zheng and John Cashman, of the Human BioMolecular Research Institute; and Mathew Mizwicki, of the department of biochemistry at UC Riverside.

The David Geffen School of Medicine at UCLA, founded in 1951, is the youngest medical school to be ranked among the top 11 in the nation by U.S. News & World Report. The school has more than 2,000 full-time faculty members, including recipients of the Nobel Prize, the Pulitzer Prize and the National Medal of Science.

For more news, visit the UCLA Newsroom.

A ticking bomb: Novel UCLA procedure treats high-risk aortic aneurysms

Rachel Champeau — Wed, 15 Jul 2009 16:15:00 GMT

Patrick Lane was plagued by recurring aortic aneurysms a decade ago that threatened his survival. His doctor at the time suggested the 74-year-old contact a leading vascular surgeon at UCLA who was pioneering a new treatment technique for high-risk patients who couldn't receive traditional surgery.

In 1998, Lane became the first patient at UCLA to be treated using the novel method, known as CESA (combined endovascular and surgical approach), which was performed by Dr. William Quinones-Baldrich. Lane is still doing well today.

For years, traditional surgery was not an option for high-risk patients with dangerous aortic aneurysms. Unlike their less high-risk peers, these individuals were forced to live with the possibility that their aneurysm, like a ticking bomb, could burst at any time, often causing instant death or damage to major organs like the kidneys, liver and lungs.

Since Lane underwent CESA, the procedure has been performed on 31 UCLA patients, and in a recent issue of the Journal of Vascular Surgery, Quinones-Baldrich and his colleagues reported excellent results in the first 20 high-risk patients with complex aortic pathology who were treated with CESA. The technique has been gaining popularity at centers throughout the world for high-risk cases.

"Due to the tricky position of some aortic aneurysms or the frailty of some patients, not everyone is a candidate for standard surgery to treat a dangerous aneurysm," said Quinones-Baldrich, a professor of vascular surgery at the David Geffen School of Medicine at UCLA. "We hope this technique may offer patients with these complex aneurysms another option."

The aorta, the largest artery in the body, runs from the heart through the chest and abdomen. Arteries branching from the aorta feed all major organs in the body such as the kidneys, intestines, brain, pancreas, liver and the extremities. If the aortic artery wall weakens due to age and arterial disease, the force of the blood flowing through the artery can cause part of the wall to stretch out like a water balloon. More than 10,000 Americans die each year from ruptured aortic aneurysms.

Many of the more serious cases involve aneurysms in a segment of the aorta where branches are supplying circulation to vital organs. These patients often have additional health conditions such as compromised cardiac, kidney and pulmonary function that make it too risky to perform traditional aortic surgery, in which the chest and abdomen are opened simultaneously and the patient is placed on assisted circulation while the aneurysm and associated branch arteries are repaired.

"Aortic aneurysm repair is one of the more complex and risky procedures in vascular surgery," he said. "New options for high-risk patients are greatly needed."

The 20 patients Quinones-Baldrich and his team treated between 1998 and 2008 were not candidates for traditional surgery and ranged in age from 51 to 89.

During the CESA procedure, the surgeons first make an incision in the abdomen to access vital arteries stemming from the aorta. During this surgical part of the technique, Quinones-Baldrich performs bypasses on these arteries in order to reroute blood flow; this allows for the eventual exclusion of the segment of the aorta affected by the aneurysm through the placement of a tiny endovascular device during the second part of the procedure. Prosthetic grafts that look like high-tech tubing are used to provide circulation to the bypassed arteries during this first part.

"Rerouting blood flow to originate from an area of the aorta not affected by the aneurysm allows us to eventually exclude circulation to the aneurysm in the second procedure by employing a tiny device called an endograft," Quinones-Baldrich said.

The minimally invasive stage of the CESA procedure is often completed at a later date, allowing the body time to recover and adjust to the new blood-flow pattern. Working through a small incision in the groin, surgeons thread the tiny, tube-like endograft through the femoral artery and guide it towards the aortic aneurysm. Once in place and released, the endograft acts like a stent, relining the aortic artery wall, and becomes the new conduit for blood flow, closing off the aneurysm.

"The CESA technique avoids opening the chest, which is done during standard surgery," Quinones-Baldrich said. "After the endograft is placed, the patients usually can go home two to three days later, compared with longer stays that generally accompany traditional surgery."

UCLA's 10-year experience with the CESA technique demonstrates that the procedure appears to be safe and durable. There was no perioperative mortality, and the cumulative survival rate at two years was 76 percent, which is comparable to the results after traditional surgical repair in acceptable-risk patients, according to researchers.

Quinones-Baldrich noted that there were major complications in six patients, including respiratory failure, deterioration of kidney function and minor heart attack, as well as paralysis in one patient. The complication of paralysis has been reported in 8 to 20 percent of cases with traditional surgery; the one CESA patient represents 5 percent of total CESA patients at UCLA.

"Although the majority of patients did well, this is a patient population with many risk factors," Quinones-Baldrich said. "It's a tough and careful decision that must be made between the patient, family and surgeon in deciding to pursue a repair or leave the aneurysm intact, which also has risks."

According to Quinones-Baldrich, the CESA approach may have several advantages compared with traditional surgery. In addition to not having to open the chest and utilize extracorporeal circulation, there is less restriction of the blood supply to organs during the CESA procedures.

The standard of care is still traditional surgery, which Quinones-Baldrich recommends for acceptable-risk patients. More study and longer follow-up needs to be completed for the CESA technique, but he's hopeful that this method will prove a viable approach for most patients, particularly those who don't have the option of conventional surgery.

Other authors included Dr. Juan Carlos Jimenez, Dr. Brian DeRubertis and Dr. Wesley Moore, all of the division of vascular surgery at the David Geffen School of Medicine at UCLA.

For more news, visit the UCLA Newsroom.

UCLA scientists identify how immune cells may help predict Alzheimer's risk

Rachel Champeau — Mon, 13 Jul 2009 17:00:00 GMT

What if you could test your risk for Alzheimer's disease much like your cholesterol levels — through a simple blood test?

UCLA scientists have discovered a way to measure the amount of amyloid beta that is being absorbed by immune cells in the blood. Amyloid beta forms the plaques considered the hallmark of Alzheimer's disease, and if the immune system isn't adequately clearing amyloid beta, it may indicate Alzheimer's risk, according to the researchers.

MP Biomedicals LLC, a global life sciences and diagnostics company dedicated to Alzheimer's disease research, has received an exclusive, worldwide license to commercialize the UCLA technology and create a diagnostic blood test for public use to screen for Alzheimer's risk.

"Early diagnosis is the cornerstone of preventive approaches to Alzheimer's disease," said Dr. Milan Fiala, lead author of the UCLA study and a researcher at the David Geffen School of Medicine at UCLA and the Veterans Affairs Greater Los Angeles Healthcare System. "We are pleased that the process we've identified using immune cells to help predict Alzheimer's risk will be further developed by MP Biomedicals."

"We are excited by the opportunity to forward the UCLA science in creating a cost-effective blood test to screen for Alzheimer's risk that could be used in any hospital or lab," said Milan Panic, CEO of MP Biomedicals.

Dr. Miodrag Micic, vice president of research and development for MP Biomedicals, noted that other blood tests for Alzheimer's diagnosis measure factors such as inflammation and infection, which are also present in other diseases like atheroclerosis and may complicate the interpretation of results.

The recently published study on the process identified by UCLA, which uses the "innate" immune system present at birth, appeared in the May issue of the Journal of Neuroimmunology.

In the study, researchers took blood samples and isolated monocytes, which from birth act as the immune system's janitors, traveling through the brain and body and gobbling up waste products — including amyloid beta. The monocytes were incubated overnight with amyloid beta, which was labeled with a fluorescent marker. Using a common laboratory method known as flow cytometry, researchers then measured the amount of amyloid beta ingested by the immune cells by assessing how much fluorescence was being emitted from each monocyte cell.

The 18 Alzheimer's disease patients in the study showed the least uptake of amyloid beta; the healthy control group, which consisted of 14 university professors, demonstrated the highest uptake. The method was able to distinguish with adequate sensitivity and specificity the Alzheimer's disease patients.

The results were found to be positive in 94 percent of the Alzheimer's patients and negative in 100 percent of the university professor control group. In addition, the results were found to be positive in 60 percent of study participants who suffered from mild cognitive impairment, a condition that increases the risk of developing Alzheimer's.

"Patients and control subjects were also tracked over time to see if their immune response changed," Fiala said. For example, an Alzheimer's disease patient over time showed declining results, while a university professor continued to demonstrate a high uptake of amyloid beta.

Micic noted that the new method could be a flag for further testing and interventions.

"Similar to screening patients for heart disease risk by a cholesterol test, a positive result for Alzheimer's risk in some patients may suggest further interventions and advanced diagnostics, such as a brain PET scan and neurocognitive testing."

The study was funded in part by MP Biomedicals LLC. Fiala is a consultant for the company and also served in the company's speakers bureau.

MP Biomedicals is a worldwide corporation with ISO-certified and FDA-approved manufacturing and distribution facilities throughout the globe. Headquartered in Southern California, the company manufactures and sells more than 55,000 products and is one of the only companies in the industry to offer a comprehensive line of life science, fine chemical and diagnostic products. MP Biomedicals is dedicated to giving scientists and researchers innovative, quality tools and superior service to aid them in their quest for groundbreaking discovery and turning the hope for life-changing solutions into a reality.

The David Geffen School of Medicine at UCLA, founded in 1951, is the youngest medical school to be ranked among the top 11 in the nation by U.S. News & World Report. The school has more than 2,000 full-time faculty members, including recipients of the Nobel Prize, the Pulitzer Prize and the National Medal of Science.

For more news, visit the UCLA Newsroom.

Children of undocumented parents may be at higher developmental risk

Mark Wheeler — Mon, 13 Jul 2009 16:10:00 GMT

Undocumented people live in a shadowy world of high fear and stress -- fear of deportation and stress brought on by a lack of economic, linguistic and educational resources.

And of course if they are parents their worries trickle down to their children. A new study from UCLA examines parents' concerns about development, learning and behavior for young children of Mexican origin and identifies whether these concerns differ by the families' citizenship or documentation status.

The study appears in the July-August issue of the journal Academic Pediatrics. It shows that, as reported by the parent, Mexican children with an undocumented parent have greater developmental risk than do Latino and white children whose parents are documented or who are U.S. citizens.

"In the United States, nearly 4.9 million or 25 percent of children younger than five years old are Latino, which makes them the largest group of young minority children," said Alexander Ortega, a professor of public health and a professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior. "That's huge. With Mexicans as the vast majority of Latino children — 64 percent — understanding their health, well-being and the development of Mexican children is critical, given future U.S. demographic changes."

He added that the concern "is there are a significant number of children with an undocumented parent whose developmental risks may be missed by the health care sector."

What's less clear, say the authors, is what's causing the concern. Few studies have examined the impact of immigration on children's development and behavior. Studies have identified that immigrant children tend to have more behavioral problems and learning difficulties in school, which may be attributable to immigration stress. Another study found that a majority of Mexican immigrant mothers perceived their children as having significant delays in language skills. These studies suggest that children who have immigrated, as well as U.S.-born children whose parents have immigrated, may have greater risk in early childhood, but until now little data have been available on how parent perceptions of developmental risk vary with immigration status.

The authors employed the California Health Interview Survey a population-based study of households drawn from every county in California that included Latino children and families, and information on the documentation status of the parents. The survey also included the Parents' Evaluation of Developmental Status (PEDS), which provides information on parents' perceptions of their children's development. Combined, the two reporting tools allowed the authors to examine the associations of family documentation and citizenship status on parents' reports of their children's development.

The sample included 5,856 children under the age of six; of that number, 1,786 had Mexican ancestry. The data were collected in English and Spanish. The response rate was 25 percent, which is consistent with those of general telephone surveys and similar to other recent major telephone health surveys nationwide.

The researchers found that Mexican children with an undocumented parent have higher odds of parent-reported developmental risk compared to white children or to Mexican children with parents who are citizens or otherwise legally authorized. Interestingly, said Ortega, it didn't appear that characteristics commonly associated with parent-reported developmental risk — household income, parent education and household language — fully explain the association between documentation status and developmental risk for Mexican children in the survey sample.

"From the survey, it's difficult to know the extent to which elevated reports of developmental problems for children with undocumented parents are due to actual differences in development versus an unmet need of parents," said Ortega. "In general, parents need reassurance from pediatric care providers about the typical development of their children. We know the undocumented have significant problems for access to healthcare, so parents may have certain expectations of development that are shaping their concerns," he said.

Timely access to primary care for young children can ameliorate parental worries or provide guidance on development-promoting activities. "The process of listening and responding to parent concerns is a major component of prevention within pediatrics," noted Ortega. Parents who are not receiving this regular reassurance may have more concerns about their kids' development, he said.

Further research is needed to understand which factors are contributing to the observations of the parents, he said. "Unmet physical and mental health needs among the undocumented parents themselves may shape their perceptions of concerns in their children," Ortega noted.

The study was supported by funding from the National Institute of Mental Health, and faculty start-up funding from the UCLA Chicano Studies Research Center. Other authors of the paper include Moira Inkelas, Alice A. Kuo and Steven P. Wallace, all of UCLA, Hai Fang from the University of Miami and Sarah M. Horwitz from Stanford University. The researchers report no conflict of interest.

For more news, see UCLA Newsroom.

UCLA faculty experts advisory: Illness prevention and health promotion

Minne Ho — Mon, 06 Jul 2009 18:51:24 GMT

In the current debate on health care reform, much of the focus has centered on expanding insurance coverage or improving medical care once illness has occurred. The UCLA Blue Sky Health Initiative, headed by a team of doctors, researchers, health care practitioners, business leaders, financiers and others in both the public and private sectors, proposes systemwide solutions designed to improve the health of society as a whole and make illness less common, less severe and less expensive to treat.

Neil Halfon is director of the Child and Family Health Program at UCLA, co-director of the federally funded Maternal and Child Health Policy Research Center and a member of the Child Health Consortium.

Arleen Leibowitz, professor of public policy, is an authority on the relationship among health care policy, economics and patient decisions.

Mark Peterson, professor of public policy and political science, has written extensively on congressional responses to presidential legislative initiatives and the ways in which presidents use their relationships with interest groups to promote their political and programmatic agendas.

Quick Facts:

· Nearly 46 million Americans lack health insurance, and 80 percent of them are in working families.

· In the next decade, health care inflation is expected to grow at an average annual rate of 6.9 percent, outpacing general inflation and economic growth.

· Each year, U.S. health care expenditures approach $2 trillion, far more per person than in Switzerland, Germany, Canada and France.

· Studies demonstrate that 54.9 percent of adults and 46.9 percent of children are not receiving the care recommended by national and professional standards and policies.

· The United States has the third-highest rate of diabetes, the third-highest rate of cardiovascular disease and the highest rate of obesity among Organisation for Economic Co-operation and Development nations.

· Among all nations in the world, the United States ranks 46th in life expectancy and 42^nd in infant mortality.

· A study by the Institute of Medicine concludes that nearly 100,000 Americans die each year from medical mistakes in hospitals.

For additional information

UCLA collaboration identifies immune system link to schizophrenia

Mark Wheeler — Wed, 01 Jul 2009 17:00:00 GMT

Schizophrenia is a devastating mental disease, thought to be caused by the interaction of both genetic and environmental factors. Because there is no biochemical test that can identify the disorder, physicians rely upon the recognition of its symptoms — which can include auditory hallucinations and paranoia — in order to make their diagnosis.

Now following on their earlier work that identified three gene locations that may be implicated in schizophrenia, researchers at UCLA and colleagues from around the world have, for the first time, identified additional genes that confirm what scientists have long suspected — that the immune system may play a role in the development of the disorder. Further, they have also identified genetic anomalies that disrupt the cellular pathways involved in brain development, memory and cognition, all markers of schizophrenia.

The research appears in the July 1 online edition of the journal Nature.

Roel Ophoff, the co-lead author and an assistant professor at the Center for Neurobehavioral Genetics at the UCLA Semel Institute for Neuroscience and Human Behavior, and his collaborators from nearly 50 institutions worldwide, performed a genome-wide scan of 2,663 people diagnosed with schizophrenia and 13,498 controls from eight European locations. They were looking for single nucleotide polymorphisms (SNP), genetic variations that are commonly present in the general population but more often present in those suffering from the disorder. In total, nearly 314,000 SNPs were included in their analysis.

They found significant associations with genetic markers on the Major Histocompatibility Complex (MHC), a group of genes that controls several aspects of the immune response. Further, they discovered additional variations in two other genes, called NRGN and TCF4, which points to perturbation of pathways involved in brain development, memory and cognition.

"This is another step forward in understanding the biological basis of this disorder, one that robs people of their lives," said Ophoff, who holds a joint appointment at the University of Utrecht, The Netherlands. "It also shows the importance of worldwide collaborations for the study of schizophrenia genetics, because it allows us to do very large numbers of scans."

The findings are significant yet not without challenge, said Ophoff, since the study aimed at the "common variants" in the human genome. "In other words," he said, "these are not rare mutations present in only a few individuals, but these genetic variants are abundantly present in the population. Anybody could carry this variant, but that doesn't mean they will necessarily develop the disease. Yet, when you look at the population at large, these variants are more often present in patients than in healthy control subjects."

And that’s important, he noted, in developing new techniques to thwart the disease. "Knowing these specific genes are involved in the pathway leading to schizophrenia provides unique clues as to which molecular mechanisms are involved," he said.

While the association between schizophrenia and the immune system has long been suspected, the evidence for it has, until now, been mostly circumstantial. And impaired cognitive and memory functions are increasingly being recognized as core features of schizophrenia, which are poorly addressed by current medications.

"The three common genetic variants we describe, then, which we feel predisposes certain individuals to schizophrenia, have the potential to be translated into targets for the development of new and novel medications," Ophoff said.

Some 40 other authors and institutions contributed to the paper, and there were multiple funding sources; for UCLA, funding was provided by the National Institute of Mental Health. Other UCLA authors included Dr. Nelson Freimer, director of the Center for Neurobehavioral Genetics and professor of psychiatry, and Rita Cantor, professor of human genetics, both members of the David Geffen School of Medicine. The UCLA authors report no conflicts of interest.

The Semel Institute for Neuroscience and Human Behavior is an interdisciplinary research and education institute devoted to the understanding of complex human behavior, including the genetic, biological, behavioral and sociocultural underpinnings of normal behavior, and the causes and consequences of neuropsychiatric disorders. In addition to conducting fundamental research, the institute faculty seeks to develop effective treatments for neurological and psychiatric disorders, improve access to mental health services and shape national health policy regarding neuropsychiatric disorders.

For more news, see UCLA Newsroom.

Conversing helps language development more than reading alone

Sarah Anderson — Mon, 29 Jun 2009 16:15:00 GMT

Adult-child conversations have a more significant impact on language development than exposing children to language through one-on-one reading alone, according to a new study in the July issue of Pediatrics, the journal of the American Academy of Pediatrics.

"Pediatricians and others have encouraged parents to provide language input through reading, storytelling and simple narration of daily events," explains study's lead author, Dr. Frederick J. Zimmerman, associate professor in the Department of Health Services in the UCLA School of Public Health. "Although sound advice, this form of input may not place enough emphasis on children's role in language-based exchanges and the importance of getting children to speak as much as possible."

The study of 275 families of children ages 0-4 was designed to test factors that contribute to language development of infants and toddlers. Participants' exposure to adult speech, child speech and television was measured using a small digital language recorder or processor known as the LENA System. This innovative technology allowed researchers to hear what was truly going on in a child's language environment, facilitating access to valuable new insights.

The study found that back-and-forth conversation was strongly associated with future improvements in the child's language score. Conversely, adult monologueing, such as monologic reading, was more weakly associated with language development. TV viewing had no effect on language development, positive or negative.

Zimmerman adds, "What's new here is the finding that the effect of adult-child conversations was roughly six times as potent at fostering good language development as adult speech input alone."

Each day, children hear an average of some 13,000 words spoken to them by adults and participate in about 400 conversational turns with adults. More conversations mean more opportunities for mistakes and therefore more opportunities for valuable corrections. Furthermore, they also provide an opportunity for children to practice new vocabulary.

Parents should be encouraged not only to provide language input to their children through reading or storytelling but also to engage their children in two-sided conversations, the study concludes.

"Talk is powerful, but what's even more powerful is engaging a child in meaningful interactions — the 'give and take' that is so important to the social, emotional and cognitive development of infants and toddlers," says Dr. Jill Gilkerson, language research director at LENA Foundation and a study co-author.

"It is not enough to speak to children," Zimmerman adds. "Parents should also engage them in conversation. Kids love to hear you speak, but they thrive on trying speech out for themselves. Give them a chance to say what's on their minds, even if it's 'goo goo gah.'"

For more news, see UCLA Newsroom.

Statement on the death of Michael Jackson at UCLA Medical Center

UCLA Newsroom — Fri, 26 Jun 2009 02:05:41 GMT

The family of Michael Jackson made this brief statement available on June 25 at Ronald Reagan UCLA Medical Center:

The legendary King of Pop, Michael Jackson, passed away on Thursday, June 25, 2009, at 2:26 p.m. It is believed he suffered cardiac arrest in his home. However, the cause of his death is unknown until results of the autopsy are known.

His personal physician, who was with him at the time, attempted to resuscitate Jackson, as did paramedics who transported him to Ronald Reagan UCLA Medical Center. Upon arriving at the hospital at approximately 1:14 p.m., a team of doctors, including emergency physicians and cardiologists, attempted to resuscitate him for a period of more than one hour but were unsuccessful.

Jackson’s family requests that the media respect their privacy during this tragic period of time.

Video: Jermaine Jackson reading statement and Michael Jackson's personal physician.

For more news, visit the UCLA Newsroom.

Remembering what to remember and what to forget

Stuart Wolpert — Thu, 25 Jun 2009 17:40:00 GMT

People in very early stages of Alzheimer’s disease already have trouble focusing on what is important to remember, a UCLA psychologist and colleagues report.

"One of the first telltale signs of Alzheimer’s disease may be not memory problems, but failure to control attention," said Alan Castel, UCLA assistant professor of psychology and lead author of the study.

The study consisted of three groups: 109 healthy older adults (68 of them female), with an average age of just under 75; 54 older adults (22 of them female) with very mild Alzheimer’s disease, who were functioning fine in their daily lives, with an average age of just under 76; and 35 young adults, with an average age of 19.

They were presented with eight lists of 12 words, one word at a time, each paired with a point value from 1 to 12. A new word with its value was presented on a screen every second. The words were common, like "table," "wallet" and "apple." They were given 30 seconds to recall the words, and were told to maximize their scores, by focusing on remembering the high-value words.

The young adults were selective, remembering more of the high-value words than the low-value words. They recalled an average of 5.7 words out of 12. The healthy older adults remembered fewer words, an average of 3.5, but were equally selective in recalling the high-value words.

"It’s not surprising that the older adults recalled fewer words," Castel said. "Memory capacity declines with age. However, the older adults were just as selective as the younger adults."

The people with very mild Alzheimer’s disease recalled an average of just 2.8 words and had some trouble in focusing on just the high-value words, recalling some lower-value words.

"They recall fewer words and their ability to be selective is worse," Castel said. "They understand that they should attend to the high-value words, but they can’t do it as well."

What are the implications of this study?

"Memory can be a limited resource," Castel said. "If we can recall only so much information, we need to be selective in old age. A trick for successful aging is to know what the important things are and to remember those things. Many older adults learn to be more selective because they know they can’t remember everything. The ability to be selective might decline when our attention is divided and in the early stages of Alzheimer’s disease."

Castel, who conducts research on human memory and aging, including how memory changes as we get older, suggests that older adults focus on fewer, important things.

"If you can remember only a few things before you travel, for example, you might want to remember to take your wallet, your plane ticket and your passport," he said. "If you forget your handkerchief and your comb, those aren’t so important."

Castel has conducted similar studies in which some words have negative point values; if you recall them, your score will decrease.

"Healthy older adults are good at not recalling them," he said. (He has not done that study with people in early stages of Alzheimer’s disease.)

If you don’t want to remember something, he said, the best thing to do is not to pay attention to it.

The research was published in the May issue of the journal Neuropsychology. It was federally funded by the National Institute on Aging, part of the National Institutes of Health. Co-authors are David Balota, professor of psychology and neurology at Washington University in St. Louis; and David McCabe, assistant professor of psychology at Colorado State University.

Castel, 33, follows his own advice.

"I can’t remember everything," he said. "I’m learning to be more strategic. I ask myself, what are the three most important things I need to do today. It’s about prioritizing."

UCLA is California's largest university, with an enrollment of nearly 38,000 undergraduate and graduate students. The UCLA College of Letters and Science and the university's 11 professional schools feature renowned faculty and offer more than 323 degree programs and majors. UCLA is a national and international leader in the breadth and quality of its academic, research, health care, cultural, continuing education and athletic programs. Four alumni and five faculty have been awarded the Nobel Prize.

For more news, visit the UCLA Newsroom.

UCLA study reveals how tiny levels of carbon monoxide could damage fetal brains

Elaine Schmidt — Thu, 25 Jun 2009 16:10:00 GMT

A UCLA study has discovered that chronic exposure during pregnancy to miniscule levels of carbon monoxide damages the cells of the fetal brain, resulting in permanent impairment. The journal BMC (BioMed Central ) Neuroscience published the findings June 22 in its online edition.

"We expected the placenta to protect fetuses from the mother’s exposure to tiny amounts of carbon monoxide,” said John Edmond, professor emeritus of biological chemistry at the David Geffen School of Medicine at UCLA. "But we found that not to be the case."

The researchers exposed pregnant rats to 25 parts per million carbon monoxide in the air, an exposure level established as safe by Cal/OSHA, California’s division of occupational health and safety.

Dr. Ivan Lopez, UCLA associate professor of head and neck surgery, tested the rats’ litters 20 days after birth. Rats born to animals who had inhaled the gas suffered chronic oxidative stress, a harmful condition caused by an excess of harmful free radicals or insufficient antioxidants.

"Oxidative stress damaged the baby rats’ brain cells, leading to a drop in proteins essential for proper function," said Lopez. "Oxidative stress is a risk factor linked to many disorders, including autism, cancer, Alzheimer’s, Parkinson’s, Lou Gehrig’s disease, multiple sclerosis and cardiovascular disease. We know that it exacerbates disease.”

"We believe that the minute levels of carbon monoxide in the mother rats’ environment made their offspring more vulnerable to illness," added Edmond. "Our findings highlight the need for policy makers to tighten their regulation of carbon monoxide."

Tobacco smoke, gas heaters, stoves and ovens all emit carbon monoxide, which can rise to high concentrations in well-insulated homes. Infants and children are particularly vulnerable to carbon monoxide exposure because they spend a great deal of time in the home.

No policies exist to regulate the gas in the home. Most commercial home monitors sound an alarm only hours after concentrations reaches 70 parts per million — nearly three times the 25 parts per million limit set by Cal/OSHA.

A grant from the University of California’s Tobacco-related Disease Research Program supported the research.

For more news, visit the UCLA Newsroom.

First direct visualization of memory formation in the brain

Mark Wheeler — Mon, 22 Jun 2009 23:25:00 GMT

FINDINGS:

UCLA and McGill University researchers have, for the first time, "photographed" a memory in the making. The study clarifies one of the ways in which connections in the brain between nerve cells, called synapses, can be changed with experience. The phenomenon is called "synaptic plasticity," and is the foundation for how we learn and remember. As we learn, the memories are stored in changes in the strength and/or number of synaptic connections between nerve cells in our brain. Long-lasting changes in synaptic connections are required for long-term memories. This is the first study to use fluorescent imaging to directly visualize protein synthesis — the making of a memory — at individual synapses during learning-related synaptic plasticity.

IMPACT:

Understanding how synapses can change with experience is critical to understanding behavioral plasticity and to understanding diseases in which learning and experience-dependent behaviors are impaired. Such diseases include mental retardation and Alzheimer's disease and anxiety and mood disorders. It also can elucidate potential strategies for improving normal cognition and behavioral plasticity.

JOURNAL:

The research appears in the June 19 edition of the journal Science.

AUTHORS:

Senior author Kelsey Martin, associate professor of psychiatry and biological chemistry; Dan Ohtan Wang, Sang Mok Kim, Yali Zhao, Hongik Hwang, Satoru K. Miura, all of UCLA; and Wayne S. Sossin, McGill University.

HOW:

The researchers used sensory and motor neurons from the sea slug Aplysia Californica that can form connections in culture. The neurons were stimulated with serotonin, which strengthens the synapses, and allowed them to detect new protein synthesis using a "translational reporter," a fluorescent protein that can be easily detected and tracked.

MORE:

This is the first study to directly visualize protein synthesis at individual synapses during a long-lasting form of synaptic plasticity. The studies revealed an exquisite level of control over the specificity of regulation of new protein synthesis. "While this was not really surprising to us given the complexity of information processing in the brain," said Martin, "visualizing the process of protein synthesis at individual synapses, and beginning to discern the elegance of its regulation, leaves us, as biologists, with a wonderful sense of awe."

FUNDING:

This study was funded by the National Institutes of Health, the W.M. Keck Foundation, and the Canadian Institutes of Health Research. The authors report no conflict of interest.

MEDIA CONTACT:

Mark Wheeler | 310-794-2265 | mwheeler@mednet.ucla.edu

Mattel Children's Hospital UCLA ranked among nation's best pediatric hospitals

Amy Albin — Fri, 19 Jun 2009 19:10:00 GMT

Mattel Children's Hospital UCLA ranks among the nation's top pediatric hospitals, according to the U.S. News Media Group's annual survey of the finest pediatric facilities in the United States.

The 2009 edition of "America's Best Children's Hospitals" is currently available online and will be published in the August issue of U.S. News & World Report, on newsstands July 21.

The survey is the most extensive listing of its kind and includes hospital rankings in 10 pediatric specialties. Nationally, Mattel Children's Hospital was recognized for excellence in nine of the 10 categories, including kidney disorders (ranked No. 3), digestive disorders (8), neurology and neurosurgery (12), heart and heart surgery (14), diabetes and endocrine disorders (15), urology (16), cancer (16), neonatal care (21), and orthopedics (26).

"By combining the overall scores of each category for all hospitals ranked in the survey, we also calculated that Mattel Children's Hospital UCLA ranked 12th in the nation and second in the state of California," said the hospital's physician-in-chief, Dr. Edward R.B. McCabe, who holds the Mattel Executive Endowed Chair in the UCLA Department of Pediatrics. "We are especially proud that two of our programs — kidney disorders and digestive disorders — were ranked the highest on the West Coast and our neurology and neurosurgery program was ranked the highest in the state. Great care is delivered to the children and families at Mattel Children's Hospital every day, and these rankings are a salute to our dedicated doctors, nurses and staff."

This year's rankings weighed a three-part blend of reputation, outcomes and care-related measures such as nursing care, advanced technology, credentialing and other factors. Hospitals were judged based on a combination of opinions from pediatric specialists about hospitals they would recommend for the sickest children and data gathered in a 65-page survey covering important hospital information, ranging from surgical death rates to whether pediatric anesthesiologists and other subspecialists are on staff. The U.S. News & World Report website offers a detailed description of the methodology.

Ranking-eligible facilities were largely drawn from two membership categories of the National Association of Children's Hospitals and Related Institutions (NACHRI): free-standing children's hospitals and large, multidisciplinary pediatric departments within medical centers. Several non-NACHRI members were added to the rankings because of known expertise or because they were recommended by experts. Of the 160 children's hospitals invited to complete the 65-page survey, 98 responded. The survey was created and administered by RTI International, which also collects the data and oversees the methodology for the annual "Best Hospitals" rankings in U.S. News & World Report.

"While they might be a small percentage of all hospital patients, a large number of children every year need high-quality hospital care," said U.S. News' health rankings editor Avery Comarow. "The objective of the 'Best Children's Hospitals' rankings is to help children with uniquely challenging medical needs, and for these special patients, it is essential they seek treatment at pediatric facilities with deep expertise. With this year's rankings, we are providing important information on the best of the best."

Mattel Children's Hospital UCLA, one of the highest-rated children's hospitals in California, is a vital component of Ronald Reagan UCLA Medical Center, ranked by U.S. News & World Report as the No. 3 hospital in nation and best in the Western United States. Mattel Children's Hospital offers a full spectrum of primary and specialized medical care for infants, children and adolescents. The hospital's mission is to provide state-of-the-art treatment for children in a compassionate atmosphere and to improve the understanding and treatment of pediatric diseases.

For more news, visit the UCLA Newsroom.

Alterations in brain's white matter key to schizophrenia, UCLA study shows

Mark Wheeler — Fri, 19 Jun 2009 18:01:25 GMT

Schizophrenia, a chronic and debilitating disorder marked in part by auditory hallucinations and paranoia, can strike in late adolescence or early adulthood at a time when people are ready to stand on their own two feet as fully independent adults.

Now scientists at UCLA think they are beginning to understand one important piece of this puzzle. In the first study of its kind, the researchers used a novel form of brain imaging to discover that white matter in the brains of adolescents at risk of developing schizophrenia does not develop at the same rate as healthy people. Further, the extent of these alterations can be used to predict how badly patients will or will not deteriorate functionally over time.

Reporting in the online edition of the journal Biological Psychiatry, lead author Katherine Karlsgodt, a postdoctoral fellow in UCLA's Department of Psychology, and senior authors Tyrone Cannon and Carrie Bearden, professors at the UCLA Semel Institute for Neuroscience and Human Behavior, focused on the brain's white matter — which forms the major connections between different brain regions — because it is known that white matter is disrupted in people who already have schizophrenia.

"We found that healthy subjects showed a normal and expected increase in measures indexing white matter integrity in the temporal lobe as they age," said Karlsgodt, "but young people at high-risk for psychosis showed no such increase — that is, they fail to show the normal developmental pattern."

While there is growing evidence that schizophrenics show changes in white matter, and there is increasing evidence that white matter connectivity may be highly relevant to the development of psychosis, there is very little known about how these changes arise, said Karlsgodt. Historically, looking at white matter has been hard to do. But in recent years, she said, researchers have begun to use a relatively new technique, diffusion tensor imaging (DTI) that uses the movement of water molecules along white matter tracts to map out the brain's pathways. In the last few years, these techniques have been applied to research schizophrenia and other disorders.

The researchers studied a control group of 25 healthy individuals and 36 teens and young adults, aged 12 to 26, at very high risk for developing schizophrenia, and followed them over a two-year period. The adolescents were identified as high risk due to genetic factors (i.e., being close relatives of someone with schizophrenia), or because they showed very early clinical symptoms of the disease. All of the subjects underwent a DTI scan at the start of the trial, along with clinical and functional assessments. Follow-up assessments of clinical and functional outcome were done at different periods over the next two years.

Failing to find a normal increase in white matter integrity over time in the at-risk subjects, said Karlsgodt, "suggests there is a fundamental difference in how typically developing young people and high-risk adolescents develop during this period right before the disease would be expected to manifest. Something may go awry with the developmental process during this period that might contribute to the onset of the disorder."

The other important finding, she said, was that by looking at white matter integrity in the temporal lobe at people's first appointment, "we could predict how well they would be functioning 15 months later at work, school and home.

"This is a very exciting finding, because it means we might be closer to being able to identify people who will need more or different treatments in the future, so that we can get them the help they need."

Research was carried out in the Clinical Neuroscience Lab of Tyrone D. Cannon of UCLA, with additional contribution from co-author Tara A. Niendam of the University of California, Davis. Research was supported by the National Institutes of Health, the National Alliance for Research on Schizophrenia and Affective Disorders, and a gift to UCLA by Garen and Shari Staglin. The authors reported no known biomedical financial interests or other potential conflicts of interest.

Karlsgodt, Bearden and Cannon are members of the Center for the Assessment and Prevention of Prodromal States (CAPPS) at the Semel Institute. CAPPS provides clinical, psychosocial and neuropsychological assessments, and psychological and psychiatric treatment. It also conducts other research aimed at early identification and prevention of these at-risk mental states.

The Semel Institute for Neuroscience and Human Behavior is a world-leading, interdisciplinary research and education institute devoted to the understanding of complex human behavior and the causes and consequences of neuropsychiatric disorders.

For more news, visit the UCLA Newsroom.

Research explores interactions between nanomaterials, biological systems

Jennifer Marcus — Fri, 19 Jun 2009 16:55:00 GMT

The recent explosion in the development of nanomaterials with enhanced performance characteristics for use in commercial and medical applications has increased the likelihood of people coming into direct contact with these materials.

There are currently more than 800 products on the market — including clothes, skin lotions and cleaning products — claiming to have at least one nanocomponent, and therapeutic nanocarriers have been designed for targeted drug delivery inside the human body. Human exposure to nanomaterials, which are smaller than one one-thousandth the diameter of a human hair, raises some important questions, including whether these "nano-bio" interactions could have adverse health effects.

Now, researchers at UCLA and the California NanoSystems Institute (CNSI), along with colleagues in academia and industry, have taken a proactive role in examining the current understanding of the nano-bio interface to identify the potential risks of engineered nanomaterials and to explore design methods that will lead to safer and more effective nanoparticles for use in a variety of treatments and products.

In a research review published in the July issue of the journal Nature Materials (and currently available online), the team provides a comprehensive overview of current knowledge on the physical and chemical properties of nanomaterials that allow them to undergo interactions with biological molecules and bioprocesses.

"What we have established here is a blueprint that will serve to educate the first generation of nanobiologists," said Dr. Andre Nel, leader of the team and chief of the division of nanomedicine at the David Geffen School of Medicine at UCLA and the California NanoSystems Institute.

Despite remarkable advances in nanoscience, relatively little is known about the intracellular activity and function of engineered nanomaterials, an area of study particularly important for the development of effective and safe nanoparticle drug-delivery systems. Much of the current knowledge derives from the study of tagged or labeled nanoparticles and their effects on cells after cellular uptake — without any detailed understanding of what these interactions may lead to, good or bad.

The review article examines the variety of ways in which nanomaterials interface with biological systems and presents a roadmap of the physical and chemical properties of the materials that could lead to potentially hazardous or advantageous interactions at the nano-bio interface. A better understanding of the biological impact, combined with appropriate stewardship, will allow for more informed decisions about design features for the safe use of nanotechnology.

In addition to Nel, the team included Tian Xia, a researcher in UCLA's nanomedicine division, UCLA associate professor of civil and environmental engineering Eric Hoek, Lutz Mädler of the University of Bremen, Darrell Velegol of Penn State University, Ponisseril Somasundaran of Columbia University, Fred Klessig of Pennsylvania Bio Systems, Vince Castranova of the National Institute for Occupational Safety and Health, and Mike Thompson of FEI Co.

"We are committed to ensuring that nanotechnology is introduced and implemented in a responsible and safe manner," said Nel, who also directs the Center for Environmental Implications of Nanotechnology, which is funded by the National Science Foundation and the Environmental Protection Agency and is headquartered at the CNSI.

"Based on our rapidly improving understanding of nano-bio interactions, we have done a thorough examination of the literature and our own research progress to identify measures that could be taken for safe design of nanomaterials," he said. "Not only will this improve the implementation and acceptance of this technology, but it will also provide the cornerstone of developing new and improved nanoscale therapeutic devices, such as drug-delivering nanoparticles."

The review article spotlighted several important research advancements:

A classification of the interactions when nanomaterials contact and bind to biological systems will help scientists understand how man-made materials may react when exposed to cells, tissues and various life forms in different natural environmental contexts.

When nanomaterials enter a biological fluid — for example, blood, plasma or interstitial fluid — the materials' surface may be coated with proteins. Understanding how these protein layers change the properties of the nanomaterials and the ways in which they interact in the body can provide valuable information on how to alter the protein coatings to allow for targeted delivery of nanomaterials to specific tissues, such as in cancer treatments.

Physicochemical properties such as size, charge, shape and other characteristics could greatly affect the ability of nanomaterials to enter a cell; this could determine whether a material can be useful in nanomedicine applications or could cause harm if taken in by life forms in an ecosystem or food chain.

Nanoparticles can elicit a wide range of intracellular responses, depending on their properties, concentrations and interactions with biological molecules. These properties and their relationships to cellular function can induce cellular damage or induce advantageous cellular responses, such as increased energy production and growth.

Based on the link between certain nanomaterial properties and potential toxic effects, the team asserts that scientists can reengineer specific nanomaterial properties that are hazardous while maintaining catalytically useful function for industrial use.

As an example of a safe design feature, some nanoparticles now receive a surface coating designed to improve safety by preventing bioreactivity. Nanoparticles in cosmetic formulations such as suntan lotions, for instance, may be coated with a water-repelling polymer to reduce direct contact with human skin. An extension of this principle uses polymers and detergents to decrease cellular uptake. However, there is the potential that when the coating wears off, the material may become hazardous. It is therefore important to consider improving the stability of coating substances. Coating nanoparticles with protective shells is also an effective means of preventing the breakup of materials that could release toxic substances upon dissolution.

"Instead of waiting for knowledge to unfold randomly, we can already begin to view the events at nano-bio interface as a discoverable scientific platform that can be used for setting up a deliberate inorganic-organic roadmap to new, better and safer products," Nel said. "What we can identify by understanding the rules that shape the nano-bio interface will have a massive impact on the ability to develop safe nanomaterials in the future."

The California NanoSystems Institute (CNSI) is an integrated research center operating jointly at UCLA and UC Santa Barbara whose mission is to foster interdisciplinary collaborations for discoveries in nanosystems and nanotechnology; train the next generation of scientists, educators and technology leaders; and facilitate partnerships with industry, fueling economic development and the social well-being of California, the United States and the world. The CNSI was established in 2000 with $100 million from the state of California and an additional $250 million in federal research grants and industry funding. At the institute, scientists in the areas of biology, chemistry, biochemistry, physics, mathematics, computational science and engineering are measuring, modifying and manipulating the building blocks of our world — atoms and molecules. These scientists benefit from an integrated laboratory culture enabling them to conduct dynamic research at the nanoscale, leading to significant breakthroughs in the areas of health, energy, the environment and information technology.

For more news, visit the UCLA Newsroom.

Long-term care costs exceed yearly income for many Calif. seniors living alone

Gwen Driscoll — Thu, 18 Jun 2009 16:00:00 GMT

(To see the data, visit www.healthpolicy.ucla.edu/news_06182009b.html.)

In Los Angeles County, being disabled can cost a year's income. That's because the annual cost of in-home care services for seniors living alone is now $319 more than this group's median income of $17,029.

Combine long-term care expenses with other basic expenses, such as food and rent, and a Los Angeles senior living alone will need twice the median income to survive, according to new data released today by the UCLA Center for Health Policy Research and the Insight Center for Community Economic Development.

In all 58 California counties, long-term health care is far out of reach for the state's most vulnerable citizens: seniors living alone who are disabled. Yet even as costs soar, Gov. Arnold Schwarzenegger has proposed the elimination of Medi-Cal–funded in-home supportive services for up to 400,000 seniors as a means of closing the state's budget gap.

"In all 58 counties, long-term care paired with basic living expenses exceeds median income," said Jenny Chung, attorney and program manager at the Insight Center. "Seniors can't afford care as it is. How are they going to cope with cuts?"

In 33 counties (57 percent of all California counties), the cost of long-term health care for elderly single women — who are more likely than men to use long-term care — exceeds the median income for single Californians aged 65 or older. In 38 counties (65.5 percent of all counties), the cost of long-term care combined with basic living expenses is at least two times the median income for this group. And in all 58 California counties, long-term care paired with basic living expenses far exceeds median income.

"When getting help at home costs a year's income, something's wrong," said Steven P. Wallace, associate director of the Center for Health Policy Research. "It means that extended families will be stretched thin to provide care or that the elderly will bankrupt themselves to pay for a service provider."

The new data provides county-by-county estimates of long-term care costs, as well as long-term care costs paired with basic living expenses. These basic living expenses are estimated using the Elder Economic Security Standard Index, or Elder Index, a tool that measures the actual costs of basic necessities for older adults in each of California's counties.

The researchers have created an accompanying table in which these costs are paired with median income — a measure of Social Security, pensions and other income for retired Californians age 65 and older who are living alone. The table, which can be sorted, can be accessed on the websites of the Center for Health Policy Research and the Insight Center.

Researchers found that the cost of a "medium" amount of long-term care — 16 hours a week — was often equal to or greater than the median income that single female seniors receive from Social Security, pensions and other sources.

When other basic living expenses were factored in, total costs nearly doubled or tripled.

Researchers used the "medium" level of long-term care as a measure because it is the most representative amount of care used by seniors in California. Female seniors living alone are the group most likely to need paid in-home assistance when they become disabled.

Approximately 973,000 California seniors live alone. Of these, 50 percent do not have enough income to meet basic expenses, as defined by the Elder Index.

Long-term care is not covered by most insurance policies. Only the lowest-income seniors in California can receive in-home care services through the state's Medi-Cal program. However, due to the state budget crisis, services for all but the most severely disabled may soon be cut.

"The only alternative, that no one wants, is going to a nursing home where Medi-Cal will eventually pick up the cost," Wallace said. "But Medi-Cal will only pay if a senior is extremely poor. Which means many seniors are caught in the middle — with too little money to afford in-home services and too much to qualify for a Medi-Cal nursing home."

Among the researchers' findings:

Contra Costa and San Francisco counties have the highest long-term care costs: $21,043 and $21,011, respectively. Yet the median income for single seniors living alone is $23,985 in Contra Costa County and $16,792 in San Francisco County.

The cost of long-term care paired with basic living expenses is highest in San Francisco and San Mateo counties: $48,446 and $48,441, respectively.

In 38 counties (65.5 percent of all counties), the cost of long-term care paired with basic living expenses is twice the median income. In at least one county, Alpine, these costs are three times the median income.

Orange County ranked the lowest of all 58 counties in terms of long-term care costs: $17,136. However, when long-term care costs are paired with basic living expenses, Orange County becomes one of the most expensive places for seniors. Long-term care costs plus basic living expenses are $42,603, raising Orange County to 11th out of 58 counties and illustrating the toll that rents and other necessities exact on seniors in expensive areas.

The Elder Economic Security Standard Index quantifies the actual costs of meeting basic necessities for older adults in each California county. The Elder Index is currently under consideration by the California Legislature as a planning tool for state aging-services programs. For more information on the Elder Standard Index, click here.

The Insight Center for Community Economic Development is a 40-year-old national research, consulting and legal organization dedicated to building economic health in vulnerable communities.

The UCLA Center for Health Policy Research is one of the nation's leading health policy research centers and the premier source of health-related information on Californians.

For more news, visit the UCLA Newsroom.

UCLA leads nation in protecting med students from drug industry influence

Elaine Schmidt — Wed, 17 Jun 2009 16:35:00 GMT

The David Geffen School of Medicine at UCLA is one of only nine medical schools out of 149 to earn an 'A' grade in a nationwide survey by the American Medical Students Association of educational policies governing students' contact with the pharmaceutical industry.

"We are proud to be in the top 6 percent of medical schools addressing this important issue," said Dr. Andrew Leuchter, associate dean of the Geffen School of Medicine. "It is crucial that our nation's physicians be trained to make decisions in the best interests of their patients, free of influence from private industry."

UCLA was one of the first U.S. medical schools to adopt tough industry-relations guidelines. In November 2006, UCLA prohibited all industry gifts to faculty, staff and students; banned industry advertising materials and sales calls in patient care areas; and limited the use of drug samples to circumstances in the best interests of patients, such as cases of financial need.

In July 2007, UCLA's guidelines were incorporated into the policy for the entire University of California system. In addition, UCLA now requires annual reporting by faculty members of all financial relationships with health care vendors.

Developed with the Pew Prescription Project, the 2009 scorecard (www.amsascorecard.org) evaluated each medical school's policies in 11 areas, including restrictions on gifts, free meals and drug samples; paid promotional presentations; interaction with sales representatives; and industry-funded education. The results provide a school-by-school analysis of policies that govern the pharmaceutical industry's interaction with faculty and students.

In addition to UCLA, top-ranked schools included Mount Sinai School of Medicine in New York; the University of Pittsburgh Medical Center; the University of Pennsylvania School of Medicine; the University of California, Davis, School of Medicine; the University of California, San Francisco, School of Medicine; the University of Texas Medical Branch at Galveston; Johns Hopkins School of Medicine; and the Mayo Medical School.

Pharmaceutical marketing to physicians has been estimated at up to $46 billion annually — roughly $35,000 per physician each year. These figures do not factor in promotion by the medical device industry. More than 100,000 pharmaceutical sales representatives visit U.S. doctors, often providing free lunches, gifts, drug samples and promotional medical literature.

The David Geffen School of Medicine tightly regulates interactions between private industry representatives and faculty, staff and students. For a detailed description of UCLA's industry-relations policies, see http://dgsom.healthsciences.ucla.edu/administration/guidelinesMain.

For more news, visit the UCLA Newsroom.

Study IDs protein assemblies that may be key factor in causing Alzheimer's

Mark Wheeler — Wed, 17 Jun 2009 00:10:00 GMT

FINDINGS:

Alzheimer's disease is the leading cause of late-life dementia. An increasing body of evidence has linked assemblies of a common peptide, the amyloid-β protein, to the disease. While plaques formed from large assemblies of this protein are known to be the eventual result of Alzheimer's, recent evidence suggests that small assemblies — or oligomers — of amyloid-β are the toxic agents responsible for the disease symptoms.

In this research, scientists used mass spectrometry to study the mixture of oligomers formed by the amyloid-β42 protein. While many types of amyloid-β assemblies have been described, the researchers found that oligomers made up of 12 units of amyloid-β42 appear to be a key neurotoxic agent in the development of Alzheimer's.

IMPACT:

Discovering the pathways of assembly may be critical in determining therapeutic targets for Alzheimer's. The identification of such a key, specific toxic assembly could pave the way for treatments that target the disease in the early stages of development.

AUTHOR:

UCLA neurology professor David Teplow, a member of the research team, is available for interviews.

JOURNAL:

The research appears online this week in the journal Nature Chemistry.

BACKGROUND:

The researchers used a technique known as electrospray-ionization ion-mobility mass spectrometry to study the mixture of oligomers formed by amyloid-β42 and some closely related proteins that do not result in disease. The technique allowed the team to observe both the mass and geometry of the oligomers formed.

FUNDING:

Funding from the National Institutes of Health, the National Science Foundation, the Alfred P. Sloan Foundation, the David and Lucile Packard Foundation, and the Biotechnology and Biological Sciences Research Council supported this work.

MEDIA CONTACT:

Mark Wheeler | 310-794-2265 | mwheeler@mednet.ucla.edu

Depression may increase Alzheimer's risk in people with memory problems

Mark Wheeler — Mon, 15 Jun 2009 20:00:00 GMT

People with memory problems who are depressed are more likely to develop Alzheimer's disease than those who aren't depressed, according to a new UCLA study.

Researchers also found, however, that the popular Alzheimer's drug donepezil may help delay the progression to Alzheimer's in depressed individuals who suffer from mild cognitive impairment or memory problems.

Mild cognitive impairment is the transition period between the cognitive decline of normal aging and Alzheimer's disease. People with mild cognitive impairment experience memory problems that are greater than expected from normal aging but do not show other symptoms of Alzheimer's, such as difficulties completing everyday activities.

The study appears in the June 16 issue of Neurology, the medical journal of the American Academy of Neurology.

The three-year study followed 756 people between the ages of 55 and 91 who had mild cognitive impairment. Of those, 208 were diagnosed with depression using a test that measures the severity and intensity of depressive symptoms. For every one-point increase on the test, a participant's risk of developing Alzheimer's went up by 3 percent.

"Our longer-term findings add to the body of evidence that suggests depression is a major risk factor for Alzheimer's disease," said Po H. Lu, an assistant professor of neurology and a member of the UCLA Mary S. Easton Center for Alzheimer's Disease Research. "Since the drug donepezil has been shown to improve the behavioral symptoms of Alzheimer's disease, our study also tested whether the drug would delay the progression to Alzheimer's disease in people with memory problems."

Study participants were given either vitamin E, donepezil or a placebo pill. Researchers found that among depressed people with mild cognitive impairment, 11 percent of those taking donepezil developed Alzheimer's disease at 1.7 years, compared with 25 percent of those who took vitamin E or the placebo. At 2.2 years, 14 percent of the donepezil group had developed Alzheimer's, compared with 29 percent of the vitamin E and placebo groups. Donepezil had little effect in the group of people who were not depressed.

"If we can delay the progression of this disease for even two years, it could significantly improve the quality of life for many people dealing with memory loss," Lu said.

Donepezil is not approved by the Food and Drug Administration for use in treating mild cognitive impairment. The drug is indicated for mild-to-moderate and severe Alzheimer's disease.

The study was supported by the National Institute on Aging, the Alzheimer's Association, an Alzheimer's Disease Cooperative Study grant, the Alzheimer's Disease Research Center, Jim Easton and the Sidell Kagan Foundation.

Other authors included J.L. Cummings, E. Teng and K. Tingus of UCLA; S.D. Edland of the University of California, San Diego; and R.C. Petersen of the Mayo Clinic College of Medicine.

Dr. Petersen has served as a paid consultant to GE Healthcare and has served on safety monitoring committees for Elan Pharmaceuticals and Wyeth; Dr. Cummings has served as a paid consultant to Abbott, Acadia, Accera, ADAMAS, Astellas, Avanir, Bristol-Myers Squibb, CoMentis, Eisai, En-Vivo, Forest, Janssen, Lilly, Lundbeck, Medivation, Merck, Merz, Myriad, Neuren, Novartis, Pfizer, Prana, Schering Plough, Sonexa, Takeda, Toyama and Wyeth.

The Mary S. Easton Center for Alzheimer's Disease Research is part of the UCLA Department of Neurology, which encompasses more than a dozen research, clinical and teaching programs. These programs cover brain mapping and neuroimaging, movement disorders, Alzheimer's disease and other dementias, multiple sclerosis, neurogenetics, nerve and muscle disorders, epilepsy, neuro-oncology, neurotology, neuropsychology, headaches and migraines, neurorehabilitation, and neurovascular disorders. The department has ranked No. 1 among its peers nationwide in National Institutes of Health funding for the last seven years (2002–08).

Two altruistic donors launch rare kidney transplant chains at UCLA

Enrique Rivero — Mon, 15 Jun 2009 19:00:00 GMT

One is a Michigan firefighter who wanted to honor the memory of his son, who died at age 24 in a tragic snowmobile accident. The other is an Air Force technical sergeant from Iowa who specializes in intelligence analysis. Besides their public service and Midwest origins, they have one other thing in common: They each donated a kidney to a complete stranger.

Harry Damon, the firefighter from Grand Rapids, Mich., and Nicole Lanstrum, who was born and raised in rural Iowa, initiated two kidney transplant chains last week at Ronald Reagan UCLA Medical Center that freed at least six kidney patients — four at UCLA and two in San Francisco — from lives on dialysis. And because their generosity helped initiate similar chains at other transplant centers, the lives of many others will be restored.

A "donor chain" creates opportunities for endless donor-recipient pairings. It starts with an altruistic donor — someone who wants to donate a kidney out of the goodness of his or her heart. That kidney is transplanted into a recipient who had a donor willing to give a kidney but whose kidney was not a match. To keep the chain going, the incompatible donor gives a kidney to another patient, unknown to him or her, who has been identified as a match, essentially "paying it forward." A specialized computer program matches donors and recipients across the country.

(View a video on these donor chains.)

Because kidneys can remain outside the body for 24 to 48 hours between removal and transplant, these chains enable donors to give kidneys to strangers of various races and ethnicities across the country.

Nearly 80,000 people are on the kidney transplant waiting list in the United States, according to the United Network for Organ Sharing. California alone has more than 16,000 people on the list.

These are the second and third chains at UCLA, which helped perform the first such transplant chain in the western United States in July 2008. The first chain in the United States was led by Dr. Michael Rees at the University of Toledo in Ohio. Overall, kidney transplant chains are rare.

To mark the generous organ donations from Damon and Lanstrum, the chains have been named the Nick Damon Transplant Chain, in honor of Harry Damon's deceased son, and the Service Before Self Transplant Chain, reflecting one of the three core values of the U.S. Air Force.

One transplant chain took place on Monday, June 8, and the second on Tuesday, June 9. The two chains will continue at California Pacific Medical Center in San Francisco and at the University of California, San Francisco, where still more renal failure patients will have life-changing transplants.

The donors and recipients from the UCLA chain met as a group for the first time June 15. Damon, whose son died three years ago, had been working with the National Kidney Registry to find someone who needed a kidney.

"For me, I'm doing this to have new beginnings in my own life," he said. "If I can help create new beginnings for someone else, it's all the better."

Damon was eventually matched with patient Sheila Whitney of Compton, Calif., who has been on dialysis for more than six years and whose son, Reginal Griffin, couldn't donate to his mother because she was highly sensitized — that is, she developed strong antibodies to her son's blood during her pregnancy, a common occurrence.

Reginal Griffin, a Long Beach, Calif., resident who is roughly the same age as Nick Damon was when the latter died, instead donated his kidney to Keenan Cheung, a father of three from La Canada, Calif., whose wife, Jeanne, has an incompatible blood type and was ruled out as a donor to her husband. With the gift from Reginal, Keenan ends four-and-a-half years of dialysis.

This gift freed Jeanne, who juggles family and a part-time job, to donate to Sonia Valencia, a resource teacher who lives in Commerce, Calif., and has been on dialysis for six years. Sonia was initially set to receive a kidney from her friend Celia Contreras, a kindergarten teacher from Pico Rivera, Calif., but they, too, had incompatible blood types.

As a result, Celia's "left-over" kidney went to California Pacific Medical Center to a recipient whose brother will then serve as the bridge donor kicking off another chain in a few weeks.

Nicole Lanstrum, whose gift initiated the June 9 chain, had wanted to donate a kidney since high school in Clarion, Iowa — just a few miles from her hometown of Dows — and had sought out the National Kidney Registry for this purpose.

Lanstrum, who has never known anyone on dialysis, is hoping that her donation will inspire others in the military to do the same.

"I just feel we're all put on this earth to make it better and no one has the same game plan," said Lanstrum, who is stationed in Tucson, Ariz. "I think this is something that God supports me in."

Lanstrum's kidney went to Valinda Jones, a registered nurse from Woodland Hills, Calif., who was to have received a donation from a friend in Indiana who is also a nurse and prefers to remain unnamed. That match didn't work out because of incompatibility.

The Indiana nurse's kidney was instead shipped to UCSF for transplantation into a woman whose sister will serve as the bridge to a new chain.

At the June 15 gathering, all the exchange donors received special lapel pins in an engraved box honoring them as "Everyday Heroes."

OneLegacy, a nonprofit organ and tissue recovery organization serving the greater Los Angeles area, facilitated the chains by coordinating interstate transport of the kidneys. As coordinators of transplants from deceased donors, organizations like OneLegacy very rarely participate in the living donation process, given that the latter are coordinated in-house by the transplant centers. However, with UCLA's living donor chains involving transplant centers in different cities, OneLegacy was asked to participate by Dr. Jeffrey Veale, director of the donor exchange program and assistant professor of urology at the David Geffen School of Medicine at UCLA.

OneLegacy ensured that operating room procedures were followed during the kidneys' packaging for transportation and that the surgeons at the receiving transplant centers hundreds of miles away knew the quality and characteristics of the kidneys on arrival. A courier was on hand outside the operating room to deliver the kidneys to the airport for transportation on a commercial airline.

"This is a procedure we do every day with deceased donors but seldom with living donors," said Thomas Mone, CEO and executive vice president of OneLegacy. "We applied the same high standards to make sure the donation chain is a success."

Veale had nothing but praise for Damon and Lanstrum, whose generosity is improving so many lives.

"About 30 to 40 percent of the people who have a willing living donor don't match that person," Veale said. "With this innovative program we can greatly expand the donor pool."

The National Kidney Registry is a nonprofit organization with the mission of saving and improving the lives of people facing kidney failure by increasing the quality, speed and number of living donor transplants in the world. The registry matches donors and recipients using a specialized computer program developed by businessman and registry founder Garet Hil. Hil started the registry when his youngest daughter needed a transplant and tests revealed that her body would have rejected his kidney, as well as kidneys from other donors.

The UCLA Kidney and Pancreas Transplant Program performed its first kidney transplant in 1957 and for the past 50 years has continued to be a national leader in both clinical research and academic excellence. UCLA is the second-largest kidney transplant program in the country and the largest in Southern California, performing hundreds of adult and pediatric transplants each year. The program has some of the best outcomes in the country, according to the Scientific Registry of Transplant Recipients, a national database of organ transplant statistics. UCLA's program has helped pioneer the use of minimally invasive laparoscopic surgery to remove kidneys from living donors.

For more news, visit the UCLA Newsroom.

New 'Idol' grabs spotlight: Study IDs enzyme that controls 'bad' cholesterol

Elaine Schmidt — Fri, 12 Jun 2009 18:50:00 GMT

UCLA scientists have discovered a new mechanism that controls cells' production of low-density lipoprotein (LDL), the so-called "bad" cholesterol that is often linked to medical problems like heart disease, stroke and clogged arteries.

In the body, cells in the liver produce a specific receptor that sticks to LDL and removes it from the blood, lowering cholesterol levels. Statin drugs also reduce LDL cholesterol levels by boosting cells' production of the receptor.

In research published in the June 11 online edition of the journal Science, the UCLA team used a mouse model to identify an enzyme called "Idol" that destroys the receptor, permitting more LDL cholesterol to circulate in the blood. By blocking Idol's activity, the researchers induced cells to produce more of the receptor and absorb more cholesterol from the body.

"We only know of three pathways that regulate the LDL receptor. The first two are already targeted by existing drugs," said principal investigator Dr. Peter Tontonoz, a professor of pathology and laboratory medicine at the David Geffen School of Medicine at UCLA and a Howard Hughes Medical Institute investigator. "Idol is the first mechanism discovered in several years that may lead to a new medication designed to control cholesterol levels."

The findings suggest that development of a drug that interferes with Idol's activity could influence cholesterol metabolism and lower levels of bad cholesterol. Doctors could prescribe the new medication in conjunction with statin drugs, which also cut cholesterol levels by targeting a different enzyme linked to the LDL receptor. This could benefit patients who cannot tolerate statin-related side effects.

Tontonoz collaborated with UCLA's Noam Zelcer, Cynthia Hong and Rima Boyadjian on the research, which was funded by the Howard Hughes Medical Institute and the National Heart, Lung and Blood Institute.

The university has filed a patent related to the research findings.

For more news, visit the UCLA Newsroom.

Leading UCLA researchers present latest findings on aging, age-related issues

Rachel Champeau — Thu, 11 Jun 2009 23:20:00 GMT

WHAT:

At a special conference sponsored by the UCLA Center on Aging and the UCLA Multicampus Program in Geriatric Medicine and Gerontology, UCLA researchers will present their latest findings on age-related issues, including Alzheimer's disease, diet and nutrition, exercise, breast cancer, fall-prevention, dementia, and much more. For information and a full program schedule, visit www.aging.ucla.edu/AnnResearchCon2007.html.

WHO:

Speakers: Lynn Daucher, the director of the California Department of Aging will deliver the conference's keynote address, "Research Network to Aging Network." Other conference speakers include:

Lynn Vavreck, UCLA assistant professor of political science: "Ageism in the 2008 Election"
Steven Clarke, UCLA professor of chemistry and biochemistry: "Strategies for Stopping Aging Chemistry in Its Tracks"
Lene Levy Storms, UCLA associate professor of social welfare: "Teaching Good Bedside Manners to Nursing Home Staff"

Panel: The conference's panel, "Nutrition and Aging: Fact vs. Fiction," will include the following participants:

Zhaoping Li (moderator), UCLA professor of clinical medicine
Catherine F. Clarke, UCLA professor of chemistry and biochemistry
Sally Frautschy, UCLA associate professor-in-residence of medicine
Fernando Gomez-Pinilla, UCLA professor of physiological science
Stephen R. Spindler, UC Riverside professor of biochemistry

WHEN:

8 a.m.–12:30 p.m., Tuesday, June 16

8 a.m.: Registration
8:20–9 a.m.: Poster session
9–10:15 a.m.: Program speakers (Vavreck, Clarke, Levy-Storms)
10:15–11 a.m.: Poster session
11–11:40 a.m.: Panel discussion
11:40 a.m.–12:30 p.m.: Keynote speaker Lynn Daucher

WHERE:

UCLA Faculty Center (map)

MEDIA CONTACT:

Rachel Champeau, UCLA Health Sciences Media Relations, 310-794-0777

PARKING:

For parking, enter the campus on Westholme Avenue, just off of Hilgard Avenue. The parking kiosk will have parking information.

Air pollution from freeway extends further than previously thought

Sarah Anderson — Wed, 10 Jun 2009 16:15:00 GMT

Environmental health researchers from UCLA, the University of Southern California and the California Air Resources Board have found that during the hours before sunrise, freeway air pollution extends much further than previously thought.

Air pollutants from Interstate 10 in Santa Monica extend as far as 2,500 meters — more than 1.5 miles — downwind, based on recent measurements from a research team headed by Dr. Arthur Winer, a professor of environmental health sciences at the UCLA School of Public Health. This distance is 10 times greater than previously measured daytime pollutant impacts from roadways and has significant exposure implications, since most people are in their homes during the hours before sunrise and outdoor pollutants penetrate into indoor environments.

The study was published last month in the journal Atmospheric Environment, with Dr. Shishan Hu, a postdoctoral scholar at the UCLA School of Public Health, as lead author.

"To measure the pollution levels, we equipped an electric vehicle with no emissions of its own with fast-response instruments for gaseous and particulate air pollutants, a GPS and video monitor, and instruments to measure temperature and winds," Winer said. "In both winter and summer of 2008, we drove toward and away from Interstate 10 on a route perpendicular to the freeway in Santa Monica between the hours of 4 a.m. and 7 a.m."

A second striking finding of the study was that although traffic volumes are lower in the pre-sunrise hours, the air pollution concentrations measured by the team were higher than even those during daytime traffic congestion peaks. Concentrations are higher before sunrise even though emissions are lower because of the unique weather conditions. In the pre-sunrise hours, wind speeds are generally very low, and while the wind direction is somewhat variable, the predominant direction is from the northeast in the winter months and the northwest in the summer months.

This means that areas south of Interstate 10 are generally downwind in the pre-sunrise hours and areas north of the freeway are generally upwind; this is consistent with the observation that vehicle-related pollutants are found much further from the freeway on the south side in the pre-sunrise hours, compared with the north side.

"Our research shows that under the low wind speeds and shallow temperature inversions during the early morning, before sunrise, air pollution from freeways is trapped near the surface, limiting dilution and creating a zone of influence many times greater than during the day," said Dr. Suzanne Paulson, a professor in the UCLA Department of Atmospheric and Oceanic Sciences and a co-principal investigator of the study. "These meteorological conditions are very common in the hours before sunrise."

In comparing the winter and summer early mornings, researchers found much higher levels of air pollution in the winter.

"This is because the sun rises later in the winter, so the early morning period captures more of the early morning rush hour," Paulsen said.

"Our findings confirm previous work showing peak levels of ultrafine particles (UFP) immediately adjacent to the freeway, but we found high concentrations persisted for up to 1.5 miles downwind of the freeway during the pre-sunrise hours," said Dr. Scott Fruin of the USC Keck School of Medicine. "Elevated UFP concentrations also extended up to 600 meters upwind of the freeway, another strong difference from daytime observations, which typically show little or no vehicle-related pollution directly upwind from freeways."

In the present study, other pollutants, including nitric oxide and particle-bound polycyclic aromatic hydrocarbons, also extended far from the freeway during the pre-sunrise hours.

Other members of the research team included Dr. Kathleen Kozawa and Steve Mara of the California Air Resources Board, which sponsored the study.

"The study raises more questions about the significant health outcomes caused or exacerbated by freeway traffic," Winer said.

Numerous epidemiologic studies have already shown that traffic-related pollution is linked to increased risk of asthma, respiratory illness, cardiovascular disease and premature mortality.

The researchers recommend that residents living near freeways should consider keeping their windows closed at night and minimize outdoor exercise near major roadways in the hours before sunrise.

For more news, visit the UCLA Newsroom.

UCLA named state lead center in new effort to combat pediatric brain injury

Mark Wheeler — Wed, 10 Jun 2009 00:00:00 GMT

The UCLA Brain Injury Research Center, together with Mattel Children's Hospital UCLA, will serve as California's lead center for research on pediatric brain injuries as part of a new national network announced June 5 in Washington, D.C.

In what is being called one of the largest collaborative efforts in pediatric medicine, UCLA will join with 51 other health care institutions representing states across the country to address issues related to the treatment of brain injury, the number one cause of death and disability in children and young adults in the United States.

The collaboration is the work of the Sarah Jane Brain Project, a nonprofit organization founded in 2007 by Patrick Donohue, whose baby daughter was shaken so hard by a caregiver that she suffered a severe brain injury.

In January, more than 60 of the top pediatric neurologists in the country, including UCLA's Dr. Christopher Giza, came together to draft the National Pediatric Acquired Brain Injury Plan, which called for the development of a national collaborative network to address the issue.

Member centers in the new network will share information and research findings on pediatric brain injuries in an effort to establish a standardized national medical plan for dealing with these injuries. As a state lead center, UCLA will be responsible for developing a master plan of care for children and young adults with brain injuries in California.

"We are so honored to have UCLA's Mattel Children's Hospital as the state lead center for California and as part of this national network of the best health care institutions in the country," Donohue said.

"It is shocking to realize that despite brain injury being the leading killer and disabler of our children, nothing has ever before been done to develop a nationally standardized medical, or even an educational, plan to address it," Donohue added. "Very little public awareness exists of pediatric brain injury."

"We are proud to be given this designation by the Sarah Jane Brain Project and to be affiliated with the foundation," said Giza, an associate professor of neurosurgery and pediatric neurology and a member of the Sarah Jane Brain Project's medical advisory board. "Most disorders of the brain, whether multiple sclerosis, Alzheimer's or autism, have strong and vocal advocacy groups. But traumatic brain injury remains a silent epidemic, affecting over 1.5 million people each year in the U.S. So I applaud the foundation for becoming a strong voice for research into pediatric brain injury and for being the driving force behind this plan."

It is estimated that the National Pediatric Acquired Brain Injury Plan will cost $125 million annually to implement across the country. The plan will address all important aspects of brain injuries and brain injury treatment, including prevention, acute care, rehabilitation, adult transition, rural/telehealth and mild traumatic brain injury.

The UCLA Department of Neurosurgery is committed to providing excellence in leadership in the major disciplines of neurosurgery. Centers of Excellence in neurosurgery have been established at UCLA in brain injury, brain tumors, epilepsy surgery, neurovascular surgery, pediatric neurosurgery, spinal and peripheral nerve surgery, and stereotactic and functional neurosurgery. Other departmental programs in development include neuroendoscopy, hydrocephalus, interventional MR surgery and neurological critical care.

Mattel Children's Hospital UCLA is a vital part of Ronald Reagan UCLA Medical Center, which is consistently ranked the best hospital in the western United States by U.S. News & World Report. Mattel hospital offers a full spectrum of primary and specialized medical care for infants, children and adolescents, with the mission of providing state-of-the-art treatment for children in a compassionate atmosphere, as well as improving the understanding and treatment of pediatric diseases.

For more news, visit the UCLA Newsroom.

Run-walk event to benefit pediatric cancer program at UCLA

Amy Albin — Mon, 08 Jun 2009 19:55:00 GMT

WHAT:

The San Fernando Valley Bruins are marking Father's Day a week early this year with the annual Dad's Day Dash, a run/walk event in which all proceeds go to benefit the pediatric cancer program at Mattel Children's Hospital UCLA. The dash will feature a 5K and 10K run/walk and a 1K "fun run" for kids. The event is presented in conjunction with the Optimist clubs of the San Fernando Valley and Westwood/UCLA Hospital.

WHEN:

7:30 a.m., Saturday, June 13

WHERE:

Warner Center Park, 21820 Califa Ave., Woodland Hills, Calif. 91367

INFORMATION:

For more information, to register, or to make a donation, visit www.w2promotions.com.

BACKGROUND:

The pediatric cancer program at Mattel Children's Hospital UCLA is ranked among the nation's best by U.S. News & World Report. In addition to providing ongoing treatment and support for young cancer patients and their families, program physicians are involved in cutting-edge research to find new ways to treat pediatric cancers. Mattel Children's Hospital UCLA, a vital component of UCLA Medical Center, offers a full spectrum of primary and specialized medical care for infants, children and adolescents. The hospital's mission is to provide state-of-the-art treatment for children in a compassionate atmosphere and to improve the understanding and treatment of pediatric diseases.

MEDIA CONTACT:

Fay Bevans, San Fernando Valley Bruins, fbevans@conet.ucla.edu

UCLA neurosurgeons discuss new trends in treatment of traumatic head injury

Mark Wheeler — Wed, 03 Jun 2009 22:40:00 GMT

WHAT:

Researchers from the UCLA Brain Injury Research Center (BIRC) will discuss their latest research and insights into the treatment of traumatic brain injury, focusing on three specific groups: professional athletes, active-duty military personnel, and children and teenagers. The event will include representatives from the U.S. Department of Defense and the World Boxing Council.

Treating brain injuries quickly and effectively can mean the difference between recovery and death or permanent disability. While physicians have long believed that the injured brain lies in a docile state and requires very little energy for recovery, UCLA researchers have found that recovery requires significant amounts of "fuel." Determining what type of fuel — glucose, pyruvate, lactate, ketones or other naturally occurring compounds — works best in which patients is the next step, and the BIRC has been awarded a prestigious grant from the National Institutes of Health to pursue this research on optimal treatments.

WHO:

Participants will include:

Dr. Neil Martin, M.D.

Chair of the UCLA Department of Neurosurgery and co-director of the UCLA Stroke Center

David Hovda, Ph.D.

Director of the UCLA Brain Injury Research Center and professor of neurosurgery

WHEN:

5 p.m., Monday, June 8

WHERE:

Ronald Reagan UCLA Medical Center (B-Level), 757 Westwood Blvd., Los Angeles 90095 (map)

BACKGROUND:

Each year, some 1.5 million Americans suffer traumatic brain injuries (TBI) — more than are stricken annually by breast and pediatric cancers, Alzheimer's and Parkinson's diseases, HIV/AIDS, and West Nile Virus combined. Despite the numbers, and the trauma and deaths such injuries cause, TBI has received comparatively little media coverage and research funding.

MEDIA CONTACT:

Mark Wheeler, Health Sciences Media Relations, 310-794-2265

mwheeler@mednet.ucla.edu

PARKING:

Press should call media contact to arrange parking.

Could standard treatment for traumatic brain injury be wrong?

Mark Wheeler — Tue, 02 Jun 2009 21:25:00 GMT

Traumatic brain injury — not heart disease, stroke or cancer — is the number one cause of death and disability in people under 45. Each year, some 1.5 million Americans, including soldiers, athletes, the elderly and children, sustain head injuries, and nearly half of them will be hospitalized and treated in an emergency room or intensive care unit.

But what if they are treated incorrectly?

The Brain Injury Research Center (BIRC) in the UCLA Department of Neurosurgery has been awarded a $4.2 million grant from the National Institutes of Health to research new ways to heal the brain after a traumatic brain injury, or TBI. Specifically, researchers will be looking at how to best feed the brain the nutrients it needs to optimize recovery.

The standard thinking for many years has been that after a TBI, the brain lies in a docile state or coma and thus requires very little energy. But research from the BIRC now shows that the brain's response to trauma requires enormous amounts of energy.

"Many patients with a traumatic brain injury exhibit hyperglycemia — high blood sugar — by the time they arrive in the ER," said David Hovda, professor of neurosurgery and director of the BIRC. "So the standard protocol was to give the patient insulin to tightly control the levels of glucose that would take them to normal. For many regions of the injured brain, this may be the wrong thing to do."

In fact, the brain needs fuel to initiate the healing process — and not just glucose, Hovda suspects. Because they have found that the way glucose is used by the brain changes after a TBI, researchers believe other naturally used compounds, including pyruvate, beta-hydroxybutyrate, lactate and ketones, should be considered in treatment. Hovda and his colleagues think that each of these fuels may serve a different purpose, depending on the severity of the injury and whether the injured individual is an adult or adolescent. The goal, therefore, is to identify the optimal brain fuels for different age groups that will improve recovery.

"Our work is challenging because we're questioning a standard protocol," said Dr. Christopher Giza, UCLA associate professor of neurosurgery and a co-investigator on the NIH grant. "If the brain is actually asking for fuel (glucose), that means that after trauma, Mother Nature is shifting gears and changing the chemistry of the brain. These concepts and constructs are what we're going to be examining closely."

"The majority of head injuries are called mild traumatic brain injuries," Hovda said. "But what we've discovered is the path of physiological consequences measured in severe head injuries also occurs in mild traumatic head injuries as well. So this research might just change what's put in the IV bag at the onset of treatment."

Over the past 20 years, there have been more than 75 clinical trials for traumatic brain injury, but none have resulted in a standard treatment for TBI. The current grant will have both a research and a clinical component: The research will look at the use of alternative fuels and how these fuels enter the brain and contribute to the healing process, while the clinical aspect will test alternative fuels and examine the possible threat to recovery after TBI when hyperglycemia is stopped.

Interest in continuing research on head trauma recovery is widespread and is supported by, among others, Major League Baseball, the National Football League, the World Boxing Council and the U.S. Department of Defense.

"We wish there was a cure for TBI," Hovda said. "But for now all that's available is rehabilitation therapy. Patients diagnosed with epilepsy or depression have medications that may help. But as of now there is no cocktail remedy for TBI. Our hope is to change that."

The UCLA Brain Injury Research Center maintains a comprehensive basic and clinical scientific program in the field of traumatic brain injury. Its scientists conduct research into imaging, neurophysiology, molecular biology, modeling, and behavioral neuroscience in order to apply this knowledge toward understanding the neurobiology of human TBI.

For more news, visit the UCLA Newsroom.

Even with no treatment available, cancer patients want to know metastasis risk

Elaine Schmidt — Mon, 01 Jun 2009 22:00:00 GMT

If you had cancer and a genetic test could predict the risk of the tumor spreading aggressively, would you want to know — even if no treatments existed to help you?

An overwhelming majority of eye cancer patients would, according to a new UCLA study published in the June edition of the Journal of Genetic Counseling.

"Our goal was to explore what people with cancer want," said Dr. Tara McCannel, director of the Ophthalmic Oncology Center at UCLA's Jules Stein Eye Institute and a researcher at UCLA's Jonsson Comprehensive Cancer Center. "We learned that patients want to know their prognosis, good or bad, even when there are no treatments at present for their condition."

The UCLA study surveyed 99 patients who had been diagnosed with ocular melanoma, which develops in the pigmented layers under the retina. Half the patients had undergone localized radiation to shrink the tumor. The rest of the group also underwent radiation but first had cells from their tumors biopsied. These cells were grown in culture and studied for a missing copy of chromosome 3 — the genetic marker most strongly linked to rapid metastatic disease.

Patients whose tumors contain the genetic marker have at least a 50 percent chance of death within five years, due to swift spreading of the tumor to the liver and other organs. Aggressive cases can result in blindness and death in as little as a year.

In the UCLA study, all the patients were asked to evaluate their interest in receiving genetic testing results related to prognosis. Of the 99 patients, 98 responded that they would have wanted predictive testing at the time of their treatment; only one would have declined.

Additionally, 98 percent of the respondents stated that supportive counseling should be offered when patients receive their test results.

"We were surprised to see such a unanimous response," McCannel said. "We expected some patients would prefer not to know, but the numbers consistently said otherwise."

"People understand that no good treatment currently exists after their cancer spreads. Everyone wants to know what their risk is for metastasis," said co-author Annette Stanton, a UCLA professor of psychology, psychiatry and biobehavioral sciences. "If the risk is low, it's a huge relief and emotional burden off patients' shoulders. If the risk is high, it enables patients to plan arrangements for their family and finances and make the most of their time alive."

The UCLA survey also measured quality of life and depression symptoms in patients who received genetic test results and compared their rankings to those of untested patients.

"Regardless of their test result, all of the patients rated themselves about the same in terms of quality of life and emotional well-being," Stanton said. "We hope that these findings reduce clinical resistance and pave the way for prognostic testing to become the standard of care in the management of ocular melanoma."

"The issue of genetic testing has been a huge source of clinical controversy," McCannel said. "People want information; they have a lot of things they still want to do in life. Knowing their prognosis offers a tool that helps them plan their lives. Our research demonstrates that it's valuable to give people these details, even when their disease is not presently treatable."

"Our results emphasize how important it is for patients to be treated in a full-service hospital research center that offers genetic testing and counseling and treats the whole patient, not just their disease," said Stanton, who is also a member of UCLA's Jonsson Cancer Center.

Tumor biopsy also helps researchers search for key genes that play a role in aggressive metastasis, improving clinicians' ability to provide the best care.

"After analyzing the tumor specimens, we grow the biopsied cells in a culture dish and can add drugs to test which ones block cancer growth," McCannel said. "That is how we're going to beat this cancer. Developing drugs to target these genes will one day result in therapies and a cure."

The technique of fine-needle aspiration biopsy for collecting cancer cells from the living eye has been utilized at the Jules Stein Eye Institute since 2004 but has been adopted by only a handful of other ophthalmic centers in the nation.

Although rare, ocular melanoma is the most common eye cancer to strike adults. The National Eye Institute reports some 2,000 newly diagnosed cases of the cancer — roughly seven in 1 million people — per year. The disease spans the age and ethnic spectrum and is not hereditary.

The study's UCLA co-authors included first author Tammy Beran, Dr. Bradley Straatsma and Barry Burgess. The research was supported by funding from UCLA's Jonsson Comprehensive Cancer Center.

For more news, visit the UCLA Newsroom.

Dental paradox: Calif. has most dentists, yet shortages exist in certain locations

Gwen Driscoll — Thu, 28 May 2009 16:00:00 GMT

Drive the length of Alpine County in northeastern California and you will see snow-covered peaks, alpine meadows and verdant forests. What you won't see: a dentist.

Alpine County has no actively practicing dentists. In San Benito and Inyo counties, there is one dentist for every 5,000 residents. Imperial and Colusa counties have one for every 4,000 residents.

In contrast, San Francisco County has 6.1 licensed dentists for every 5,000 residents, and neighboring Placer County and Marin County have 5.2 and 5.0 per 5,000, respectively.

The differences demonstrate that "if you don't live in a city or a major urban area, you may have a long drive to treat a toothache," said Nadereh Pourat, director of research planning at the UCLA Center for Health Policy Research and the author of a new fact sheet on dentists in California, "Distribution and Characteristics of Dentists Licensed to Practice in California, 2008."

The fact sheet quantifies the number of dentists statewide and in each county, as well as the proportion of dentists to residents and the number of areas where shortages of dentists exist.

Pourat found that California has nearly 32,000 licensed dentists, or approximately 14 percent of the total number of dentists nationwide — the largest percentage of any state.

California also has 233 dental health professional shortage areas (DHPSAs). These are smaller areas within counties that have a dentist-to-population ratio of one-to-5,000 or less, or that have a population with unusually high needs or insufficient capacity for care among existing dentists.

"There's a lot of demand and not a lot of dentists," Pourat said. "And if you have to travel an hour to see a dentist, that's a serious obstacle to care."

Shortage areas are further challenged by a growing wave of retirement-age dentists. Statewide, only 15 percent of active dentists received their license within the past five years, while 20 percent have been licensed for 30 or more years.

Among the other findings:

Los Angeles County has the largest total number of licensed dentists, with 7,854, but also the largest number of dental health professional shortage areas, with 37.

Dentists in rural counties more often divide their time between multiple locations. This may mean longer wait times to see the dentist in some areas.

Many rural areas do not have access to dental care provided in publicly funded community clinics. In those areas, free or low-cost dental care may not be available.

45 percent of newly licensed dentists are female. This is a significant change in dentist demographics: Only 4 percent of dentists nearing retirement are female.

Funding for this fact sheet was provided by the California HealthCare Foundation, an independent philanthropy committed to improving the way health care is delivered and financed in California.

The UCLA Center for Health Policy Research is one of the nation's leading health policy research centers and the premier source of health-related information on Californians.

For more news, visit the UCLA Newsroom.

Menopause transition may cause trouble learning

Enrique Rivero — Wed, 27 May 2009 16:10:00 GMT

The largest study of its kind to date shows that women may not be able to learn as well shortly before menopause, compared with other stages in their lives.

The research was published in the May 26 print issue of Neurology, the medical journal of the American Academy of Neurology.

Over four years, the researchers studied 2,362 women who were between the ages of 42 and 52 and had had at least one menstrual period in the three months before the study started.

The women were given three tests: verbal memory, working memory and a test that measured the speed at which they processed information. Scientists tested the women throughout the four stages of the menopause transition: premenopause (no change in menstrual periods), early perimenopause (menstrual irregularity but no gaps of three months), late perimenopause (having no period for three to 11 months) and postmenopause (no period for 12 months).

The researchers found that processing speed improved with repeated testing during premenopause, early perimenopause and postmenopause, but that scores during late perimenopause did not show the same degree of improvement. Improvements in processing speed during late perimenopause were only 28 percent as large as improvements observed in premenopause.

For verbal memory performance, improvement was not as strong during early and late perimenopause, compared with premenopause. Improvements in verbal memory during early perimenopause were 29 percent as large as improvements observed in premenopause. During late perimenopause, verbal memory improvement was 7 percent as large as in premenopause.

Combined, these findings suggest that during the early and late perimenopause, women do not learn as well as they do during other menopausal transition stages.

"These perimenopausal test results concur with prior self-reported memory difficulties — 60 percent of women state that they have memory problems during the menopause transition," said Dr. Gail Greendale, a professor of medicine in the division of geriatrics at the David Geffen School of Medicine at UCLA and the study's primary investigator. "The good news is that the effect of perimenopause on learning seems to be temporary. Our study found that the amount of learning improved back to premenopausal levels during the postmenopausal stage."

The study also found that taking estrogen or progesterone hormones before menopause helped verbal memory and processing speed. In contrast, taking these hormones after the final menstrual period had a negative effect: Postmenopausal women using hormones showed no improvement in either processing speed or verbal memory, unlike postmenopausal women not taking hormones.

"Our results suggest that the 'critical period' for estrogen or progesterone's benefits on the brain may be prior to menopause, but the findings should be interpreted with caution," Greendale said.

Other researchers on this study were M.-H. Huang, R.G. Wight, T. Seeman and A.S. Karlamangla of UCLA; C. Luetters of the University of California, Irvine; N.E. Avis of Wake Forest University; and J. Johnston of the Alaska Native Tribal Health Consortium.

The National Institutes of Health (NIH), the National Institute on Aging, the National Institute of Nursing Research and the NIH Office of Research on Women's Health supported the study.

The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. Neurologists have undergone specialized training in diagnosing, treating and managing disorders of the brain and nervous system, such as multiple sclerosis, Alzheimer's disease, narcolepsy and stroke.

Chancellor Block 'greatly concerned' about budget deficit

Office of Media Relations — Wed, 27 May 2009 00:07:22 GMT

This is a statement from UCLA Chancellor Gene Block released May 26, regarding the campus budget.

To the Campus Community:

In the wake of last Tuesday's election, we are all greatly concerned about the budget deficit and its impact on the University of California and UCLA. You may have read that the state Legislative Analyst's Office has increased, yet again, the projected budget shortfall — from $21 billion, contemplated at the time of last Tuesday's election, to $24 billion.

There will be three levels of decision-making in the coming months that affect the severity and nature of cuts to the university: state government (legislature and governor), UC system (President Yudof and the Regents) and UCLA. We do know that the cuts will be severe, and there is no question that we are facing difficult and painful choices.

We are in no position at this time, however, to predict the level and extent of cuts to the university that may impact our current planning levels. Right now, I encourage you to visit http://newsroom.ucla.edu/portal/ucla/campus-budget.aspx for up-to-date information about the state deficit, and UC and UCLA actions.

As the governor and state legislature negotiate next year's budget, UC and UCLA will advocate for our critical needs and priorities, such as the Cal Grants program. Recently, as you may know, the media reported that the governor is proposing the potential elimination of Cal Grants, which would greatly reduce low-income families’ access to the University of California. I am deeply concerned about these recent reports. President Yudof has expressed similar sentiment.

Nevertheless, we face a difficult period of uncertainty. As we move through this process, please do what you can to stay informed, help the campus achieve cost efficiencies and continue to lend your voice as an ambassador for public higher education in California.

Sincerely,

Gene D. Block
Chancellor

UCLA conference explores impact of economic crisis on human trafficking

Enrique Rivero — Fri, 22 May 2009 18:45:00 GMT

WHAT:

As the economic crisis worsens, reports of human trafficking have increased in Los Angeles, with documented cases of slave labor in restaurants, hotels, the garment industry, agriculture, child and elder care, and construction. "Impact of the Economic Crisis: Increase in Reports of Human Trafficking in L.A. County and Globally," a breakfast and briefing for the media and women's health experts, brings together health and law enforcement officials and human trafficking survivors to outline the local and global impact of this situation.

The event is sponsored by the Iris Cantor–UCLA Women's Health Center, with generous support from the David and Lucile Packard Foundation, the Coalition to Abolish Slavery and Trafficking, the Annenberg Foundation, and the Weingart Foundation.

WHO:

Participants will include:

Kay Buck
Executive director of the Coalition to Abolish Slavery and Trafficking

Kimberly Agbonkpolor

Los Angeles Police Department's L.A. Metropolitan Task Force on Human Trafficking

Terri Thorfinnson

Chief of the California Department of Health Services' Office of Women's Health

Susie Baldwin

Chief of the health assessment unit of the Los Angeles County Department of Public Health's Office of Health Assessment and Epidemiology

Human trafficking survivors

WHEN:

Friday, May 29

8:45 a.m.: Breakfast and check-in
9:30–10:30 a.m.: Program
10:30–11 a.m.: Q&A with presenters and panelists
11–11:30 a.m.: One-on-one interview opportunities

WHERE:

Covel Commons, on the UCLA campus (map)

BACKGROUND:

According to the United Nations' International Labor Organization, more than 12 million people worldwide are currently victims of human trafficking; the U.S. Department of Justice says the U.S. is a destination country for thousands of victims. Slave laborers rescued in Los Angeles have been documented to be citizens of Mexico, the United States, and countries in Central and South America, Asia, and Africa.

R.S.V.P. & INFORMATION:

R.S.V.P. is required. For reservations, directions and parking information, please contact Robin Lam at 310-794-8063 or robinlam@mednet.ucla.edu.

MEDIA CONTACT:

Enrique Rivero, UCLA Health Sciences Media Relations, 310-794-2273

erivero@mednet.ucla.edu

Limiting medical residents' work hours would cost $1.6 billion annually

Enrique Rivero — Fri, 22 May 2009 18:15:00 GMT

New recommendations by the national Institute of Medicine to limit the work hours of medical residents and improve their educational conditions would cost the nation's teaching hospitals about $1.6 billion annually to hire substitute workers, according to a new report from the RAND Corp. and UCLA.

While society may benefit if such changes reduce medical errors, as intended, limiting trainee workloads would create a substantial new expense for academic medical centers, according to the study, published in the May 21 edition of the New England Journal of Medicine.

"Adopting new restrictions on the work hours of physicians in training would impose a substantial new cost on the nation's 8,500 physician training programs," said lead author Dr. Teryl K. Nuckols, assistant professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA and a researcher at RAND, a nonprofit research organization. "There is no obvious way to pay for these changes, so that's one major issue that must be addressed."

In December 2008, the Institute of Medicine released a report calling for revisions to medical residents' workloads and schedules to decrease the chances of fatigue-related medical errors and to enhance the learning environment. Recommendations included requiring time for sleep during prolonged shifts, reducing shifts to 16 hours if residents do not have time for sleep, reducing residents' workloads and increasing the number of days residents must have off.

Graduate medical education programs traditionally have required residents to work long hours, often more than 100 per week. Such training programs generally run three to seven years following medical school.

The study by RAND Health and UCLA provides new details about the potential costs and clinical implications of the Institute of Medicine recommendations, expanding upon a cost analysis described in the original report.

Should the recommendations be adopted, researchers say teaching hospitals would need to make up for residents' shorter work hours by either hiring other providers, such as physician assistants, to do the work or by expanding the number of residency positions.

While adding residency slots could help ease physician shortages in some specialties, it also could lead to oversupply in others, according to the study. Researchers estimate that residency positions would need to grow by about 8 percent overall to meet staffing needs under the Institute of Medicine recommendations.

"The trainees who are working more than the proposed limits would allow are not necessarily in the specialties where more physicians are needed," Nuckols said. "For example, pediatric residents work a lot of hours, but there is no evidence that there are too few pediatricians."

Researchers estimate that adopting the Institute of Medicine's recommendations would cost each major teaching hospital about $3.2 million annually on average. That figure is higher than some proven quality-improvement efforts for hospitals, such as computerized physician order entry and medication bar-coding systems. But it would be less expensive than other proposals, such as requiring that there be one nurse for every four patients.

One study of shorter work shifts suggests that reducing resident work hours could cut serious medical errors by 25 percent in medical intensive care units. But few errors cause injury, and the effects could be different in other clinical settings, according to the study. In addition, revising work rules could prompt other types of medical errors as the care of hospitalized patients is more frequently handed from one provider to another.

Researchers say adopting the work hours and workload recommendations of the Institute of Medicine report would be more expensive for teaching hospitals than a major revision of resident work hours adopted by training programs six years ago. Those rules say that residents should not work more than an average of 80 hours per week, among other limits. Nearly a quarter of the costs estimated by the researchers would be necessary, however, just to bring residents into compliance with those current rules.

"Residency programs already have picked much of the low-hanging fruit by reducing the non-educational duties placed on residents," Nuckols said. "Further changes will require that hospitals hire professionals with high levels of training, such as nurse practitioners and physicians, and that will be expensive."

Other authors of the study are Dr. Jose J. Escarce of RAND and UCLA; Dr. Jay Bhattacharya of Stanford University, who is a member of the Institute of Medicine committee that issued the report; and Dianne Miller Wolman and Cheryl Ulmer of the Institute of Medicine.

Support for the study was provided by the Institute of Medicine, under contract to the federal Agency for Healthcare Research and Quality.

RAND Health, a division of the RAND Corp., is the nation's largest independent health policy research program, with a broad research portfolio that focuses on quality, costs, health services delivery, and health promotion and disease prevention, among other topics. RAND Health is the creator of COMPARE (Comprehensive Assessment of Reform Efforts), a one-of-a-kind online resource that provides objective analysis about national health care reform proposals. Visit www.randcompare.org to learn more.

The General Internal Medicine and Health Services Research Divison in the department of medicine at the David Geffen School of Medicine at UCLA provides a unique interactive environment for collaborative efforts between health services researchers and clinical experts with experience in evidence-based work. The division's 100-plus clinicians and researchers are engaged in a wide variety of projects that examine issues related to access to care, quality of care, health measurement, physician education, clinical ethics and doctor-patient communication. Researchers in the division have close working relationships with economists, statisticians, social scientists and other specialists throughout UCLA and frequently collaborate with their counterparts at the RAND Corp. and the Charles Drew University of Medicine and Science.

For more news, visit the UCLA Newsroom.

Elderly women with 'dowager's hump' may be at higher risk of earlier death

Enrique Rivero — Thu, 21 May 2009 16:20:00 GMT

Hyperkyphosis, or "dowager's hump" — the exaggerated forward curvature of the upper spine seen commonly in elderly women — may predict earlier death in women whether or not they have vertebral osteoporosis, UCLA researchers have found.

In a study published in the May 19 issue of Annals of Internal Medicine, researchers found that older white women with both vertebral fractures and the increased spinal curvature that results in the bent-over posture characteristic of hyperkyphosis had an elevated risk for earlier death. The finding was independent of other factors that included age and underlying spinal osteoporosis.

Women who had only hyperkyphosis, without vertebral fractures, did not show an increased risk for premature death.

Hyperkyphosis can be caused by a number of factors besides osteoporosis, including habitual poor posture and degenerative diseases of the muscles and intervertebral discs.

"Just being bent forward may be an important clinical finding that should serve as a trigger to seek medical evaluation for possible spinal osteoporosis, as vertebral fractures more often than not are a silent disease," said Dr. Deborah Kado, an associate professor of orthopedic surgery and medicine at the David Geffen School of Medicine at UCLA and the study's primary investigator. "We demonstrated that having this age-related postural change is not a good thing. It could mean you're likely to die sooner."

For the study, the researchers reviewed data on 610 women, age 67 to 93, from a cohort of 9,704 participants in the Study of Osteoporotic Fractures. The participants were recruited between 1986 and 1988 in Baltimore, Md.; Minneapolis, Minn.; Portland, Ore.; and Pennsylvania's Monongahela Valley. Researchers measured spinal curvature with a flexicurve and assessed vertebral fractures from spinal radiographs; they assessed mortality based on follow-ups averaging 13.5 years.

Adjusting for age, as well as osteoporosis-related factors such as low bone density, moderate and severe vertebral fractures, and the number of prevalent vertebral fractures, the researchers found that women with previous vertebral fractures and increasing degrees of spinal curvature were at increased mortality risk from the spinal condition, regardless of age, smoking, spinal bone-mineral density, or the number and severity of their spinal fractures.

These study findings provide evidence that it is not just vertebral fracture alone but the associated increased spinal curvature that may be most predictive of adverse health outcomes. Other studies linking hyperkyphosis to poor health, such as impaired physical function, increased fall risk, fractures and mortality, have been unable to exclude the possibility that vertebral fractures alone were the underlying explanation for the findings.

The researchers note several caveats. This study focused on women, though hyperkyphosis also affects men; measurements for vertebral fractures were based only on height ratios, which could lead to misclassification of other causes of height ratio decreases, such as Scheuermann disease; and the timing of the assessments could have affected the results, though it's unlikely to have made much difference.

However, this study demonstrates a possible association between hyperkyphosis and increased risk for earlier death independent of the number and severity of vertebral fractures or osteoporosis in older women, the researchers write.

"These results add to the growing literature that suggests that hyperkyphosis is a clinically important finding. Because it is readily observed and is associated with ill health in older persons, hyperkyphosis should be recognized as a geriatric syndrome — a 'multifactorial health condition that occurs when the accumulated effect of impairments in multiple systems renders a person vulnerable to situational challenges.'"

Study co-authors include Arun S. Karlamangla of UCLA; Li-Yung Lui and Steven R. Cummings of the California Pacific Medical Center Research Institute; and Kristine E. Ensrud and Howard A. Fink of the University of Minnesota.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Institute on Aging funded this study.

The UCLA Department of Orthopaedic Surgery provides consultation and treatment for disorders of the musculoskeletal system. Department faculty members provide comprehensive services for such specialties as joint replacement and reconstructive surgery, microvascular surgery, sports medicine, arthroscopy, foot and ankle surgery, hand surgery, pediatric orthopedics, spinal diseases, orthopedic trauma, orthopedic oncology, and metabolic bone disease. In 1998, UCLA and Los Angeles Orthopaedic Hospital formed a strategic alliance through which Orthopaedic Hospital was integrated with UCLA in the replacement facility for Santa Monica–UCLA Medical Center and Orthopaedic Hospital.

UCLA scientists identify new gene linked to autism risk

Elaine Schmidt — Tue, 19 May 2009 21:20:00 GMT

UCLA scientists have discovered a variant of a gene called CACNA1G that may increase children's risk of developing autism, particularly boys. The journal Molecular Psychiatry publishes the findings in its May 19 advance online edition.

Classic autism strikes four times as many boys as girls. When including the entire spectrum of autism disorders, such as the milder Asperger syndrome, boys are 10 times more likely to be diagnosed than girls.

"This is a strong finding," said Dr. Stanley Nelson, professor of human genetics at the David Geffen School of Medicine at UCLA and the study's principal investigator. "No one has scrutinized the role that CACNA1G plays in autism.

"We found that a common form of the gene occurs more frequently in the DNA of families that have two or more sons affected by autism but no affected daughters," he said. "Our study may explain why boys are more susceptible to the disorder than girls."

Nelson and his colleagues zeroed in on a region of chromosome 17 that previous studies have tied to autism. The research team scoured the DNA of 1,046 members of families with at least two sons affected by autism for common gene variants.

A variant is a gene that has undergone subtle changes from the normal DNA yet is shared by a significant portion of the population.

The researchers used tools of the Human Genome Project to scan thousands of variants across all genes in the suspicious region of the chromosome and to pluck out the most common forms.

"We wanted to identify what was happening in this region of chromosome 17 that boosts autism risk," Nelson said. "When the same genetic markers kept cropping up in a single region of the DNA, we knew we had uncovered a big clue."

The researchers traced the genetic markers to CACNA1G, which helps move calcium between cells. They discovered that the gene has a common variant that appears in the DNA of nearly 40 percent of the population.

"This alternate form of CACNA1G consistently increased the correlation to autism spectrum disorders, suggesting that inheriting the gene may heighten a child's risk of developing autism," Nelson said.

How the gene contributes to higher autism risk remains unclear, but Nelson emphasized that it cannot be considered a risk factor on its own.

"This variant is a single piece of the puzzle," he said. "We need a larger sample size to identify all of the genes involved in autism and to solve the whole puzzle of this disease."

The UCLA team's next step will be to sequence the gene in people who possess the altered variant in order to identify the exact change that increases autism risk. These subtle variations offer potential markers for the real mutation causing greater susceptibility to the disease.

Nelson's co-authors included Samuel Strom, Jennifer Stone, John ten Bosch, Barry Merriman, Rita Cantor and Daniel Geschwind, all of UCLA. The study was funded by the National Institute of Mental Health and Cure Autism Now, which merged with Autism Speaks in 2007.

The DNA samples and clinical data were provided by families who donated blood to the Los Angeles–based Autism Genetic Resource Exchange (AGRE), a program created and funded by Cure Autism Now.

"When parents like me first formed AGRE, this was our dream, that talented scientists would use our gene bank to collaborate and bring us closer to understanding autism," said Jon Shestack, co-founder of Cure Autism Now and a board member of Autism Speaks. "AGRE has played an important role in almost every major autism genetics paper in the past five years."

Autism is a complex brain disorder that strikes in early childhood. The condition disrupts a child's ability to communicate and develop social relationships and is often accompanied by acute behavioral challenges. The Centers for Disease Control and Prevention reports that one in 150 American children is diagnosed with an autism spectrum disorder. The diagnosis of autism has expanded tenfold in the last decade.

For more news, visit the UCLA Newsroom.

Dental researchers ID new target in fight against osteoporosis, periodontitis

Sandra Shagat — Mon, 18 May 2009 21:40:00 GMT

Osteoporosis and periodontitis are common diseases whose sufferers must cope with weakness, injury and reduced function as they lose bone more quickly than it is formed. While the mechanism of bone destruction in these diseases is understood, scientists have had less information about how bone formation is impaired.

Now, researchers at the UCLA School of Dentistry, working with scientists at the University of Michigan and the University of California, San Diego, have identified a potential new focus of treatments for osteoporosis, periodontitis and similar diseases.

In a paper published May 17 in the online edition of the journal Nature Medicine, Cun-Yu Wang, who holds UCLA's No-Hee Park Endowed Chair in the dental school's division of oral biology and medicine, and colleagues suggest that inhibiting nuclear factor-kB (NF-kB), a master protein that controls genes associated with inflammation and immunity, can prevent disabling bone loss by maintaining bone formation.

The findings could offer new hope to millions who struggle with osteoporosis and periodontitis each year. The National Institutes of Health estimates that in the United States alone, more than 10 million people have osteoporosis, and many more have low bone mass, putting them at risk for the disease, as well as for broken bones. According to the American Academy of Periodontology, mild to moderate periodontitis affects a majority of adults, with between 5 and 20 percent of the population suffering from a more severe stage of the disease.

The NF-kB protein, a culprit in inflammatory and immune disorders, plays a major role in both osteoporosis and periodontitis, disrupting the healthy balance of bone destruction and formation. It is this balance that Wang and his fellow scientists seek to restore, and perhaps even improve upon, by finding new ways to promote net bone accumulation.

"Most studies focus on the part that NF-kB plays in the regulation of osteoclasts — bone-resorbing cells. For the past five years, we looked closely at the effect of NF-kB on osteoblasts — bone-forming cells," said Wang, the study's principal investigator and a member of UCLA's Jonsson Comprehensive Cancer Center. "We knew that NF-kB promoted resorption. What we discovered in our in vitro and in vivo studies is that this protein also inhibits new bone formation, giving us a fuller picture of its role in inflammation and immune responses."

"This landmark paper by Dr. Wang and his colleagues is not only top-notch molecular science, but it also holds promise for clinicians trying to provide the most enlightened treatment of women with postmenopausal osteoporosis," said John Adams, a UCLA professor of orthopedic surgery. "The paper shows how the molecular manipulation of a previously unsuspected pro-inflammatory pathway in the bone-forming cell, the osteoblast, can regulate the capacity of that cell to make new bone."

Many currently available treatments work to prevent further bone loss but are not able to increase bone mass. Wang's research results support the idea that a new drug that prevents the action of NF-kB in cells may represent a major therapeutic advance.

"Although it has been known for some time that inflammation inhibits bone formation, the groundbreaking work by Dr. Wang and his colleagues elucidates the critical role of NF-kB in the mechanism that underlies this phenomenon," said Philip Stashenko, a professor at the Harvard School of Dental Medicine and president and CEO of the Forsyth Institute, an oral health treatment and research organization. "Many drugs that block NF-kB are in development, and these findings suggest that new treatments to preserve bone in periodontitis, osteoporosis and related bone diseases are imminent."

As a next step, Wang and his research team are planning to test small molecules that inhibit the specific bone-resorption and bone-inhibition actions of NF-kB in osteoporosis and periodontitis.

The study was supported by grants from the National Institute of Dental and Craniofacial Research and the National Institute of Diabetes and Digestive and Kidney Diseases.

An abstract of the paper is available at http://dx.doi.org/10.1038/nm.1954.

For more news, visit the UCLA Newsroom.

UCLA study shows traumatic brain injury haunts children for years

Mark Wheeler — Thu, 14 May 2009 21:55:00 GMT

Traumatic brain injury is the single most common cause of death and disability in children and adolescents, according to the national Centers for Disease Control and Prevention. Now, UCLA researchers have found that the effects of a blow to the head, whether it's mild or a concussion, can linger for years.

Talin Babikian, lead study author and a UCLA postdoctoral fellow in psychiatry and biobehavioral sciences, and senior author Robert Asarnow, a UCLA professor of psychiatry, analyzed 28 selected articles about traumatic brain injury, or TBI, published between 1988 and 2007, quantifying for the first time all of the available literature on the effects of TBI on the developing brains of children and adolescents. Their findings appear in the May issue of the journal Neuropsychology.

The key, and most surprising, finding, the authors say, was that over time, children and adolescents with a severe TBI appear to fall even farther behind their peers than was previously thought, making intervention and monitoring especially important in this group.

Various levels of TBI in children were included in the studies that were reviewed. The extent of a brain injury is typically based on the Glasgow Coma Scale, a standard clinical tool used to measure the severity of these injuries. The scale measures a person's eye/pupil response, motor response and verbal communication to determine whether a TBI is mild, moderate or severe.

Children in the studies were sorted by TBI severity and the time since their injury. All three severity levels were examined, and follow-up exams were done, on average, 0–5 months, 6–23 months or 24-plus months after injury for 14 key aspects of neurocognition.

Additional key findings of the study:

Time didn’t heal all wounds — the worse the injury, the worse the neurocognitive outcome over time, especially on measures of general intellectual functioning and brain processing speed. The moderate and severe TBI groups were similarly impaired after examination at 24-plus months. While there was modest recovery in intellectual functioning and attention, weaknesses in many children with even moderate TBI persisted even two years after the injury, compared with children in control groups.
For children diagnosed with severe TBI, more help was needed. They showed significant problems within months on IQ, executive functioning (processing speed, attention), and verbal memory (both immediate and delayed) measures. After two or more years, all areas studied were impaired.

"The good news is that the studies showed that children with mild traumatic brain injuries and concussions may show some difficulties in cognition initially, but the effects are subtle and typically diminish over time," Babikian said. "The bad news, though, is the existence of a subgroup of patients who show persistent neurocognitive problems and need to be screened and followed.

"And because younger children have more development ahead of them, the same injury can affect a 4-year-old and a 12-year-old very differently," she said. "Further, children who suffer a severe brain injury may show a slower rate of development as a group, highlighting the importance of targeted treatment developed specifically for children with severe TBI."

Equally important, Babikian said, is the take-home message of prevention.

"Because younger children with a traumatic brain injury seem to generally do worse than their older counterparts," she said, "the public health implication of this research is a reminder of the importance of the use of protective measures to minimize the effects of a brain injury when one does occur, as well as prevention through consistent use of helmets and seat belts."

The research was funded by the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health, and by the Della Martin Foundation. The authors report no conflict of interest.

The UCLA Department of Psychiatry and Biobehavioral Sciences is the home within the David Geffen School of Medicine at UCLA for faculty who are experts in the origins and treatment of disorders of complex human behavior. The department is part of the Semel Institute for Neuroscience and Human Behavior, a world-leading interdisciplinary research and education institute devoted to the understanding of complex human behavior and the causes and consequences of neuropsychiatric disorders.

For more news, visit the UCLA Newsroom.

Businessman convicted in scheme to sell body parts

Phil Hampton — Thu, 14 May 2009 21:33:48 GMT

A Los Angeles County jury today found a Rancho Cucamonga businessman guilty of grand theft by embezzlement, tax evasion and other felonies in connection with a scheme to sell body parts donated to UCLA's medical school.

Ernest V. Nelson, was found guilty of selling body parts to medical and pharmaceutical research companies without permission from the campus. His conspirator, Henry Reid, the former director of UCLA's donated body program, pleaded guilty and was sentenced in January to more than four years in prison and ordered to pay $500,000 in compensation to the David Geffen School of Medicine.

When the scheme came to light in 2004, the campus voluntarily shut down the program and instituted a comprehensive series of strategies designed to enhance security, build in transparency and widen oversight. Medical school officials said the new program is running smoothly and that they are confident the measures will ensure that donated bodies are used only to advance scientific research and the education of medical students.

UCLA police Chief Karl Ross praised the work of his detectives. "The work of the UCLA investigators in this complex, multi-state investigation was the key component in ensuring a successful prosecution and sentencing," said Ross. "I want to acknowledge their excellent work for almost five years to ensure that justice was served."

How to build a bigger brain

Mark Wheeler — Tue, 12 May 2009 16:20:00 GMT

Push-ups, crunches, gyms, personal trainers — people have many strategies for building bigger muscles and stronger bones. But what can one do to build a bigger brain?

Meditate.

That's the finding from a group of researchers at UCLA who used high-resolution magnetic resonance imaging (MRI) to scan the brains of people who meditate. In a study published in the journal NeuroImage and currently available online (by subscription), the researchers report that certain regions in the brains of long-term meditators were larger than in a similar control group.

Specifically, meditators showed significantly larger volumes of the hippocampus and areas within the orbito-frontal cortex, the thalamus and the inferior temporal gyrus — all regions known for regulating emotions.

"We know that people who consistently meditate have a singular ability to cultivate positive emotions, retain emotional stability and engage in mindful behavior," said Eileen Luders, lead author and a postdoctoral research fellow at the UCLA Laboratory of Neuro Imaging. "The observed differences in brain anatomy might give us a clue why meditators have these exceptional abilities."

Research has confirmed the beneficial aspects of meditation. In addition to having better focus and control over their emotions, many people who meditate regularly have reduced levels of stress and bolstered immune systems. But less is known about the link between meditation and brain structure.

In the study, Luders and her colleagues examined 44 people — 22 control subjects and 22 who had practiced various forms of meditation, including Zazen, Samatha and Vipassana, among others. The amount of time they had practiced ranged from five to 46 years, with an average of 24 years.

More than half of all the meditators said that deep concentration was an essential part of their practice, and most meditated between 10 and 90 minutes every day.

The researchers used a high-resolution, three-dimensional form of MRI and two different approaches to measure differences in brain structure. One approach automatically divides the brain into several regions of interest, allowing researchers to compare the size of certain brain structures. The other segments the brain into different tissue types, allowing researchers to compare the amount of gray matter within specific regions of the brain.

The researchers found significantly larger cerebral measurements in meditators compared with controls, including larger volumes of the right hippocampus and increased gray matter in the right orbito-frontal cortex, the right thalamus and the left inferior temporal lobe. There were no regions where controls had significantly larger volumes or more gray matter than meditators.

Because these areas of the brain are closely linked to emotion, Luders said, "these might be the neuronal underpinnings that give meditators' the outstanding ability to regulate their emotions and allow for well-adjusted responses to whatever life throws their way."

What's not known, she said, and will require further study, are what the specific correlates are on a microscopic level — that is, whether it's an increased number of neurons, the larger size of the neurons or a particular "wiring" pattern meditators may develop that other people don't.

Because this was not a longitudinal study — which would have tracked meditators from the time they began meditating onward — it's possible that the meditators already had more regional gray matter and volume in specific areas; that may have attracted them to meditation in the first place, Luders said.

However, she also noted that numerous previous studies have pointed to the brain's remarkable plasticity and how environmental enrichment has been shown to change brain structure.

Other authors of the study included Arthur Toga, director of the UCLA Laboratory of Neuro Imaging; Natasha Lepore of UCLA; and Christian Gaser of the University of Jena in Germany. Funding for the study was provided by the National Institutes of Health. The authors report no conflicts of interest.

For more news, visit the UCLA Newsroom.

UCLA scientists identify how key protein keeps chronic infection in check

Elaine Schmidt — Thu, 07 May 2009 23:20:00 GMT

Why is the immune system able to fight off some viruses but not others, leading to chronic, life-threatening infections like HIV and hepatitis C?

A new UCLA AIDS Institute study suggests the answer lies in a protein called interleukin-21 (IL-21), a powerful molecule released by immune cells during chronic infection. Published May 7 in the online edition of Science, the finding could explain how the immune system limits viral replication, restricting a virus's spread through the body.

The researchers looked at two types of T-cells — CD4 T-cells and CD8 T-cells — which are immune cells that play an important role in the body's response to infection. The CD4 T-cells help the immune system by producing IL-21 during chronic infection, bolstering the CD8 T-cells' ability to fight off the virus.

"The CD4 cells are the regulators — the generals, if you will," said principal investigator David Brooks, assistant professor of microbiology, immunology and molecular genetics at the David Geffen School of Medicine at UCLA. "The CD8 cells go out and kill the invaders; they're like the privates in the field."

To shed light on how CD4 T-cells help their CD8 counterparts clear viruses, the researchers infected mice with one of two strains of a virus. They knew that the first strain would generate a short-term infection and the second a chronic infection.

The scientists tested each strain on two groups of mice. One group was normal and the other was bred without IL-21 receptors.

In the normal mice, the first strain elicited a strong T-cell response that completely eliminated the virus in 10 days. The second strain caused a chronic infection that exhausted the T-cells, hampering their ability to fight the virus. The UCLA team detected high levels of IL-21 in these mice, suggesting that the protein plays a crucial role in sustaining the T-cells' ability to mount an immune response during long-lasting infection.

When the scientists infected the mice that lacked IL-21 receptors with the chronic infection strain, something curious happened. The majority of virus-fighting CD8 T-cells disappeared, preventing the immune system from containing the spread of the virus.

"IL-21 fuels CD8 T-cells' ability to function," Brooks said. "These immune cells are running a long-distance race to contain the virus before it spreads. If they don't get fed, they collapse on the track."

Without IL-21, the CD8 T-cells dwindled, even when the CD4 T-cells produced a robust response. The result indicates that the T-cells rely on IL-21 to resolve persistent infection.

"After the immune system loses CD8 T-cells, it's unable to clear the virus," Brooks said. "This tells us that IL-21 is a critical player in the body's fight against chronic infection."

The study was funded by the UCLA Center for AIDS Research, the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA, and the National Institutes of Health. Brooks' co-authors included Heidi Elsaesser of UCLA and Karsten Sauer of the Scripps Research Institute.

The UCLA AIDS Institute, established in 1992, is a multidisciplinary think tank drawing on the skills of top-flight researchers in the worldwide fight against HIV and AIDS, the first cases of which were reported in 1981 by UCLA physicians. Institute members include researchers in virology and immunology, genetics, cancer, neurology, ophthalmology, epidemiology, social science, public health, nursing and disease prevention. Their findings have led to advances in treating HIV, as well as other diseases, such as hepatitis B and C, influenza and cancer.

For more news, visit the UCLA Newsroom.

Startup uses new incubator space in CNSI to commercialize UCLA technology

Jennifer Marcus — Thu, 07 May 2009 22:00:00 GMT

UCLA has opened its new technology incubation space within the California NanoSystems Institute to Matrix Sensors Inc., a startup company in the process of developing multichannel gas and biological sensor systems based on technology developed jointly by UCLA and Stanford University researchers.

The technology holds promise for the highly sensitive and accurate detection of harmful gases, which could have practical applications in both public and industrial settings.

Matrix Sensors is a seed-stage company founded in March 2006 by UCLA chemistry and biochemistry professor James Gimzewski and Stanford electrical engineering professors Butrus (Pierre) T. Khuri-Yakub and Calvin F. Quate, the key researchers and inventors in the area of developing CMUT (capacitive micromachined ultrasonic transducer) technology for chemical and biological sensors.

As part of this arrangement, Matrix Sensors has obtained an exclusive license for this technology that will provide the University of California with an equity position in the company. Matrix has rented lab space in the incubator at the CNSI and has access to core lab facilities to pursue research and development work.

The company proposes to use CMUT technology for gas and biological analytes. The goal of the technology is to develop products with high analyte resolution, accuracy and stability suitable for commercial applications, such as monitoring the release of gases in large public settings.

Atomic-force microscope instrumentation will be used to characterize sensor microchips to do functionalization work. This will lay the foundation to test, in careful and controlled ways, how well the chemical layers can be applied. The initial goals are to make microchip devices that are chemically sensitive and to characterize the nature of the chemical sensitivity.

"The CNSI is committed to accelerating the transfer of new technologies from the laboratory to the clinical and commercial marketplace," said Leonard H. Rome, interim director of the CNSI and senior associate dean of research at the David Geffen School of Medicine at UCLA. "Matrix can serve as a potential model for how UCLA may support startups with unique access to faculty and lab facilities to nurture early-stage R&D. This directly flows from the institute's mission to facilitate collaborations with private industry for the rapid commercialization of new innovations."

"At this stage in the company's development, we can't possibly afford to set up sufficient lab space on our own," said Mike Cable, CEO of Matrix Sensors. "Having access to core lab facilities, particularly the Nano and Pico Characterization Lab, with state-of-the-art atomic-force microscopes, will be essential to our ability to take the R&D to the next level."

"The versatility of these microchip sensors is very encouraging in terms of practical applications," Gimzewski said. "We think the sensors can be placed in portable handheld devices such as cell phones, which broadens the accessibility of instant analysis."

The California NanoSystems Institute (CNSI) is an integrated research center operating jointly at UCLA and UC Santa Barbara whose mission is to foster interdisciplinary collaborations for discoveries in nanosystems and nanotechnology; train the next generation of scientists, educators and technology leaders; and facilitate partnerships with industry, fueling economic development and the social well-being of California, the United States and the world. The CNSI was established in 2000 with $100 million from the state of California and an additional $250 million in federal research grants and industry funding. At the institute, scientists in the areas of biology, chemistry, biochemistry, physics, mathematics, computational science and engineering are measuring, modifying and manipulating the building blocks of our world — atoms and molecules. These scientists benefit from an integrated laboratory culture enabling them to conduct dynamic research at the nanoscale, leading to significant breakthroughs in the areas of health, energy, the environment and information technology.

For more news, visit the UCLA Newsroom.

UCLA scientists reveal how deadly pediatric disorder develops in brain

Elaine Schmidt — Wed, 06 May 2009 21:55:00 GMT

A deadly brain disorder in toddlers may find its first treatment in drugs for Alzheimer's disease.

UCLA scientists have discovered how a form of the rare genetic disease known as Sanfilippo syndrome develops in the young brain, causing severe mental retardation and death as early as age 14. Published this week in the early online edition of Proceedings of the National Academy of Sciences, the findings suggest that new Alzheimer's drugs may provide therapy for the currently untreatable metabolic disorder.

Four different enzyme deficiencies cause Sanfilippo syndrome, leading to the disorder's classification as type A, B, C or D. The UCLA team studied type B, the second most common form.

"We knew that Sanfilippo syndrome type B results from a mutation of the gene that produces the enzyme needed to break down sugar molecule chains in the body," said Elizabeth Neufeld, a professor of biological chemistry at the David Geffen School of Medicine at UCLA. "We studied the disease in mice bred to possess the same gene defect seen in human patients."

Neufeld's team found that mice with the defective gene produce higher amounts of two proteins called lysozyme and P-tau. They tracked the proteins to neurons in the medial entorhinal cortex — an important memory center in the brain. One of the first areas to be affected by Alzheimer’s disease, the region also has been implicated in other abnormalities in Sanfilippo syndrome.

Earlier research had linked high levels of lysozyme to the production of P-tau, a misshapen protein that helps form the strands that clump into tangles in the brain. These tangles impair neuron function and are a hallmark of Alzheimer's and other degenerative brain diseases.

"This is really exciting," said co-author Stanislav Karsten, a UCLA assistant professor of neurology and of obstetrics and gynecology. "If we can replicate our discovery of P-tau in the brains of human patients, it may be possible to treat Sanfilippo syndrome with new drugs created for Alzheimer's disease. We believe our finding will accelerate the development of an effective therapy for this heartbreaking disorder."

Many scientists have searched for P-tau in the brains of Sanfilippo syndrome patients and in animal models. The UCLA team was the first to uncover it.

"We were fortunate to find the P-tau, because it appears in only a very small part of the brain," said lead author Kazuhiro Ohmi, a UCLA assistant researcher in biological chemistry.

Sanfilippo syndrome falls under MPS, a family of disorders involving mucopolysaccharides, which are long chains of sugar molecules used to build connective tissue. After the body finishes using these sugars, it breaks them down with enzymes and disposes of them.

Children with Sanfilippo syndrome lack the enzyme to digest the molecules, and they store them instead, leading to misshapen cells and enlarged organs. While infants rarely show signs of the disorder, symptoms worsen as children grow and their cells suffer more damage.

Fewer than one in 75,000 children are born with Sanfilippo syndrome. Both parents must carry and pass on the defective gene in order for their child to be affected — a one-in-four chance. Unaffected children have a two-in-three chance of carrying the gene.

Neufeld's earlier research identified the enzyme deficiencies that cause MPS. Her findings led to tests that enabled physicians to accurately diagnose the syndromes and counsel families. She is a consultant for Zacharon Pharmaceuticals, a biotechnology firm in San Diego.

The study's co-authors included Lili Kudo and Sergey Ryazantsev, both of UCLA. The research was funded by the National Institute of Neurological Disorders and Stroke, the Children's Medical Research Foundation, and the Alzheimer's Association.

To learn more about families living with Sanfilippo syndrome, visit the National MPS Society website at www.mpssociety.org.

For more news, visit the UCLA Newsroom.