Week 45: Research Day – A Resounding Success
On Thursday, November 10, the department of medicine (DoM) resumed its tradition of hosting the department-wide Research Day, which was hosted at Covel Commons on the UCLA campus. Research Day was suspended for two years during the COVID-19 pandemic. A few months ago, I had a series of conversations with some of the research leaders in the DoM about Research Day, to understand its history and traditions. It was clear that we should resume this activity, but I had some initial reservations regarding if and when we could safely do so. I floated the idea of having a virtual event, which was quickly shot down. I acquiesced and I am pleased that I did. The co-chairs of Research Day were Dr. Jose Escarce and Dr. Tomas Ganz, veterans of previous events. They made the conscious decision to feature junior faculty as plenary lecturers, inviting four inspiring junior colleagues to present summaries of their work.
The first up was Chelsea Shover, PhD, an assistant professor in the division of general internal medicine and health services research. Dr. Shover presented her seminal work describing the outcomes of engaging same-day peer ambassadors to increase COVID-19 vaccination among people experiencing unsheltered homelessness in Los Angeles County. Her presentation revealed lessons learned in building trust within this high-risk population and strategies for respectfully increasing community engagement in public health. The initiative was so successful that it was ultimately adopted and funded by LA County. A link to a recent publication in the Journal of Infectious Diseasesdescribing aspects of this work is below.
Next up was Albert Shieh MD, MS, assistant professor in the division of geriatrics. Dr. Shieh presented his clinical investigation examining Study of Women’s Health Across the Nation (SWAN) participants, that revealed independent associations between insulin resistance and pre-diabetes that may contribute to increased peri-menopausal bone loss in women. Given the increasing prevalence of diabetes and obesity globally and in the United States, these studies have important implications for preventing and treating osteoporosis in many women at increased risk for diabetes as they go through menopause. A link to a recent publication in the journal JCI-Insight describing aspects of this work is below.
The third plenary presenter was Quen J. Cheng MD, PhD, an assistant professor in the division of infectious diseases. Dr. Cheng, a 2019 STAR graduate, gave a talk describing a novel mechanism leading to activation of innate immunity. Note that in general, innate immunity is considered a nonspecific response, whereas the adaptive immune system is thought of as being very specific. Dr. Cheng started his talk by reminding the audience that many hold the view that innate immunity is perceived as not being as “smart” as adaptive immunity. During his talk, Dr. Cheng proceeded to convince us that the regulation of innate immunity is incredibly sophisticated. Specifically, he described new work that elegantly revealed how the regulation of macrophage activation by various stimuli, is mediated by the transcription factor, nuclear factor κB (NF-κB). When transcription factors regulate genes, we often think of them binding constitutively to the promoters of genes. In a series of elegant experiments, Dr. Cheng showed that NF-κB binding can oscillate moving on and off the promoters at high frequency in a relatively short time frame to dramatically activate macrophages. Think AC versus DC electricity. A link to a recent publication in the journal Science describing aspects of this work is below.
The final presenter was Elaine Hsiao, PhD, associate professor in the department of microbiology, immunology and molecular genetics and a member of the UCLA Microbiome Center, who is jointly appointed in the division of digestive diseases in the DoM. Dr. Hsiao presented an overview of her large body of work linking the commensal bacteria that live in our guts (microbiota) with the metabolism of serotonin in the whole body. Serotonin is a neurotransmitter that acts in the brain. Dr. Hsiao provided compelling evidence that activity of these bacteria in the gut can regulate serotonin activity in the brain, with important implication for disorders such as depression and even autism. In fact, she showed results that commonly used drugs for depression that act by altering serotonin uptake and metabolism, have dramatic effects on these bacteria within the gut. So not unexpectedly, after her lecture I asked if depression begins in the gut. Although, this could be an interesting headline, Dr. Hsiao noted that it is probably more complicated than that, but that the gut-brain axis may nevertheless play an important role. Links to two recent review articles by Dr. Hsiao in the journals Science and Annual Review of Immunology, respectively, describing her work are below.
In my welcome remarks at Research Day, I reminded the attendees of the importance of research and innovation to the mission of the DoM.
I noted the nearly 300 abstracts that were submitted for Research Day and how this reflected the depth and breadth of the research that takes place in the DoM every day. The research ranges from implementation science and outcomes research, to clinical investigation, to fundamental mechanistic work including molecular mechanisms of diseases. I reminded the attendees that this diversity represents our embrace of all expressions of high-quality research that is defined by rigor and impact. I recapped some of our impressive research statistics such the nearly $275M in total research funding that our faculty has obtained during the first 6-months of this calendar year, our greater than $336M grants and contracts portfolio in FY 22, and our national rankings in NIH funding. I also celebrated the national accolades for research accomplishment received by our trainees and our faculty across the career spectrum from junior faculty to senior professors, which I have discussed over the months in my weekly emails. I underscored the ongoing work that we must do to ensure that we are actively nominating our colleagues for national recognition. I discussed the critical value of collaboration to advance our research mission and the extent to which events like Research Day can be catalytic in accelerating collaborations within our large department.
Our research achievements should not be taken for granted though and we must plan strategically for the future, while acknowledging challenges that must be addressed such as research space management within the DoM, the DGSOM, and the importance of building shared resources that benefit the entire community. I reminded attendees of opportunities that we must seize, not only to maintain a robust pipeline of future investigators, including expanding the ranks of physician scientists, but to increase the quality and availability of mentoring across the career spectrum. In this regard, we will be launching the recruitment of a new vice chair for research for the DoM, who will work closely with me and senior leadership within the DoM and DGSOM to advance our research mission. I also committed to launching a research operations group overseen by the research vice chair, that will be tasked with engaging all members of the research community on a regular basis to identify and work to address ongoing challenges faced by our investigators. They will ensure that barriers are identified and addressed in a timely and effective manner.
Also noteworthy was the large number of trainees who participated, ranging from undergraduate and medical students, residents, fellows and post-docs. Their enthusiasm was palpable, and their participation reminded all of us of our commitment to ensuring that we invest in those who will succeed us in advancing science and discovery. I am optimistic that if we keep our eyes on the ball, the future will be bright. The poster sessions were vibrant, and I witnessed many collaborations being established. Poster judges were hard at work and poster awardees will be announced later this week.And then there was food.
We kicked off research day with lunch, providing a wonderful opportunity for networking and fellowship on a crisp afternoon after a couple days of well needed rain. What we did not anticipate however, was the nearly 100 “walk in” registrants and attendees at Research Day that swelled the ranks of participants to nearly 400 attendees, which did challenge food supplies during the wine and cheese reception that followed the poster session in the early evening.I worked the line to assure disappointed and “hangry” colleagues at the end of the line that we will make sure to make it up to them next year. I think that I convinced some of our distinguished colleagues who were at the end of the buffet line that food quantity will be higher next near. I am sure they will hold me accountable next Research Day!
A shout out to the Yanina Venegas and members of our administrative team who put in many extra hours behind the scenes to ensure that logistics were in place to ensure a successful event.
Enjoy additional photographs from Research Day 2022 HERE.
In keeping with our steady research progress, I was pleased to learn this week about a new research award to our colleagues at the West Los Angeles VA (GLA-VA). A team of UCLA researchers at the GLA-VA, led by Matthew Rettig, MD, professor-in-residence in the department of medicine and chief of hematology-oncology at the West Los Angeles VA, were awarded a $6.4 million grant from the Department of Veterans Affairs to develop artificial intelligence algorithms to accurately predict metastatic recurrence amongst veterans with high risk, localized prostate cancer.
Prostate cancer is the most commonly diagnosed malignancy other than non-melanoma skin cancer in the United States, and high risk, localized prostate cancer represents 20-25% of the ~250,000 incident cases of prostate cancer in the US. Outcomes of high risk, localized prostate cancer are quite variable, with some patients remaining in remission and others suffering from metastatic progression and death. Our ability to discriminate between patients who will fare well following curative-intent treatment versus those destined for lethal metastatic progression remains poor.
The VA/UCLA multidisciplinary investigative team is represented by urology (Isla Garraway, MD, PhD), radiation oncology (Nicholas Nickols, MD, PhD) and external experts in epidemiology, artificial intelligence, radiology, and pathology. This group has generated a searchable database of 1.2 million veterans with prostate cancer that will be leveraged to collect the following three sources of data:
- High resolution digital pathology images of diagnostic prostate needle biopsies
- Prostate MRI
- Area Deprivation Index (a composite of ~20 factors related to social determinants of health outcomes)
Artificial intelligence, including computer vision and machine learning approaches, will be applied to generate prognostic models for each of the three data sources. Once an optimal model for each individual data source has been developed, the models will then be combined in all possible permutations to identify a simple, low cost “super classifier” artificial intelligence model to predict metastatic recurrence. The resulting predictive model will be made publicly available to assist in clinical decision making and to test treatment intensification and de-intensification strategies in prospective clinical trials. Congratulations team!
Celebrating the heroism of one of our housestaff
Finally, I want to share with you the story of one of our residents who is truly a hero. On the morning of October 28th, Dr. Mallory E. Blackwood performed critical lifesaving action while off duty. Dr. Blackwood and Charles Mitchem, a USMC Marine Corps Veteran and UCLA’s Veteran Education Outreach Coordinator, witnessed the immediate aftermath of a severe motor vehicle collision on I-5/CA-99 North between the Grapevine and Bakersfield. The collision involved a small four-door sedan passenger car which was crushed and partially on fire after colliding with a large tractor and a commercial trailer. Dr. Blackwood could see the victim was not responsive, had multiple life-threatening injuries, a compromised airway, and was crushed in place by the dashboard.
Utilizing a medical kit they had in the car, Dr. Blackwood sprang into action to provide critical lifesaving aid to the victim. Dr. Blackwood entered through the vehicle's rear to triage the victim and provide aid. Instantly, Dr. Blackwood supported the victim's cervical spine and established an airway while simultaneously identifying the most urgent needs and relaying those to others who were assisting at the scene. A Swedish medical doctor assisted Dr. Blackwood in providing aid while they both navigated language barriers and waited for emergency services to arrive to the scene.
“It is evident by those who witnessed the scene of the accident that Dr. Blackwood's actions in the immediate aftermath of the accident were clearly instrumental in stabilizing the victim until emergency services arrived, and possibly saving his life. Dr. Blackwood upheld the highest forms of moral fiber, initiative, and human virtue. Dr. Blackwood reflected great credit upon herself, her profession, and the UCLA Health system through her actions on October 28th, 2022,”states Mitchem.
The best work among us…..
Some of you may have heard that the Power Ball lottery winner is from California. At Research Day, we had a mini-raffle to promote networking. We could not match the PowerBall jackpot, but offered five, $1,000 travel grants to all poster participants who completed the form below by getting the signature of someone that they networked with and staying for the drawing at the end of the wine and cheese reception. What participants might not have realized was that I was testing a scientific hypothesis that the main reason to meet with the department chair is to request money. Based on the number of forms that I signed, I am inclined to conclude that my hypothesis was correct. The picture below is of me and Dr. Sapna Khowal a research fellow in the laboratory of Dr. Anthony Heaney in the division of endocrinology. Unfortunately, Dr. Khowal did not win the DoM networking raffle, but I really enjoyed our conversation. The five raffle winners and their poster titles will be announced later, and I can assure you that the check is in the mail.