1. < Cardiology/Epi

On Friday, November 17, the department of medicine (DoM) continued its tradition of hosting the annual department-wide Research Day, which was held at Ackerman Union on the UCLA campus this year. Having been suspended for two years during the COVID-19 pandemic, this is the event's second year back in person. By any measure research day was an astounding success. There were nearly 500 attendees, including 426 registered attendees, in addition to speakers and the many faculty who volunteered to be poster judges.

Following my statements DoM's Vice Chair of Research Dr. Judith Currier shared her own welcome to all attendees, emphasizing the importance of learning from today's presenters and thanking the incredible organizing team and judges.

Research Day is a unique opportunity to showcase research, creativity, and innovation across all divisions in the DoM, and highlights the innovative research and creative work carried out by our faculty, trainees, students, and staff. To that end, we were proud to feature the work of five outstanding colleagues representing distinct divisions in the DoM during our plenary session to launch research day. A summary of the presentations follows below. The amazing thing about the talks was the clear evidence of multiple collaborations that transcended divisional boundaries that were necessary to advance each speaker’s respective project. This represents two of the strategies within the research pillar of our strategic plan. Specifically to:

• Implement a DoM-wide approach for identifying targeted, multidisciplinary research areas. 
• Foster a department-wide research community that encourages collaborative, innovative, high-impact research across all areas.

The first speaker was Elizabeth Tarling, PhD, FAHA, associate professor of medicine, division of cardiology. Dr. Tarling presented her seminal work on what she calls the "ABC's" of cholesterol transport in lung disease spanning basic research and clinical practice. Her presentation, based on studies carried out with DoM Sr. Clinical Executive Vice Chair Dr. Tisha Wang, focused on the role of improving cholesterol transport as a potential therapy for patients with the autoimmune disorder, Pulmonary Alveolar Proteinosis (PAP). She highlighted diagnostic and therapeutic strategies based on the presence and titer of  an auto-antibody to granulocyte/macrophage colony-stimulating factor (GM-CSF). Her work revealed a correlation between antibody titers, disease severity and clinical response. Dr. Tarling’s work revealed that strategies to enhance or restore the defective macrophage function could improve the condition. Reflecting on the implications of her work, she shared the following:

"I stay inspired by my patients -- it's amazing to see individuals who were on a lung machine walk into the room, and know that our work made a difference."

Following Dr. Tarling's inspiring presentation, Rajat Singh, MD, professor of medicine in the division of digestive diseases, took the stage to share about his work on how the lysosomal quality control pathway autophagy plays an essential role in preventing fatty liver disease. Dr. Singh opened up his talk with a background on autophagy and autophagy failure. Autophagy is a natural, self-serving mechanism in which the body removes damaged or dysfunctional parts of a cell and recycles other parts toward cellular repair. As a result, autophagy failure, Dr. Singh explained, can result in a large number of molecular problems seen as symptoms of common diseases today, such as metabolic disorders, cancer, neurodegeneration, and more.

Since starting their lab, Dr. Singh and his team has progressively mapped the role of autophagy in metabolism. Along the way, they noted that fasting increases autophagy. They've found evidence that you can reprogram your metabolism based on eating intervals, and that twice a day feeding likely promotes metabolic flexibility. Speaking on the implications of this research, he shared

"if you can pair dietary interventions with pharmacological interventions, we can better address disorders such as obesity and fatty liver disease. He proposed that an approach that meets people where they are, by asking them only to change the timing of what they eat, not their entire diet or caloric intake, has the potential for longer term efficacy."

The third plenary presenter was Melissa Lechner, MD, PhD, assistant professor of medicine in the Onco-Endocrinology Program in the Division of Endocrinology, Diabetes, and Metabolism at UCLA. Dr. Lechner's presentation described potential therapeutic targets identified by her research team for endocrine immune-related adverse events (IRAEs) that occur in many cancer patients treated with immune checkpoint inhibitors (ICIs). The presentation wonderfully demonstrated the impact of bringing research to practice, with a focus on the common IRAE -- ICI-thyroiditis. ICI-thyroiditis can result in destruction of thyroid tissue and the need for thyroid hormone replacement therapy to mitigate significant negative health impacts. Lechner and her team studied the phenotypes of thyroid-infiltrating immune cells isolated from individuals with ICI-thyroiditis to examine what might be driving the IRAE and the implications for treatment. They found through mouse and in vitro studies that the protein Interleukin 21 (IL-21) may be causing CD4+T cells to induce an autoimmune response. This finding led them to examine IL-21 as a possible driver of ICI- induced thyroid disease and more recently diabetes mellitus. The team is now investigating the impact of blocking IL-21 using JAK inhibitors such as Ruxolitinib to treat or prevent these endocrine complications.

The fourth plenary was delivered by John Mafi, MD, PhD, associate professor of medicine in the division of general internal medicine and health services research, whose family was present to cheer him on. All of us in medicine witnessed the unprecedented expansion and practice of telemedicine in the wake of the COVID-19 pandemic. Less clear has been how telemedicine expansion specifically impacted the utilization and equity of access to ambulatory care in the U.S. the during pandemic years. Dr. Mafi and his team explored this question, and presented on their findings which will have implications for how telemedicine is incorporated into the growth of our ambulatory care strategy within the DoM, UCLA Health and beyond. Among the takeaways from their research was the finding that telemedicine preserved access to US ambulatory care by replacing in-person visits, particularly for socioeconomically disadvantaged Americans. He explained that though there were limitations to the study, its findings have important implications for U.S. health policy. To start, Dr. Mafi hopes that this research can help make a case for extending parity in reimbursement levels between in-person services and telehealth services.

The final presenter was Tzung K. Hsiai, MD, PhD, professor of medicine and bioengineering who holds the Maud Cady Guthman Endowed Chair in the Department of Medicine and Bioengineering. Dr. Hsiai used his presentation to discuss the urgent need to address metabolic disorders (MDs), which he describes as "the silent killers" that affect more than a third of all U.S. adults. His groundbreaking research shows us that there are a number of ways to accelerate metabolic research advancements into practice to address MDs. Dr. Hsiai demonstrated one example of such an approach in his discussion of research findings on the role of changes in blood flow for cardiac structure and function, and how incorporating exercise can be effective at mitigating MD risk.

Dr. Hsiai underscored the need to move beyond straightforward clinical thinking towards research, innovation, and changes in clinical practice to address MDs, including promoting wearable sensors, the use of data science techniques, and 'omics medicine. In his words,

"we need to promote patients' ability to age gracefully and with dignity."

After the plenary session the poster session began! The hum of conversations at numerous posters echoed through the hall. This year, 307 poster abstracts were submitted as poster presentations by junior faculty and trainees across three themes: 1) basic research, 2) health services research, and 3) clinical translational research.

The hundreds of research submissions covered a wide range of medical research areas, from cancer biology to pharmacology and drug development to health services and equity. With so many presentations it was impossible to visit each poster. As a result, the department will be hosting the research day abstracts and posters online, behind a UCLA log-in, so that you can virtually visit those posters that you were not able to visit in person on Research Day. Our team will be reaching out to all presenters to secure their permission to post their posters online.

The breadth, depth, and diversity of the submissions are representative of the dynamic research that takes place each and every day in the DoM. I have no doubt that we are at the cutting edge of research in respective fields,  leveraging this activity to train the next generation of biomedical research leaders. Enthusiasm was palpable throughout the poster session reflecting interactions between presenters  (junior faculty and trainees) attendees, and poster judges.

Some of the research was global in nature, such as Dr. Kathryn Dovel's presentation of findings from two randomized control trials (RCTs) on ways to improve re-initiation in care among men with HIV in Malawi; some were hyper-local, such as April Banayan and Mariam Khan's poster presentation on perceived barriers and facilitators in hypertension management among Black patients at UCLA Health. Some posters emphasized biodesign innovation, such as medical student Rachel Wahhab's poster presentation on utilizing biopsy-free virtual histology for improved clinical efficiency in the Mohs setting; and others provided novel insights on long-standing problems, such as Dr. Estelle Everett's study on preterm labor and hypertensive disorders in adolescent pregnancies with diabetes between 2006 and 2019. The basic science offerings were also impressive. You will need to go online to see them all.

And though only five poster competition winners will be awarded and will be announced in the near future, what was evident, was that all posters represented unique research inputs that contribute to the success of the DoM's impressive research portfolio.

Upon reflecting on this year's Research Day, I am overwhelmed by our commitment to high-quality research defined by rigor and impact, and the many forms that commitment can take. The impact of these commitments is visible through our research metrics, our funding portfolio, our awards, our publications and the commitment of our faculty to mentoring  junior faculty, and trainees from diverse backgrounds.

It is worthwhile reminding you that the DoM has received $32,470, 371 in new federal fundsduring fiscal year 22-23, the Los Angeles VA GLA has received $43,889,497 in new federal grants, and our department was ranked the top NIH-funded department of medicine by the Blue Ridge Institute for Medical Research. We will continue to celebrate the national accolades for research accomplishment received by our trainees and faculty across the career spectrum from junior faculty to senior professors -- many of whom were part of Research Day's success.

And while these statistics demonstrate our impact, we wanted to make sure to supplement it with feedback from our attendees. That's why this year, we prompted a range of individuals at Research Day to share with us: "What has inspired you today?" Here are some of the responses:

On a personal note, I was simply inspired by seeing our community come together for our shared goal and commitment to advancing knowledge and discovery. I was inspired by the enthusiasm of the trainees and the sense of happiness in having members of our department gather, exchange ideas, forge new collaborations and simply catch up with colleagues, whom they might not have seen for a while. We might need to start searching for a bigger venue for next year!

I hope that you all enjoyed DoM Research Day 2023 as much as I did and are feeling even more energized to keep pushing the boundaries of medical research together at the DoM as part of our strategic plan.

Enjoy additional photographs from DoM Research Day 2023 HERE.

DISCOVER UCLA INTERNAL MEDICINE SERIES KICKS OFF

In addition to Research Day, a second recent highlight for me was attending the first installment of our Internal Medicine residency recruitment virtual open house series, Discover UCLA IM, where I had the opportunity to share some remarks.  I was impressed by the strong turnout by more than 70 applicants to our residency program, who wanted to learn more about our commitment as a department to Equity, Diversity & Inclusion (EDI). The event was hosted by chief resident, Dr. Tara Townes who provided the applicants with an in-depth look at the way in which EDI is woven into the fabric of the DoM. Dr. Townes shares, “My goal was for every applicant to leave the event with a sense of inspiration and confidence, feeling assured that they will thrive and flourish here. In some ways, the event was a narrative of my own path through college, medical school, and residency at UCLA. I emphasized the contributions of numerous faculty and residents who significantly influenced both my personal and professional growth. I had the privilege of recounting the indelible experiences shared with each of them. Having all of them present was a genuine honor.”

I greatly enjoyed hearing from our faculty about the incredible work that they are leading to advance our EDI goals. It was truly inspirational and exemplary of our commitment to advance the field of medicine and ensure that while we are doing so, we are making sure that all people of the department of medicine are valued, respected, and celebrated as we work together to advance our missions. Meet the faculty and residents who were spotlighted at this event below.

I am grateful for the community that we are building together in the DoM, and as you celebrate Thanksgiving with your family and friends later this week, I hope that you can be thankful for being a member of our Department. Travel safely and try not to eat too much!

Dale

P.S. 

One additional highlight of Research Day was my presentation to winners of the networking competition. This was a cross between a raffle and the Price is Right. Five early career participants will be recipients of $1,000 travel grants to attend a scientific meeting.

The five winning tickets are pictured below on the cover of my abstract book, along with pictures of the happy winners and one group of hopefuls.

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