Year 3. February 5. Recognizing Some of our Many Innovators
Last week, I presented our state of the department, outlining where we’ve been, where we’re going, and plans for how we’ll get there. We are LEADERS and as such, my recognition of recent significant accomplishments across research, funding, and leadership within the past few weeks is a natural follow up. It is clear that our department’s strategic goals are not in the distance, they’re right in front of us, and we are already well on our way to reaching them. The examples below confirm just that.
Claudio Scafoglio, MD, PhD, Awarded Discovery Boost Grant from the American Cancer Society
As physicians and researchers, we know that the scientific process involves testing multiple hypotheses. We also know that while some hypotheses are based on large amounts of evidence, some are not, and therefore require more risk to test. That's where grants like the Discovery Boost Grant (DBG) from the American Cancer Society (ACS) importantly come into play. According to the ACS, the DBG supports "high-risk, high-reward exploratory cancer research across the research continuum." We are pleased to share that the department of medicine's (DoM) Adjunct Associate Professor Claudio Scafoglio, MD, PhD, has been awarded a DBG for his high-risk, high-reward research on cancer cells.
The basic premise of Dr. Scafoglio's research is testing the push-pull relationship between glucose and cancer cells, and whether we can starve cancer cells of glucose while preventing those cells from becoming more aggressive as a result. Dr. Scafoglio shared that his mentors developed a probe that detects the activity of glucose transporters -- which can be thought of as the door for glucose to enter the cell. It turned out that this activity can signal the increased metabolic activity of cancer cells, which can potentially aid earlier cancer diagnoses. After considering the implications for diagnosis, Dr. Scafoglio and his team turned to the possibility of blocking glucose transporters for cancer treatment. What they've found thus far is that by blocking glucose transporters in certain cancer cells, the cells develop less well, as they are deprived of glucose. The flip side of that positive finding, however, was the finding that the cells adapt by becoming less differentiated, meaning they don't look at all like normal cells and grow significantly faster when they are able to get glucose in a different way.
You'd think the investigation would end there, right? Dr. Scafoglio doesn't think so, and instead is now planning a study to identify a supplement of different metabolites that allows glucose transporters to stay blocked while keeping the cells relatively satisfied to mitigate aggression. Dr. Scafoglio offered a helpful metaphor to help explain:
"If you starve yourself to lose weight, you'll lose weight but become more aggressive, and likely gain even more weight back when you stop your diet. But if you could supplement yourself to make yourself to feel better while fasting, you'll lose weight without the aggressiveness or the relapse."
It's a risky premise, but a risky premise with a potentially large payoff.
"These types of grants are very important because they allow you to test some hypotheses that are difficult to convince reviewers about," Dr. Scafoglio shares. "When you say you want to starve cancer on one side and feed it on the other, it sounds crazy. But ACS believed in this possibility. It would mean a lot to me if my hypothesis is correct because it would be the first step in bringing these new potential treatments to patients."
We are rooting for you, Claudio.
George Agak in Dermatology, Awarded American Association of Immunologists Fellowship Award to Support Postdoctoral Research on Skin Microbiome
We are pleased to announce that George Agak, PhD, Assistant Professor of Dermatology, has been selected as the recipient of the 2024 American Association of Immunologists (AAI) Intersect Fellowship for Computational Scientists and Immunologists! Understanding the interaction between the bacteria and viruses that normally live on our skins (microbiome) and our immune responses to them will increase our understanding of the factors that maintain healthy skin, and how this is disturbed in conditions such as acne.
The award will support Dr. Agak's project "Computational analysis of cell types and genetic elements of Cutibacterium acnes phylotypes associated with healthy and acne skin." The long-term goal of this project and Dr. Agak's lab at UCLA is to understand how host-microbiome interactions result in disease and use these findings to develop microbiome-based therapeutics for treatment of skin diseases caused by dysbiosis.
Funding from the award will be instrumental in advancing our objectives, particularly by supporting the work of Postdoctoral Fellow Woodvine Otieno, PhD. Currently in Year 2 of postdoctoral training, Dr. Otieno completed his PhD at Xi’an Jiao Tong University in China and holds a master’s degree from the Jomo Kenyatta University of Agriculture and Technology in Kenya. Dr. Otieno boasts a diverse set of training experiences and accomplishments across microbiology, biotechnology, and bioinformatics.
"I am continually impressed by how Dr. Otieno thinks outside the box," Dr. Agak shared. "He has also impressed me with his ability to find creative ways to address any challenges that he faces."
This project will be carried out in collaboration with UCLA's Matteo Pellegrini, PhD, whose computational expertise will allow for the development of novel tools for analyzing high-throughput sequencing data, including single-cell RNA sequencing. These approaches have been used in a range of settings, including tissue decomposition and biomarker discovery, and will hopefully lend to advanced scientific discovery in this context.
To date, the interplay between the skin microbiome and T cell responses in acne skin is poorly understood. As such, insights on the role of the microbiome in the induction of antimicrobial T cell responses have broad implications for the future development of i) novel probiotics for acne treatment, ii) novel approaches to modulate TH1 and TH17 function to control inflammation and tissue injury, and iii) novel treatments for chronic inflammatory skin disorders and autoimmune diseases. Please join us in congratulating Dr. Agak, Dr. Otieno, and Dr. Pellegrini!
The World’s Experts on Mitochondria Convene to Debate and Share the Latest Research Developments at UCLA’s Mitochondria Symposium
Among the many ways that UCLA is unique is our standout commitment to mitochondrial research and organellar biology. With four core facilities focused on mitochondrial research, as well as training and resources dedicated to promoting future mitochondrial researchers, we are among the top institutions in the world committed to this field. Thus it comes as no surprise, that the 6th Mitochondria Symposium at UCLA, which took place in December 2023, was a resounding success. The symposium, spearheaded by Orian Shirihai, MD, PhD, professor in the division of endocrinology, and his team, brought together over 300 attendees from 15 countries and offered an array of formats for scientific presentation and discussion. The goal of the symposium was to offer many opportunities for participants to contribute towards one of the largest and most prominent symposiums on mitochondria research and innovation, and it’s safe to say we met that goal.
(Pictured above: Presenters and guests at the 6th Mitochondria Symposium at UCLA)
Unlike some academic conferences, this gathering was participatory and debate-oriented in nature, in spirit with the field of organellar biology. In day one’s session format, for instance, which was playfully named “Kill the Expert,” experts in the field were tasked with defending their opinions on the choice of methods used to measure a key biological parameter in presentation format. These presentations were followed by response from knowledgeable interrogators and audience members who shared their opinions on the topic. Such topics ranged from measuring mitochondrial motility, mtDNA release and the study of mitochondrial fuel preference. In a presentation about aging, these discussions exposed some remarkable controversies of the current efforts and goals in the field.
In a continuation of this interactive format, day two consisted of round table discussion session, in which attendees were split into 15 tables on 15 different subjects. Each table had 3 presenters, including basic researchers, clinicians and biotech investors who were tasked at giving their view of the current gaps in technology and knowledge in the field. Each table’s discussion revealed the fascinating discrepancy between scientists and clinicians on what the gaps are that warrant addressing by research. The third and final day of the conference consisted of parallel sessions focused on the interests of trainees and faculty, respectively, and featured a newly introduced panel, “Mentoring Challenges and Solutions,” in which established faculty members were invited to share opinions on best mentoring practices and their solutions to solve and prevent conflicts.
(Pictured above: Panelists at the 6th Mitochondria Symposium at UCLA)
The benefits of the conference didn’t stop at the mental stimulation, however, as each morning attendees stretched and physically challenged themselves by participating in a 45-minute exercise led by a professional fitness trainer. Overall, the symposium served as a significant contribution to the field of mitochondrial research and organellar biology that UCLA is helping to lead. What started as a local half-day symposium in 2017, has now expanded into a 3-day international conference, and we can’t wait to see it grow even further.
Huge shout out to the core team of 5 organizers and the additional 30 volunteers who worked tirelessly during the days of the symposium and the weeks prior to make this event the success it was!
Health Services Research Symposium Exemplifies Research & Collaborative Excellence
On Friday, January 12, The Division of General Internal Medicine and Health Services Research (GIMHSR) at UCLA hosted their 6th Annual Health Services Research Symposium in honor of Dr. Martin Shapiro. By any measure, the day-long event was a resounding success with nearly 100 attendees, 18 speakers, and strong presentations across the spectrum of health services research.
I was privileged to kick off the impressive program with welcoming remarks, during which I emphasized the importance of health services research to the improvement in care quality not just within the DoM, but in the entire field of internal medicine. I also highlighted the strong collaboration between VA and UCLA-based investigators in GIMHSR, which has yielded a wide range of impactful discoveries and programs, many of which were highlighted throughout the day.
Much like any strong scientific study, the day began grounded in data: Specifically, a panel on the use of large datasets for generalizable health services research presented by Douglas Bell, MD, PhD, Ya-Chen Tina Shih, PhD, Evelyn Chang, MD, and Yusuke Tsugawa, MD, MPH, PhD. Each speaker presented a case study of a specific type of data -- such as Medicare data, or a data infrastructure -- such as UCLA's Data Core, in empowering and simplifying health services research. The panel emphasized the importance of making use of datasets that are low-hanging fruit from our home institution of UCLA/the VA and from national-level data to glean insights into how we can improve health services. The cherry on top of this panel was a presentation by David Elashoff, PhD, who built on the panel discussion to review the activities and advancements of UCLA's Statistical Core.
(Pictured above: Dr. Chang (left) and Dr. Shih (right) presenting at the 6th Annual Health Services Research Symposium at UCLA.)
The second panel, "Improving Community and Population Health," demonstrated the type of research and projects that can be carried out using the data touched on in panel 1. The panelists were Estelle Everett, MD, Utpal Sandesara, PhD, Evan Shannon, MD, and Kimberly Narain, MD, MPH, PhD, moderated by Katherine Chen, MD, PhD. It's remarkable the breadth of topics covered in this one panel -- from medical pluralism and female infanticide in India to extreme heat and adverse health outcomes among veterans to addressing structural racism through children's literature.
Across the wide-ranging topics, however, was the theme of equity and patient-centered care to improve communities. Dr. Everett, for instance, spoke about the existing barriers that underserved communities face in accessing continuous glucose monitors (CGM). After sharing the disturbing statistic that Medicaid patients with diabetes were 2 to 5 times less likely to use a CGM than non-Medicaid patients, Dr. Everett was prompted to design her own study to understand what those key barriers are and how a CGM can impact distress and glucose monitoring satisfaction. There were several notable findings, among them that lack of CGM use is most strongly predicted by insurance status, and that the reason for discontinuation of a CGM is usually unknown. These results, and the takeaways from each panelist, demonstrated the importance of not stopping when we develop a beneficial intervention or approach, and how progress can actually worsen inequities if we're not careful.
(Pictured above: Dr. Sandesara (left) and additional panel participants (right) presenting at the 6th Health Services Research Symposium at UCLA)
Following a break, Benjamin Seligman, MD, PhD, Sae Takada, MD, PhD, MHS, David Zingmond, MD, SP, and Melissa Wei, MD, MPH, MS, brought us back down to the individual patient level in their panel "Managing the Complex Patient." From frailty and COVID-19, to measuring and managing multimorbidities, to the utilization of portable medical orders for end-of-life care. Each presentation focused on the nuanced care of patients who are most at risk of adverse health outcomes, are marginalized in healthcare, and/or hold a complex patient profile.
For example, Dr. Takada presented findings on the impact of incorporating the CDC's Social Vulnerability Index (SVI) into patient visits as a proxy for social determinants of health. She found that SVI correlates positively with no-show visits at UCLA, even when adjusting for race and insurance status. She also found that a high SVI is correlated with specific care outcomes, like not getting the flu vaccine and a reduction in healthcare utilization. This study, much like the other cases presented in the panel, demonstrated how approaching a patient from a holistic perspective not only can improve their care, but also can improve our broader knowledge of complex barriers, where they stem from, and how to address them.
The apex of the symposium was a keynote session delivered by Albert L. Siu, MD, MSPH, professor and chair emeritus (2003-2017) of the Brookdale Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai. Dr. Siu mapped out a detailed and informative case study on the implementation of "hospital at home" across the arc of discovery, early testing, efficacy, scaling, and sustainability. The talk brought all panel themes from throughout the day together and then some, touching on data, population health, complex patient care, implementation science, and even politics. The concept of "hospital at home," originally spearheaded by Bruce Leff, MD, enables some patients with acute needs to receive healthcare in their homes, as opposed to a hospital. Though thankfully more ubiquitous now, Dr. Siu aptly noted that, in the early 2000s, "hospital at home was a round object in a world that only recognized four sided objects."
However, it's precisely the novelty of that care model they were working to promote that made it such a relevant case study to current health services research in which we are striving to implement care models that are novel in our current context, but hopefully won't always be. What Dr. Siu demonstrated is the amount of time and forethought it takes to achieve this goal, the fact that successful implementation is rooted in evidence, and that unexpected events or developments may play a role in success. When it came to hospital at home, for instance, even though they had strong data that this care model significantly lowered readmissions, reduced transfer to acute medical facilities, and increased satisfaction among patients and caregivers alike, the government struggled to adapt it to a payment model, and implementation stalled until the pandemic. Now, we have about a million people receiving care through hospital at home and are on the cusp of national dissemination nationwide.
The lesson is poignant, and inspires deep determination, which I know pervades the GIMHSR. Martin Shapiro, MD, PhD, who closed the symposium with his reflections, said it best:
"It would be great if the health systems could be more self-reflective of the pressing problems and the need for them to fully embrace and reflect the challenges that we see every day. Our health systems need to be relevant, and we are doing everything we can to make them relevant. So, as you pursue your career, and think about the big problems, don't fail to be bold, to speak up for what you believe."
I know I feel more inspired than ever to work towards lasting health system change following this event, and I hope you all do too. Huge thank you to all presenters and organizers on a successful and impactful day.
UCLA cardiology receives $2 million to establish Connor Dunn Endowed Fund
Finally, and in the vein of pushing our research efforts forward to new heights, we are thrilled to share that the UCLA Division of Cardiology has received a $2 million gift from a UCLA alumnus to endow research focused on cardiovascular and cardiometabolic health through the establishment of the “Connor Dunn Endowed Fund in Preventive Cardiovascular Health.” As outlined by the full press release, which you can view here, Alumnus Kirk Dunn made the generous gift in honor of his late son, Connor Dunn.
The goal of the endowed fund will be to further the work of Dr. Tamer Sallam -- vice chair for research training in the DoM, and executive co-director of our STAR Program – whose work focuses on how genetics impact cardiometabolic diseases like heart attack and stroke.
We are so grateful to Kirk Dunn, who has been an active member of the UCLA community since graduating from UCLA in 1983. We look forward to the many ways that the work of Dr. Sallam and his team will benefit patients through their cutting-edge research.
National Mentoring Month Recognizes Faculty Impact
National Mentoring Month celebrates the collaboration between individuals to bolster professional and personal development by recognizing mentors, elevating the impact of mentoring relationships, and amplifying the importance of mentoring to drive positive change and excellence across training and careers.
During National Mentorship Month, Keith Norris, MD, PhD, professor and executive vice chair for equity, diversity and inclusion was featured for his role as a mentor and his passion for equity. When asked, “Why is mentoring important for enhancing diversity and equity in the biomedical workforce,” Dr. Norris stated,
“Mentoring provides the tools, experience and confidence needed to help level the playing field so people from any background can realize their full potential.”
Dr. Norris is also a co-principal investigator of the Coordination and Evaluation Center at UCLA (CEC). The Center is part of the NIH Diversity Program Consortium (DPC) that aims to evaluate practices to engage, mentor and train students, enhance faculty development and strengthen institutional capacity for research training.
Read their Mentoring Month blog on LinkedIn for resources and posts from faculty and trainees engaged in STEMM research and education.
Our DoM faculty share their latest research and perspectives about issues affecting our community at-large. Find out who was in the news this past week.
"We must understand what is driving these differences in order to advance health equity after infection,"said Dr. Joann Elmore, principal investigator of the study site and a professor in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA.
"We want people to get in bed feeling like sleep could happen,"said Jennifer Martin, a professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles.
"It's really important to try and harness the power of neoadjuvant studies to try to identify patients that need appropriate escalation of therapy, as well as identifying patients who need de-escalation of therapy."Dr. Nicholas P. McAndrew, assistant clinical professor of medicine and hematologist-oncologist at the David Geffen School of Medicine at UCLA and member of the UCLA Health Jonsson Comprehensive Cancer Center
I participated in the Mitochondria Symposium. I was invited to be part of a “Kill the Expert” symposium as a presenter. I argued with the organizers that I was not prepared to be martyred, seeing that I have a department to run, so the session was re-branded “Keep the Expert”. The two questioners played the part well, even though they wore Ninja head bands. So here I am expressing my gratitude to one the ninjas, Rajat Singh.