Mereja

Author: Serkadis

  • Thanskgiving for the ages: Unique heart valve procedure a holiday blessing for 94-year-old

    Vivian Valentine, a 94-year-old Santa Monica resident, has much to be thankful for this Thanksgiving. A new lifesaving heart-valve procedure, performed without traditional open heart surgery at UCLA, has given her a new lease on life.  
     
    Her holiday wish: to live to be 100 and to continue to sing in her church choir. Her doctors say she may just do that, given the success of the procedure, which is known as transcatheter aortic valve replacement, or TAVR.
     
    Like many older patients, Valentine was too frail to undergo conventional surgery to replace her main heart valve, which was so clogged with calcium deposits that it couldn’t open wide enough to adequately pump blood through her body. As a result of this condition, called aortic stenosis, she was chronically tired, couldn’t perform everyday tasks, suffered from heart palpitations and swelling in her legs, and was at a much higher risk of heart failure and death.
     
    Luckily, doctors at UCLA were able to help her using the new, minimally invasive TAVR procedure, which was approved last year by the U.S. Food and Drug Administration. Although other minimally invasive surgical procedures have been used on the aortic valve in the past, they relied on incisions in the chest wall and required cardiopulmonary bypass. 
     
    With the new procedure, far fewer surgical risks are involved. TAVR allows doctors for the first time to replace the aortic valve without a chest incision, and it only rarely utilizes a bypass machine, helping to prolong the lives of patients who aren’t candidates for traditional surgery. The new valve is deployed using a catheter — a long tube that travels through an artery in the groin up to the heart. Once in place, the valve is opened and starts working immediately.
     
    Procedures like TAVR offer new options for patients who are inoperable or excessively high-risk candidates for conventional open aortic-valve replacement surgery. Previously, these patients, who are often in their 80s and even 90s, had no choice but to accept a diminished quality of life or a shortened life.
     
    “This new procedure can give older patients a new lease on life and a chance to live better, longer,” said Dr. Jonathan Tobis, a clinical professor of cardiology at the David Geffen School of Medicine at UCLA and director of interventional cardiology for the UCLA Health System. 
     
    Tobis noted that older patients with aortic stenosis who couldn’t undergo traditional heart surgery previously had only a 50 percent chance of living two years after their symptoms were diagnosed.
     
    Valentine is UCLA’s oldest TAVR patient to date.
     
    “These new, minimally invasive surgical techniques can really help extend and improve the quality of life for older patients who previously had few options,” said Dr. Richard J. Shemin, chief of cardiothoracic surgery for the Geffen School of Medicine and the UCLA Health System. “It is our goal to provide the best valve replacement device and the least invasive technology, which allows our patients to resume a more normal life.”
     
    As for Valentine, she left the hospital just three days after her Nov. 14 TAVR procedure at Ronald Reagan UCLA Medical Center. Her doctors say her prognosis is good and that she can soon resume her regular activities. 
     
    Her son, Lynn Lawrence, who owns a beauty salon in Altadena, was concerned at the prospect of his mother having a heart procedure at such an advanced age. “However,” he said, “I was just amazed at how well she’s doing — even the first day after the procedure.”
     
    Valentine, who said her damaged heart used to pound so loudly it sounded like Louis Armstrong playing trumpet in her chest, now says walking and breathing are much easier. And since the procedure, she noted, her heart is much quieter. Dr. Shemin said that is due to her heart murmur stabilizing with better blood flow through the valve.
     
    Valentine is eager to get back to singing soprano in both the Santa Monica Emeritus College Gospel Choir and the Redeemer Baptist Church choir. She’s been performing since 1957 and says it really keeps her going. She even sang a medley of her favorite songs — “Love Lifted Me,” “Amazing Grace” and “God Has Smiled on Me” — to her doctors from her hospital bed.
     
    A Santa Monica resident since 1944, the family matriarch is also looking forward to enjoying the upcoming holidays with her seven grandchildren, seven great-grandchildren and three great-great-grandchildren.
     
    TAVR is the latest in a trend of major surgical procedures now being performed without invasive surgery at UCLA. With this unique technology, cardiologists and heart surgeons work closely together in performing the procedure. Valentine’s team included heart surgeons Dr. Shemin and Dr. Murray Kwon and cardiologists Dr. Tobis, Dr. William Suh and Dr. Gabe Vorobiof. Valentine’s longtime cardiologist is Dr. Lawrence Lazar.
     
    The cardiac team also relies on key anesthesiologists, nurses and technologists who help address the needs of each individual patient. 
     
    For more information about the TAVR procedure at UCLA, visit www.uclahealth.org/TAVR call 310-206-8232.
     
    For more news, visit the UCLA Newsroom and follow us on Twitter.

  • Researchers report potential new treatment to stop Alzheimer’s disease

    Last March, researchers at UCLA reported the development of a molecular compound called CLR01 that prevented toxic proteins associated with Parkinson’s disease from binding together and killing the brain’s neurons.
     
    Building on those findings, they have now turned their attention to Alzheimer’s disease, which is thought to be caused by a similar toxic aggregation or clumping, but with different proteins, especially amyloid-beta and tau.
     
    And what they’ve found is encouraging. Using the same compound, which they’ve dubbed a “molecular tweezer,” in a living mouse model of Alzheimer’s, the researchers demonstrated for the first time that the compound safely crossed the blood–brain barrier, cleared the existing amyloid-beta and tau aggregates, and also proved to be protective to the neurons’ synapses — another target of the disease — which allow cells to communicate with one another.
     
    The report appears in the current online edition of the journal Brain.
     
    “This is the first demonstration that molecular tweezers work in a mammalian animal model,” said Gal Bitan, an associate professor of neurology at UCLA and the senior author of the study. “Importantly, no signs of toxicity were observed in the treated mice. The efficacy and toxicity results support the mechanism of this molecular tweezer and suggest these are promising compounds for developing disease-modifying therapies for Alzheimer’s disease, Parkinson’s and other disorders.”
     
    Molecular tweezers are complex molecular compounds capable of binding to other proteins. Shaped like the letter “C,” these compounds wrap around chains of lysine, a basic amino acid that is a constituent of most proteins. Bitan and his colleagues, including Aida Attar, first author of the study and a graduate student in Bitan’s lab, have been working with a particular molecular tweezer called CLR01.
     
    In collaboration with scientists at the Università Cattolica in Rome, the researchers, working first in cell cultures, found that CLR01 effectively inhibited a process known as synaptotoxicity, in which clumps of toxic amyloid damage or destroy a neuron’s synapses.
     
    Even though synapses in transgenic mice with Alzheimer’s may shut down and the mice may lose their memory, upon treatment, they form new synapses and regain their learning and memory abilities.
     
    “For humans, unfortunately, the situation is more problematic because the neurons gradually die in Alzheimer’s disease,” Bitan said. “That’s why we must start treating as early as possible. The good news is that the molecular tweezers appear to have a high safety margin, so they may be suitable for prophylactic treatment starting long before the onset of the disease.”
     
    Next, using a radioactive “label,” the researchers were able to confirm that the compound had crossed the mouse’s blood–brain barrier and was effective in clearing the brain of amyloid-beta and tau aggregates.
     
    “This work shows that molecular tweezers do a number of things — they help to ameliorate multiple pathologic features of Alzheimer’s, including amyloid plaques, neurofibrillary tangles and brain inflammation, and our cell culture experiments demonstrated that molecular tweezers block the toxic effect of amyloid-beta on synaptic integrity and communication,” Bitan said.
     
    “We call these unique tweezers ‘process-specific,’ rather than the common protein-specific inhibitors,” he added, meaning the compound only attacks the targeted toxic aggregates and not normal body processes. “That’s a big deal, because it helps confirm evidence that the molecular tweezers can be used safely, ultimately supporting their development as a therapy for humans.”
     
    The next step, Bitan hopes, is to confirm that the tweezers improve memory and not just brain pathology. The researchers say they are working on this question and already have encouraging preliminary data.
     
    There were multiple authors on the study in addition to Bitan and Attar. Please see the study for the complete list.
     
    The work was supported by the UCLA Jim Easton Consortium for Alzheimer’s Drug Discovery and Biomarker Development; American Health Assistance Foundation grant A2008-350; RJG Foundation grant 20095024; a Cure Alzheimer’s Fund grant; individual pre-doctoral National Research Service Award 1F31AG037283; National Institute of Health grant R01AG021975; and a Veteran’s Administration Merit Award.
     
    The UCLA Department of Neurology, with over 100 faculty members, encompasses more than 20 disease-related research programs, along with large clinical and teaching programs. These programs 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 in the top two among its peers nationwide in National Institutes of Health funding.
     
    For more news, visit the UCLA Newsroom and follow us on Twitter.

  • Airborne particles smuggle pollutants to far reaches of globe

    Pollution from fossil fuel burning and forest fires reaches all the way to the Arctic, even though it should decay long before it travels that far. Now, lab research can explain how pollution makes its lofty journey: rather than ride on the surface of airborne particles, pollutants snuggle inside, protected from the elements on the way. The results will help scientists improve atmospheric air-quality and pollution transport models.

    The results also show that the particles that envelop pollutants also benefit from this arrangement. The new study in Environmental Science & Technology shows that the airborne particles, made from natural molecules mostly given off by live or burning plants, last longer with a touch of pollutant packed inside. The pollutants are known as polycyclic aromatic hydrocarbons, or PAHs, and are regulated by environmental agencies due to their toxicity.

    “What we’ve learned through fundamental studies on model systems in the lab has very important implications for long-range transport of pollutants in the real world,” said physical chemist Alla Zelenyuk of the Department of Energy’s Pacific Northwest National Laboratory. “In this study, we propose a new explanation for how PAHs get transported so far, by demonstrating that airborne particles become a protective vessel for PAH transport.”

    Floating in the air and invisible to the eye, airborne particles known as secondary organic aerosols live and die. Born from carbon-based molecules given off by trees, vegetation, and fossil fuel burning, these airborne SOA particles travel the currents and contribute to cloud formation. Along for the ride are pollutants, the PAHs, that have long been thought to coat the particles on their surface.

    For decades, atmospheric scientists have been trying to explain how atmospheric particles manage to transport harmful pollutants to pristine environments thousands of miles away from their starting point. The particles collected in areas such as the Arctic also pack higher concentrations of pollutants than scientists’ computer models predict.

    The predictions are based on the assumption that the particles are like liquid spheres, whose fluidity allows PAHs to escape. But they don’t escape, and one recent advance has helped to pin down why PAHs are remaining stuck in their particle lairs. Zelenyuk and her colleagues at EMSL, DOE’s Environmental Molecular Sciences Laboratory at PNNL, developed an ultra-sensitive instrument that can determine the size, composition and shape of individual particles.

    Called SPLAT II, the instrument can analyze millions of tiny particles one by one. The ability of this novel instrument to characterize individual particles provides unique insight into their property and evolution.

    Using SPLAT II to evaluate laboratory-generated SOA particles from alpha-pinene, the molecule that gives pine trees their piney smell, Zelenyuk has already discovered that SOA particles aren’t liquid at all. Her team’s recent work revealed they are more like tar — thick, viscous blobs that are too solid to be liquid and too liquid to be solid.

    Armed with this data, Zelenyuk and researchers from Imre Consulting in Richland and the University of Washington in Seattle set out to determine the relation between the SOA particle and the PAHs. Again they used alpha-pinene for the SOA. For the PAH, they used pyrene, a toxic pollutant produced by burning fossil fuels or vegetation such as forests.

    They created two kinds of particles. The first kind exemplified the classical SOA: first they produced the particles with alpha-pinene and then coated them with pyrene. The second kind resembled what likely happens in nature: they mixed alpha-pinene and pyrene and let the particles form with both molecules present. Then they sent the particles through SPLAT and watched what happened to them over time.

    With the pyrene-coated particles, the team found the PAH pyrene evaporating off the surface of the particle quickly, all of it gone after four hours. By the next day, the particle itself had shrunk by about 70 percent, showing that the alpha-pinene SOA also evaporates, although more slowly than pyrene.

    When they created the particles in the presence of both SOA and PAH, the PAH evaporated much more slowly. Fifty percent of the original PAH still remained in the particle after 24 hours. In addition, the SOA particle itself stayed bulky, losing less than 20 percent of its volume.

    These results showed the team that PAHs become trapped within the highly viscous SOA particles, where they remain protected from the environment. The symbiotic relationship between the atmospheric particles and pollutants surprised Zelenyuk: SOAs help PAHs travel the world, and the PAHs help SOAs survive longer.

    Zelenyuk and her colleagues performed comparable experiments with other PAHs and SOAs and found similar results.

    In the real world, Zelenyuk said, the evaporation will be even slower. These results will help modelers better simulate atmospheric SOA particles and transport of pollutants over long distances.

    This work was supported by the Department of Energy Office of Science and PNNL’s Chemical Imaging Initiative.

    Reference: Alla Zelenyuk, Dan Imre, Josef Beránek, Evan Abramson, Jacqueline Wilson and Manish Shrivastava, Synergy between Secondary Organic Aerosols and Long-Range Transport of Polycyclic Aromatic Hydrocarbons, Environmental Science & Technology, Nov. 7, 2012, doi: 10.1021/es302743z.

  • New global subsidy that provides access to most effective malaria drugs shows promise

    A new international program, conceived in part by a UCLA physician, has rapidly transformed access to lifesaving anti-malarial drugs by providing cheap, subsidized artemisinin-based combination therapies in seven African countries that account for a quarter of the world’s malaria cases.
     
    The first independent evaluation of the Affordable Medicines Facility–malaria (AMFm) program was recently published in the journal The Lancet. The program is based at the Global Fund in Geneva, an international financing institution dedicated to disbursing funds to prevent and treat infectious diseases. The evaluation shows that the program improved access to key artemisinin combination therapies, or ACTs, which offer broader protection and less antibiotic resistance than anti-malaria medications currently available in those African nations.
     
    The Oct. 31 Lancet study was accompanied by an editorial by a panel of some of the world’s most eminent scientists in this field, which praised AMFm’s ability to reach critical populations but also warned that despite the program’s success, its future funding could be threatened. 
     
    “Losing African children to malaria is such an unnecessary tragedy,” said Dr. Claire Panosian Dunavan, a clinical professor of infectious diseases at the David Geffen School of Medicine at UCLA, who was one of eight co-authors of the Lancet editorial. “Now that the global subsidy for ACTs has been proven to work through AMFm, I would hate to see the program end.”
     
    Panosian Dunavan, an expert in tropical diseases, is also one of the original authors of the 2004 Institute of Medicine report “Saving Lives, Buying Time,” which first proposed a global subsidy for modern anti-malarial drugs and led to the development of the AMFm program. 
     
    “Over the last 10 years, I’ve learned a lot from my economist colleagues,” she said. “Leveraging private markets to deliver lifesaving treatments to the global poor is indeed possible, as this global subsidy for malaria drugs has now demonstrated.”
     
    Panosian Dunavan worked closely with economist and Nobel laureate Kenneth J. Arrow, Dr. Ramanan Laxminarayan of the Center for Disease, Dynamics, Economics and Policy, and others in writing the original financing report and the Lancet editorial.
     
    In their comments, the editorial authors write, “In November 2012, the Board of the Global Fund will vote to either continue AMFm in a modified form after December 2013, or terminate the program. There is a strong push from donors (though not from countries) to integrate AMFm into the regular Global Fund model, whereby countries would choose how much of their country budget envelopes, which are already committed to other priorities supporting the public sector, to reallocate to AMFm. We believe that this approach will create instability in artemisinin demand, lower the number of ACT manufacturers, increase ACT prices, and abandon the millions who depend on AMFm-subsidized ACTs.”
     
    Worse, they say, “With the world’s largest global health funder [the U.S. President’s Malaria Initiative (PMI)] expressing unremitting opposition, even after the positive independent evaluation, the program’s future is uncertain. PMI has yet to suggest an alternative that would come close to the access afforded by AMFm in the private sector.”
     
    The Lancet study evaluated national AMFm pilot programs in Ghana, Kenya, Madagascar, Niger, Nigeria, Tanzania (including Zanzibar) and Uganda.
     
    “Africa is home to 80 percent of malaria cases, yet most of the population do not have access to affordable ACTs”, said Kara Hanson of the London School of Hygiene and Tropical Medicine, one of the lead authors of the evaluation study. “Access is restricted by unreliable public health facility supply, high prices and limited availability in the private sector, where most people go to buy medicines. Cheaper, less effective anti-malarials currently dominate the market. Worryingly, artemisinin monotherapies (artemisinin alone, rather than in combination) are also widely available in some countries, and use of these medicines can encourage development of resistance to ACTs.”
     
    Changes in availability, price and market share were assessed in each country using nationally representative surveys of public- and private-sector outlets that stock anti-malarial drugs —both before the introduction of subsidized quality-assured ACTs (QAACTs) and supporting interventions, such as communication campaigns, and six to 15 months after their introduction.
     
    Between August 2010 and the end of 2011, more than 155 million doses of QAACTs were subsidized by AMFm. QAACT availability more than doubled in five countries, and market share more than doubled in four. The effect of AMFm was more limited in Niger and Madagascar, where AMFm ACT orders were lower.
     
    AMFm had a particularly dramatic effect on the private sector, where QAACT market share increased in all pilot programs, with the increase exceeding 30 percentage points in five. What is more, private, for-profit QAACT prices fell substantially (by up to 80 percent) in six countries, with the decrease ranging from $1.28 to $4.82 (U.S.) per dose.
     
    The market share of artemisinin monotherapies also experienced large declines in Nigeria and Zanzibar, the two countries where their presence on the market was highest at the start of the program.
     
    Although AMFm had less impact on public health facilities’ ACT supply, the study authors point out that there were substantial delays in ordering drugs and implementing the full program in some countries.
     
    “But not all of the changes observed can be attributed to AMFm,” the authors cautioned. “There was some evidence from two countries that prices had already begun to fall before AMFm started and the market share of ACTs had started to increase, although most of this increase occurred in the public sector.”
     
    According to study author Hanson, “It is clear that tapping into the private sector distribution chain can have a major influence on which anti-malarial treatments are available and their price and quality in just a few months, but more information is needed about whether the subsidized drugs are reaching those most in need and on how diagnostics can be scaled up in the public and private sectors.”
     
    For more news, visit the UCLA Newsroom and follow us on Twitter.

  • PNNL Science Artfully Displayed in Calendar and Traveling Exhibit

    For the first time in Pacific Northwest National Laboratory’s 47 year history PNNL is showcasing its science in a print calendar available to the general public. The artwork  will also go on the road  as part of a traveling exhibit throughout Washington state.

    PNNL’s 2013 “Discovery in Action” calendar features thirteen captivating scientific images along with the  stories behind them — from technology used to cool buildings more efficiently to minerals used to treat radioactive waste, and microbes important to improving human health to materials that capture the sun’s energy.

    “Science is amazing and beautiful,” said John LaFemina, PNNL’s director of Institutional Strategy. “The images in this calendar and traveling art exhibit clearly illustrate that the work we do at PNNL contributes to the safety, security and prosperity of our nation. They are also inspirational expressions of the creative skill and imagination of our staff; they are beautiful works of art.”

    Calendar images were selected from 99 staff-submitted entries during PNNL’s third annual Science as Art contest. The twelve winning entries were selected by the general public, who could vote for their favorite images on PNNL’s Facebook site this spring. All 99 photos are available for viewing on PNNL’s Facebook page.

    PNNL’s 2013 “Discovery in Action” calendar, published by BrownTrout Publishers, Inc., is available in limited quantities for purchase online at Amazon.com. Suggested retail price is $14.99. A downloadable PDF of the calendar is also available.

    Adjacent to each image in the calendar are the names of the PNNL team members as well as research partners and funding agencies including Thomas Jefferson National Accelerator Facility, University of Notre Dame, Washington State University and University of Central Florida. Funding agencies include the Department of Energy, Department of the Interior, Nuclear Regulatory Commission, National Security Agency, Department of Health and Human Services and the National Science Foundation.

    Images within PNNL’s 2013 calendar were captured using instrumentation at PNNL and two DOE national user facilities including EMSL, the Environmental Molecular Sciences Laboratory at PNNL, and the Advanced Photon Source at Argonne National Laboratory.

    Artwork presented in the calendar will also be on display at Columbia Basin College Planetarium Dec. 3-Feb. 1, and LIGO Hanford Observatory Jan. 28-March 1. Other upcoming exhibit locations include the Pacific Science Center in Seattle, WSU Tri-Cities, and other locations. Dates will be posted online when confirmed. Click here for more information about PNNL’s science in art.

  • UCLA Nursing researchers spotlight role of nursing in social justice at major symposium

    Nurses who conduct research on aging issues often hear stories from older adult patients that highlight the inequalities in our health care system, illustrate the boundaries of ethical decision-making that can impact clinical outcomes, and bring into focus unresolved social policy issues.
     
    Sadly, these voices do not get the attention they need or deserve.
     
    Now, researchers from the UCLA School of Nursing will examine these issues of social justice and how nurses can give voice to the elderly and other vulnerable populations to influence policy and care-delivery during a symposium at the Gerontological Society of America Annual Scientific Meeting on Nov. 15. Their presentation, “Advocating for Hidden Voices, Social Justice Among Vulnerable Populations,” runs from 8 to 9:30 a.m.
     
    “In their research, our nurses have heard stories about the discrimination and disparities among the marginalized in our society,” said Linda Phillips, director of the Center for Advancement of Gerontological Nursing Sciences at the UCLA School of Nursing. “As nurses and researchers, we have a responsibility to not tolerate these disparities for vulnerable populations.”
     
    During the symposium, researchers will discuss how the issues of social justice have arisen in a variety of areas during the development and implementation of their research:

    Abuse in California’s skilled nursing facilities
    Nursing homes are a place where seniors should be safe. Yet according to government figures, one-third of nursing homes in California have been cited for causing serious harm or death to patients. This presentation will discuss elder abuse in skilled nursing facilities and how the lack of fines and enforcement offer little incentive to initiate change in practice.
     
    African American men and prostate cancer
    Prostate cancer incidence and mortality rates are highest among older African American men; inadequate health care access, low socioeconomic status and race are all key factors. This presentation will focus on the role gerontological nurse–researchers can play in addressing these types of problems and will discus outcomes associated with financially based treatment inequities and how to use these stories to influence policy.
     
    Aging among older homeless woman
    The “golden years” are often looked upon by older adults as a period for reflection and enjoyment, but many find themselves destitute and homeless. Approximately 33 percent of chronically homeless adults are over 50 and are at high risk for chronic illness, social isolation and victimization. Moreover, they lack housing and access to health care. This presentation will discuss the development and implementation of programs that can meet the needs of this vulnerable population.
     
    Disparities among racial and ethnic groups
    Despite strong and convincing evidence of health disparities and expansive difference in health outcomes, there are limited studies being done that focus on the unique challenges faced by certain racial and ethnic groups. The final presentation will showcase the need for funding to address health disparities among these groups and where we are at currently in terms of funded research.
     
     
    “By sharing this research, we hope to the raise awareness of these healthcare discrepancies and start the work to make changes that build a healthy community for all,” Phillips said.
      
    The UCLA School of Nursing is redefining nursing through the pursuit of uncompromised excellence in research, education, practice, policy and patient advocacy. For more information, visit nursing.ucla.edu.
     
    For more news, visit the UCLA Newsroom and follow us on Twitter.

  • PNNL expertise highlighted at Supercomputing

    From identifying common patterns in data to speeding up computers, researchers from the Department of Energy’s Pacific Northwest National Laboratory will share their computational expertise at this year’s Supercomputing conference.

    Also referred to as SC12, the annual gathering is the international conference for high-performance computing, networking, storage and analysis. It runs Nov. 10-16 at the Salt Palace Convention Center in Salt Lake City. Two noteworthy talks featuring PNNL research are described below.

    New algorithm pin-points similar data in seconds

    Data is everywhere these days. Biologists sift through vast amounts of error-prone data to understand how our cells work. Even librarians slog through mountains of information to better understand the materials they catalog. The key to comprehending today’s information explosion is finding meaningful patterns buried in the data — and then finding comparable data patterns in other, related sources. This technique is called network alignment. Computational scientists at PNNL and Purdue University have developed new methods to identify similar patterns in any type of data. Their procedures help find proteins that act the same in humans and mice, and help find ideas that act the same for librarians and Wikipedia editors.

    The existing methods used to solve these kinds of problems have been too slow to cope with the growing amount of data, prompting the PNNL and Purdue team to make them faster. To do this, they developed a new algorithm that uses an approach called approximate matching, which saves time by matching nearly identical patterns instead of exactly identical ones. They also developed new computer implementations that enabled the algorithm to use all a computer’s processors in parallel to quickly identify relationships between two different networks. Tests using both of these improvements showed that the algorithm found similar interactions between thousands of proteins in two species in just seconds and found comparable ideas between hundreds of thousands of topics in library systems and Wikipedia entries in less than a minute.

    PNNL’s Mahantesh Halappanavar led the research on how to quickly find approximate matchings with help from Purdue’s Arif Khan and Alex Pothen. And, Purdue’s David Gleich led the work on how to use approximate matchings to align networks. Gleich will present a paper describing this research Wednesday.

    4:30-5 p.m., Wed., Nov. 14: A multithreaded algorithm for network alignment via approximate matching, Arif Khan, David Gleich, Mahantesh Halappanavar & Alex Pothen, Room 355-EF.

    Software translates code, speeds up data-crunching

    Large and complex networks in parallel computers can lead to inefficient communications between processors that also slows down computation. This makes it difficult to achieve exascale computing, which is one thousand times faster than today’s fastest petascale supercomputers.  Scientists are developing strategies to reduce the time it takes to compute data and communicate those results between parallel processors. A team of researchers from PNNL, University of California, San Diego, and Lawrence Livermore National Laboratory have developed new software called Bamboo to help do just that.

    Traditionally, scientists have broken up a complex algorithm to speed things up. Different processors calculate bits of the algorithm and then each processor communicates its results to the others. Such division of labor is quicker than one processor doing all the work by itself. But communicating bunches of data between multiple processors can cause information bottlenecks that slow down the whole process. One solution is to initially calculate a portion of a processor’s data and communicate those results while the other portion is still being calculated. Called overlapping communications and calculations, this approach can reduce the overall time it takes to complete a job, but it requires extremely complex codes. That’s where Bamboo comes in. Bamboo automatically translates standard MPI parallel codes into a format that can easily overlap communication with available computation.  Without Bamboo, scientists have the onerous task of manually developing overlapping MPI code. Tests showed Bamboo-generated code was as good as or better than human-developed codes.

    PNNL’s Eric Bylaska drew on his experience developing complex code for NWChem, DOE’s premier molecular modeling software package, to help develop realistic test programs for the Bamboo framework. The University of California, San Diego’s Scott Baden, who led the project, will present a paper describing the team’s results Wednesday.

    10:30-11 a.m., Wed., Nov. 14: Bamboo – Translating MPI Applications to a Latency-Tolerant, Data-Driven Form, Tang Nguyen, Pietro Cicotti, Eric Bylaska, Dan Quinlan & Scott Baden, Room 255-EF.

  • Breast cancer and depression: UCLA gets $5M to study why survivors are at such high risk

    UCLA researchers have received a $5 million grant from the National Cancer Institute for a study aimed at developing a risk profile for breast cancer survivors likely to suffer from depression. The prevalence of depression among survivors is three to five times greater than in the general population.
     
    UCLA will be teaming on the five-year study with Kaiser Permanente, which will provide the 300 volunteers needed for the study by culling through electronic patient records to locate women who have been treated for breast cancer and have not had a history of depression.
     
    Researchers believe that cancer and its treatment induce inflammation, which in turn leads to sleep disturbance and depression. Sleep disturbance occurs in more than half of breast cancer survivors and is thought to contribute to the elevated risk of depression in these women. Depression negatively impacts quality of life and increases the risk of death, possibly due to an increased chance of cancer recurrence.
     
    Through the study, researchers hope to find out if certain sub-sets of breast cancer survivors are at greater risk for depression by examining their DNA for potential biomarkers and genetic anomalies. If they can identify a risk profile, a study would be launched later to evaluate prevention measures, said the study’s principal investigator, Dr. Michael Irwin, a professor of psychiatry and biobehavioral sciences at the Cousins Center for Psychoneuroimmunology, part of the Semel Institute for Neuroscience and Human Behavior at UCLA.
     
    “Depression in breast cancer survivors is a huge problem. It often goes undiagnosed and is undertreated,” Irwin said. “If we can identify those breast cancer survivors at elevated risk for sleep disturbance and, therefore, depression, we can diagnose and treat it earlier, with better outcomes. Additionally, if we can identify those at greatest risk, efforts can be implemented early to prevent the occurrence of depression in the first place.
     
    “Because depression is so prevalent and difficult to treat in breast cancer survivors, prevention of depression will dramatically improve the quality of their life.”
     
    For many cancer patients, their survival is complicated by long-term physical and behavioral late effects of their treatment, especially depression, Irwin said. Yet despite the high prevalence of depression among breast cancer survivors, the unique clinical, behavioral and biological factors that contribute to this increased depression risk is not known.
     
    “There are no published prospective data that have examined the independent contribution of sleep disturbance on depression occurrence in breast cancer survivors,” Irwin said. “Increasing evidence implicates that sleep disturbance is activating inflammatory signaling, which serves as a biological mechanism that contributes to depression. We hope to define the genomic and biologic processes that results in this depression.”
     
    Irwin’s ultimate goal is preventing the cascade of events that lead to depression — inflammation and sleep disturbance — but more information is needed first.  This study is vital to providing valuable clues as to how that cascade occurs, he said.
     
    “You can’t design a prevention trial unless you know the risk profile and the magnitude of the problem,” Irwin said. “What makes this so exciting is that by partnering with Kaiser Permanente, we can do this work in a primary care sample, which will significantly help speed recruitment.”
     
    Study volunteers, once identified, will come in for an interview, give a blood sample that will measure levels of inflammation and provide DNA for examination. This process will be repeated every six months for two years. The volunteers also will be called once a month and asked a series of questions to determine if they are becoming depressed.
     
    “If depression is suspected, we can bring them in immediately and evaluate them,” Irwin said. “That will be a big benefit for volunteers as they’ll get diagnosed and treated much sooner than they normally would be.”
     
    Irwin said he expects it will take two to three years to successfully recruit the 300 volunteers needed.
     
    The UCLA Cousins Center for Psychoneuroimmunology encompasses an interdisciplinary network of scientists working to advance the understanding of psychoneuroimmunology by linking basic and clinical research programs and by translating findings into clinical practice. The center is affiliated with the Semel Institute for Neuroscience and Human Behavior and the David Geffen School of Medicine at UCLA.
     
    For more news, visit the UCLA Newsroom and follow us on Twitter. 

  • Autism expert’s new book empowers parents to get involved in their child’s development

    It is a helpless feeling for a parent whose child has been diagnosed with autism, UCLA’s Tanya Paparella writes in her new book, “More Than Hope: For Young Children on the Autism Spectrum.” But with the right tools early on, she says, mothers and fathers can rest a little easier knowing they can have long-lasting, positive impact on their child’s development.
     
    Paparella should know. An associate clinical professor in the UCLA Division of Child Psychiatry, she has spent more than 20 years treating children with autism spectrum disorders (ASD), a range of impairments that strikes early in childhood. ASD disrupts a child’s ability to communicate and develop social relationships and is often accompanied by acute behavioral challenges.
     
    “Parent’s become overwhelmed with the thought that their little one is ‘on the spectrum,’” Paparella said. “It turns people’s lives upside down as they struggle to cope with their own emotions, family and everyday life.”
     
    Further, she noted, many parents are desperate to intervene immediately to help their children, but they often don’t know where to start, and they frequently face an extended — and agonizing — waiting period before formal clinical interventions begin.
     
    Paparella says she wrote the book, along with co-author Laurence Lavelle, a UCLA faculty member and recipient of the university’s Distinguished Lecturer Award, to address that sense of frustration on the part of parents and to empower them by providing an easy-to understand set of practical strategies they can use to intervene early.
     
    “Parents can make an enormous difference to their children’s development if they know what to do. The earlier the intervention, the better — and parents are at the forefront,” she said. “Young children on the autism spectrum can make tremendous change and achieve what seemed impossible before they were treated. The effects of early intervention can be astounding.”
     
    Paparella has had outstanding success with early interventions for children with ASD — many as young as 2 years old — in her longtime work as a faculty member at the UCLA Center for Autism Research and Treatment and director of UCLA’s Early Childhood Partial Hospitalization Program, an internationally recognized treatment program for young children with autism at the Semel Institute for Neuroscience and Human Behavior.
     
    In “More Than Hope,” she draws on what she has learned over two decades of cutting-edge research and treatment and distills it into a series of powerful, parent-friendly interventions that target each significant area of developmental difficulty in autism — from language and gestures to social interaction and recognizing facial expressions. 
     
    In each area, Paparella explains why children with autism learn and behave differently and provides step-by-step intervention approaches that can be incorporated into everyday activities by parents to help their children develop better communication and social skills and encourage normal behavior.
     
    These teaching strategies, Paparella said, are highly practical and have been proven to work. By offering parents and caregivers the critical knowledge so many of them lack at the outset of an autism diagnosis, she hopes they will feel empowered to intervene early, leading to long-lasting benefits for each child and their family.
     
    An added plus, she noted, is that while children with autism should also engage in therapies with specialists, by using these strategies, families can significantly reduce the financial overhead incurred by relying only on specialists for intervention.
     
    Paparella also emphasizes in the book that parents are not to blame for their child’s autism.
     
    “We don’t yet have all the answers about what causes autism,” she said, “but the consensus is that it is a combination of genetics and environmental factors.”
     
    For more information on “More Than Hope,” please visit www.autismintervention.info and http://on.fb.me/QZQ4la.
     
    UCLA has one of the strongest autism research and treatment programs in the country. Its Center for Autism Research and Treatment (CART) is one of the National Institutes of Health’s Autism Centers of Excellence (ACE) and was the only ACE center in the nation to recently be awarded renewed funding for the next five years. The funding will support ongoing research focused on examining genes’ link to behavior, developing clinical interventions for those severely affected by the disorder, and explaining why autism affects more boys than girls. The goal of this work is to understand the full range of ASD.
     
    The UCLA Center for Autism Research and Treatment (CART) conducts research and clinical trials and provides diagnoses, family counseling and treatment for individuals with autism spectrum disorders. It 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 and follow us on Twitter.

  • Transforming America by redirecting wasted health care dollars

    The respected national Institute of Medicine estimates that $750 billion is lost each year to wasteful or excessive health care spending. This sum includes excess administrative costs, inflated prices, unnecessary services and fraud — dollars that add no value to health and well-being.
     
    If those wasteful costs could be corralled without sacrificing health care quality, how might that money be better spent?
     
    In a study published in the current online edition of the American Journal of Preventive Medicine, Frederick J. Zimmerman, professor and chair of the department of health policy and Management at the UCLA Fielding School of Public Health, and colleagues outline some of the myriad ways that $750 billion could benefit Americans.
     
    “If cut from current health care expenditures, these funds could provide businesses and households with a huge windfall, with enough money left over to fund deficit reduction on the order of the most ambitious plans in Washington,” Zimmerman said. “The money could also cover needed investments in transportation infrastructure, early childhood education, human capital programs, rural development, job retraining programs and much more. And it could transform America with little to no reduction in the quality of, or access to, health care actually provided.”
     
    Zimmerman noted that while different observers would likely have different priorities regarding the alternative uses toward which the wasted expenditures could be directed, all would agree that the alternatives proposed in this study have inherent social value.
     
    “When the fastest-growing part of the economy is also the least efficient, the economy as a whole loses its ability over time to support our current living standards,” said Jonathan Fielding, a UCLA professor of health policy and management and director of the Los Angeles County Department of Public Health, who is a co-author of the study. “The U.S. has become irrationally attached to its inefficient health care system. Recognizing the opportunity costs of this attachment is the first step in repairing the system.”
     
    In the study, the research group, which also included Dr. Steven Teutsch, chief science officer of the Los Angeles County Department of Public Health, and first author Jeffrey C. McCullough, a graduate student at the UCLA Fielding School, presented one scenario of how that money could be used.
     
    For one, the authors propose that more than $410 billion per year — or 55 percent of the savings — could be returned to the private sector for individuals and companies to use as they please; another $202 billion (27percent) could go toward deficit reduction, yielding a greater reduction than the congressional “super committee” sought and failed to achieve. An additional $104 billion (14 percent) could support additional investments in human capital and physical infrastructure.
     
    “For example,” Zimmerman said, “the Head Start program could be doubled in size, universal preschool could be provided, average class size could be reduced from 22–25 to 13–17 students. And trained nurses could conduct regular home visits for high-risk pregnancies.”
     
    Two percent of the savings, amounting to $18 billion, could promote urban and rural quality of life by improving the built environment surrounding schools, expanding and modernizing public libraries, improving wastewater treatment and providing rural development grants to every small town in the nation. Job-training opportunities would be affordable for nearly 50,000 unemployed persons. And under the research group’s scenario, the remaining 2 percent of the savings would be devoted to fully funding an extensive wish list of transportation projects to alleviate road congestion and promote mass transit alternatives.
     
    Freeing up this money would be no easy task, Fielding warned. These excess expenditures will be difficult to reduce because the costs are spread across many groups, and the financial beneficiaries are coordinated, clear-minded and powerful, he said. Overcoming this resistance will require concerted collective action on the part of many economic sectors, governmental agencies and other organizations that are not used to seeing themselves as sharing interests with the others.
     
    But whatever one’s values and preferences, said Zimmerman, “eliminating excess medical care costs provides a monumental opportunity to reallocate those resources to strengthen our international competitiveness, enhance our well-being and build a healthier nation.”
     
    The result of redirecting some $750 billion per year, he said, could be transformative for Americans, and the potential uses for these funds are panoramic in both scope and possibility.
     
    “This will not be an easy fight,” Zimmerman said. “But we believe reconceptualizing our excess health care spending by looking at its opportunity cost to society is an important first step.”
     
    A video of the group’s research is available online at www.ajpmonline.org/content/video_pubcasts_collection.
     
    This research was not supported by external grants or funding. The authors report no conflict of interest.
     
    The UCLA Fielding 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 and follow us on Twitter. 

  • Going live with a smarter electric grid

    A project designed to make the region’s and nation’s electric grid more reliable and efficient will be showcased today during an event at the University of Washington where students will be able to view how they are using energy in real time.  The UW project is one of 11 projects across five Northwest states that comprise the Pacific Northwest Smart Grid Demonstration Project, a public/private demonstration launched in February 2010.

    Sponsored by the Department of Energy’s Office of Electricity Delivery and Energy Reliability, and co-funded by the participating utilities, the demo is beginning a two-year period of collecting energy use data.

    The 11 participating utilities will evaluate the benefits of smart grid technologies locally — in their respective cities — and at the regional level. The project team will look at how a smarter grid can help deliver electricity more efficiently to avoid congestion in the transmission system and how more wind power can be used. The project’s data collection and analysis efforts are expected to provide an unprecedented view into how smart grid concepts can provide regional benefits while improving consumer choice and reliability locally.

    “The two-way information exchange in the Pacific Northwest Smart Grid Demonstration Project allows grid operators to make the existing electric grid more efficient — while also exploring how using other technologies, such as energy storage devices, smart appliances and wind power, can bolster the reliability of our system,” said Carl Imhoff, Electricity Infrastructure Market Sector manager at Battelle in Richland. Battelle is leading the demonstration project for the DOE’s Office of Electricity Delivery and Energy Reliability.

    “The data we’ll gather during the next two years will enable us to evaluate the costs and benefits of a smart grid to consumers in all types of utilities in the Pacific Northwest. We’ll also evaluate how we can optimize our power system while, at the same time, adding more variable, renewable energy resources such as wind and solar,” he said.

    The UW’s Role
    The University of Washington has invested nearly $10 million in the project. Before the project began, the UW had seven meters on campus providing a limited view into the campus’ energy use. As Seattle City Light’s largest customer, the UW has worked with the utility to install more than 200 smart meters across campus in nearly every building. The meters give energy users real-time information and analysis on energy usage and will improve the UW’s understanding of how much energy they are using and how efficiently they are using it. At new residence halls on campus, students will have real-time access to their energy use data by way of in-room energy management devices. Graduate students also will be able to gather and study this data for use in classroom instruction.

    “The University of Washington is recognized as a national leader in sustainability within the higher education community,” says UW Provost Ana Mari Cauce. “The project provides an exciting opportunity for testing how 21st century technology can reduce energy consumption. Given our students’ keen interest in the environment, it is appropriate that much of our research on smart grids will occur within our residence halls and that the initial research will be conducted by students in our Program on the Environment.”

    Regional knowledge
    At the regional level, the Pacific Northwest Smart Grid Demonstration Project is testing an innovative concept called “transactive control” through information exchanges connecting the 11 participating utilities, each volunteering to participate in the study with the Electricity Infrastructure Operations Center located at Battelle’s facilities in Richland, Wash. There, information about demand for electricity, amount of wind power available and wind forecasts are translated into incentive signals, or prices, which are updated every five minutes and sent to participating utilities. This allows contributors to make local decisions on how their piece of the smart grid project can support local and regional grid needs.

    The Battelle-led project team is using the signal to test a variety of smart technologies in different geographies, in different weather, in different situations, to learn the most they can about how the grid can operate most efficiently.

    The move to “go-live” with the transactive control signal is the continuation of more than a decade of smart grid research in the Pacific Northwest.

    Learning from the past
    “Six years ago in a similar project on the Olympic Peninsula in Washington state we learned that a small group of consumers using a smart energy signal similar to transactive control could save about 10 percent on their monthly power bill and help their utility reduce peak demand by 15 percent,” said Imhoff. “Now, we’ll be able to see how a broader set of customers, from different climate and geographic regions, can save energy or money, or both.” he said.

    During the Olympic Peninsula GridWise® Demonstration Project, 115 consumers were outfitted with smart water heaters and electric dryers that responded to a smart signal and would intermittently turn their heating elements off, anywhere from 20 seconds to two minutes, during times of peak demand on the grid. Researchers found consumers didn’t notice because water would remain hot and the barrel of the dryer would continue to spin during these short periods of time. Researchers also found the impact from those smart devices made a difference in the amount of money consumers paid for power each month, and in the amount of energy saved during times of peak demand on the grid. Project participants are now looking to that intermittency used in a broader scale with a diverse set of smart appliances and an even smarter signal.

    Building the business case
    As a primary partner in the project, the Bonneville Power Administration is leading a regional effort to develop a business case for smart grid — to show which major infrastructure and technology investments will provide the best value to Northwest ratepayers in the long run.

    “One of the main goals of this smart grid project is to develop the regional cost/benefit analysis,” according to BPA Deputy Director Bill Drummond.  “And that’s important because demonstrating that the benefits of smart grid outweigh the costs is crucial for any utility considering moving forward with these investments.”

    The “go live” event takes place at 10:30 a.m. at Alder Hall Commons, located at 1315 NE Campus Parkway (entrance on NE 40th St. between Brooklyn Ave. NE and University Way NE). U.S. Senators Patty Murray and Maria Cantwell, UW Provost Ana Mari Cauce; Bill Drummond, Deputy Director of the Bonneville Power Administration; and Battelle Senior Vice President and Pacific Northwest National Laboratory Director Mike Kluse will be on hand for the celebration.

    The Pacific Northwest Smart Grid Demonstration Project was co-funded by American Recovery and Reinvestment Act funding through the DOE, and the project’s utility and vendor partners. More information about the project is available at www.pnwsmartgrid.org.

    Project Participants
    Battelle leads a strong collaboration that includes the Bonneville Power Administration and the following 11 utility representatives based in the Pacific Northwest:

    • Avista Utilities – Spokane, Wash.
    • Benton PUD – Kennewick, Wash.
    • City of Ellensburg – Ellensburg, Wash.
    • Flathead Electric Cooperative, Inc. – Kalispell, Mont.
    • Idaho Falls Power – Idaho Falls, Idaho
    • Lower Valley Energy – Afton, Wyo.
    • Milton-Freewater City Light & Power – Milton-Freewater, Ore.
    • NorthWestern Energy – Butte, Mont.
    • Peninsula Light Company – Gig Harbor, Wash.
    • Portland General Electric – Portland, Ore.
    • University of Washington/Seattle City Light – Seattle, Wash.

    The demonstration also involves a diverse team of technology providers including: Alstom Grid, IBM/Netezza, 3TIER Inc., and Quality Logic Inc. Washington State University and Central Washington University also are directly involved.

  • UCLA Health System statement on condition of patients involved in Inglewood shooting

    Gloria Jimenez, age 28, is currently in good condition, and her daughter, age 7, is in fair condition at Ronald Reagan UCLA Medical Center and Mattel Children’s Hospital UCLA. Both suffered gunshot wounds during an incident that took place in Inglewood, Calif., on Oct. 20.
     
    Ms. Jimenez wanted to release the following statement:
     
    “I would like to thank everyone in the community, the emergency responders and the doctors and nurses at UCLA for their ongoing support. It is a very sad time for our family and we appreciate your kind words and thoughts and quick response for our care. We feel blessed to have so many people there for us.”
     
    No other information or interviews are available at this time.

  • In vitro fertilization linked to increased risk of birth defects

     
    In vitro fertilization may significantly increase the risk of birth defects, particularly those of the eyes, heart, reproductive organs and urinary system, according to a new UCLA study.
     
    UCLA researchers presented findings from their abstract, “Congenital Malformations Associated With Assisted Reproductive Technology: A California Statewide Analysis,” on Oct. 20 at the American Academy of Pediatrics National Conference and Exhibition in New Orleans.
     
    Despite the increasing use of IVF in the United States, links between birth defects and IVF are poorly understood, the researchers said. The management of birth defects accounts for a large part of pediatric surgical care and demands significant health care resources. According to the Centers for Disease Control and Prevention, California has the highest rate of IVF usage in the United States. 
     
    For the study, the researchers looked at infants born in California from 2006 to 2007 following the use of assisted reproductive technologies — fertility treatments involving the manipulation of both eggs and sperm — primarily IVF. They examined the mother’s age, race and the number of times she had previously given birth, as well as the infant’s gender, year of birth, whether the infant was part of a multiple birth (twins, triplets, etc.) and the presence of major birth defects.
     
    “Our findings included a significant association between the use of assisted reproductive technology, such as certain types of in vitro fertilization, and an increased risk of birth defects,” said lead author Dr. Lorraine Kelley-Quon, a general surgery resident at Ronald Reagan UCLA Medical Center, who conducted the research at Mattel Children’s Hospital UCLA.
     
    Among the 4,795 infants born after IVF and 46,025 naturally conceived infants with similar maternal demographics examined in the study, the researchers identified 3,463 infants with major birth defects.
     
    They found that birth defects were significantly increased for infants born after IVF, compared with naturally conceived infants (9.0 percent vs. 6.6 percent), even after controlling for maternal factors. Specifically, IVF infants had greater rates of malformations of the eye (0.3 percent vs. 0.2 percent), heart (5.0 percent vs. 3.0 percent) and genitourinary system (1.5 percent vs. 1.0 percent).  
     
    Overall, IVF infants’ odds of having birth defects were 1.25 times greater than those of naturally conceived infants with similar maternal characteristics.
     
    The researchers also looked at infants born following fertility treatments that, unlike IVF and other assisted reproductive technologies, do not involve the manipulation of both eggs and sperm, including artificial insemination and ovulation induction. They found that the risk of birth defects for these infants was not significant.
     
    “For parents considering in vitro fertilization or other forms of assisted reproductive technology, it is important that they understand and discuss with their doctor the potential risks of the procedure before making a decision,” said Kelley-Quon.
     
    The study was funded by the Robert Wood Johnson Foundation Clinical Scholars Program.
     
    In addition to Kelley-Quon, UCLA co-authors included Chi-Hong Tseng, D. Carla Janzen and Dr. Stephen B. Shew.
     
    The authors have no financial ties to disclose.
     
    For more news, visit the UCLA Newsroom and follow us on Twitter.

  • UCLA faculty members elected to Institute of Medicine

    Two UCLA faculty members, Dr. Sherin U. Devaskar and Jack Needleman, have been elected to the prestigious Institute of Medicine of the National Academies, one of the highest honors in the fields of health and medicine.
     
    Devaskar and Needleman join 68 other new members and 10 foreign associates elected for their “outstanding professional achievement and commitment to service,” the institute announced Oct. 15.
     
    Devaskar, physician-in-chief at Mattel Children’s Hospital UCLA and UCLA’s assistant vice chancellor for children’s health, is a highly accomplished investigator renowned for unraveling the processes responsible for the fetal and neonatal origins of chronic childhood and adult disorders, including obesity and diabetes. She is a professor of pediatrics at the David Geffen School of Medicine at UCLA and holds UCLA’s Mattel Executive Endowed Chair.
     
    Needleman, a professor in the department of health services at UCLA’s Fielding School of Public Health and a faculty associate at the UCLA Center for Health Policy Research, has transformed the measurement of hospital patients’ quality-of-care linked to nurses, improved management practices to increase quality and safety, and helped propel passage of national legislation. Quality measures he developed have been adopted by the Agency for Healthcare Research and Quality, Medicare, the Joint Commission and the National Quality Forum.   
     
    “The Institute of Medicine is greatly enriched by the addition of our newly elected colleagues, each of who has significantly advanced health and medicine,” said the institute’s president, Harvey V. Fineberg. “Through their research, teaching, clinical work and other contributions, these distinguished individuals have inspired and served as role models to others.”
     
    Established in 1970, the Institute of Medicine is one of the National Academies — along with the National Academy of Sciences, the National Academy of Engineering and the National Research Council — and serves as a resource for independent, scientifically informed analysis and recommendations on health issues.
     
    With the newly elected members, Institute of Medicine membership now totals 1,928.
     
    For more news, visit the UCLA Newsroom and follow us on Twitter.

  • Science supports sex addiction as a legitimate disorder

    The idea that an individual might suffer from a sexual addiction is great fodder for radio talk shows, comedians and late night TV. But a sex addiction is no laughing matter. Relationships are destroyed, jobs are lost, lives ruined.
     
    Yet psychiatrists have been reluctant to accept the idea of out-of-control sexual behavior as a mental health disorder because of the lack of scientific evidence.
     
    Now a UCLA-led team of experts has tested a proposed set of criteria to define “hypersexual disorder,” also known as sexual addiction, as a new mental health condition.
     
    Rory Reid, a research psychologist and assistant professor of psychiatry at the Semel Institute of Neuroscience and Human Behavior at UCLA, led a team of psychiatrists, psychologists, social workers, and marriage and family therapists that found the proposed criteria to be reliable and valid in helping mental health professionals accurately diagnose hypersexual disorder.
     
    The results of this study — reported in the current edition of the Journal of Sexual Medicine — will influence whether hypersexual disorder should be included in the forthcoming revised fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), considered the “bible” of psychiatry.
     
    The importance of the study, Reid said, is that it suggests evidence in support of hypersexual disorder as a legitimate mental health condition.
     
    “The criteria for hypersexual disorder that have been proposed, and now tested, will allow researchers and clinicians to study, treat and develop prevention strategies for individuals at risk for developing hypersexual behavior,” he said.
     
    The criteria, developed by a DSM-5 sexual and gender identity disorders work group for the revised manual, establish a number of symptoms that must be present. These include a recurring pattern of sexual fantasies, urges and behaviors lasting a period of six months or longer that are not caused by other issues, such as substance abuse, another medical condition or manic episodes associated with bipolar disorder. Also, individuals who might be diagnosed with this disorder must show a pattern of sexual activity in response to unpleasant mood states, such as feeling depressed, or a pattern of repeatedly using sex as a way of coping with stress.
     
    Part of the criteria also states that individuals must be unsuccessful in their attempts to reduce or stop sexual activities they believe are problematic.
     
    “As with many other mental health disorders,” said Reid, “there must also be evidence of personal distress caused by the sexual behaviors that interfere with relationships, work or other important aspects of life.”
     
    In order to evaluate the criteria for hypersexual disorder, Reid and his colleagues conducted psychological testing and interviews with 207 patients in several mental health clinics around the country. All of the patients were seeking help for out-of-control sexual behavior, a substance-abuse disorder or another psychiatric condition, such as depression or anxiety.
     
    The researchers found that the proposed criteria for hypersexual disorder accurately classified 88 percent of hypersexual patients as having the disorder; the criteria were also accurate in identifying negative results 93 percent of the time. In other words, the criteria appear to do a good job of discriminating between patients who experience hypersexual behavior and those who don’t, such as patients seeking help for other mental health conditions like anxiety, depression or substance abuse.
     
    “The results lead us to believe that the proposed criteria tend not to identify patients who don’t have problems with their sexual behavior,” Reid said. “This is a significant finding, since many had expressed concerns that the proposal would falsely classify individuals.”
     
    Reid also noted that the ability of the criteria to accurately identify hypersexual disorder in these patients was quite high and compared favorably to other psychiatric diagnoses.
     
    Another significant finding of the study, he said, was that patients who met the criteria for hypersexual disorder experienced significantly greater consequences for their sexual activities, compared with individuals with a substance-abuse diagnosis or a general medical condition. Of the 207 patients they examined, 17 percent had lost a job at least once, 39 percent had a relationship end, 28 percent contracted a sexually transmitted infection and 78 percent had interference with healthy sex.
     
    “So an individual meeting the criteria for hypersexual disorder can experience significant challenges and consequences in their life,” Reid said. “Our study showed increased hypersexual behavior was related to greater emotional disturbance, impulsivity and an inability to manage stress.”
     
    Interestingly, the researchers found that 54 percent of the hypersexual patients felt their sexual behavior began to be problematic before the age of 18. Another 30 percent reported that their sexual behavior began to be problematic during their college-aged years, from 18 to 25.
     
    “This appears to be a disorder that emerges in adolescence and young adulthood, which has ramifications for early intervention and prevention strategies,” Reid said.
     
    The study also examined the types of sexual behavior that hypersexual patients reported. The most common included masturbation and excessive use of pornography, followed by sex with another consenting adult and cybersex. The study noted that hypersexual patients had sex with commercial sex workers, had repeated affairs or had multiple anonymous partners — amounting to an average of 15 sex partners in the previous 12-month period.
     
    “It’s not that a lot of people don’t take sexual risks from time to time or use sex on occasion to cope with stress or just escape, but for these patients, it’s a constant pattern that escalates until their desire for sex is controlling every aspect of their lives and they feel powerless in their efforts to change,” Reid noted.
     
    Other authors on the study included Heather McKittrick, Margarit Davtian, and senior author Dr. Timothy Fong, all of UCLA; Bruce N. Carpenter and Randy Gilliland of Brigham Young University; Joshua N. Hook of the University of North Texas; Sheila Garos of Texas Tech University; Jill C. Manning, in private practice; and Erin B. Cooper of Temple University. Dr. Fong has the following relationships: speaker’s bureau for Reckitt Benckiser, Pfizer Pharmaceuticals, and grant support from Psyadon Pharmaceuticals. The other authors report no conflict of interest.
     
    Most of the study was unfunded; researchers donated their time. Some travel expense was funded internally through the UCLA Department of Psychiatry.
     
    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 strategies for prevention and treatment of neurological, psychiatric and behavioral disorder, including improvement in access to mental health services and the shaping of national health policy.
     
    For more news, visit the UCLA Newsroom and follow us on Twitter. 

  • Taking race out of the equation in measuring women’s risk of osteoporosis and fractures

    For women of mixed racial or ethnic backgrounds, a new method for measuring bone health may improve the odds of correctly diagnosing their risk of osteoporosis and bone fractures, according to a UCLA-led study.
     
    Currently, assessing osteoporosis and the risk of fractures from small accidents like falls requires a bone density scan. But because these scans don’t provide other relevant fracture-related information, such as bone size and the amount of force a bone is subjected to during a fall, each patient’s bone density is examined against a national database of people with the same age and race or ethnicity.
     
    This approach, however, doesn’t work for people of mixed race or ethnicity because comparison databases can’t account for mixed heritage. A similar problem exists for those from smaller racial or ethnic groups for which there are not comparison databases.
     
    “All the current ways of determining your risk for fractures require knowing your race and ethnicity correctly, and they ignore the fact that racial and ethnic groups are not homogenous,” said study co-author Dr. Arun Karlamangla, a professor of medicine in the geriatrics division at the David Geffen School of Medicine at UCLA. “It also flies in the face of the current reality in Southern California, where so many people are of mixed ethnicity.”
     
    Given that osteoporosis and hip fractures are leading causes of injury in older people, alternative means of measuring risk are needed. Now, a UCLA-led team of researchers has found a way of assessing risk without knowledge of a person’s race or ethnicity. The method involves combining bone mineral density measures with body size and bone size to create composite bone strength indices.
     
    The findings are published in the October issue of the Journal of Clinical Endocrinology and Metabolism.
     
    The researchers studied data on nearly 2,000 women in the U.S. between the ages of 42 and 53 who were of Caucasian, African American, Japanese and Chinese heritage. The data came from the Study of Women’s Health Across the Nation; UCLA was one of seven sites that recruited women for the study.
     
    Using the new composite bone strength indices, the researchers tested how the method predicted fracture risk in this group of women over a period of 10 years. They found that when they did not take into account the women’s race or ethnicity, they were able to predict fracture risk using the indices just as accurately as they could using the traditional method of combining bone mineral density measures with race and ethnicity information.
     
    “The importance of bone size to fracture risk has been recognized by engineers and radiologists for some years now,” said the study’s lead investigator, Dr. Shinya Ishii, who started the research while a fellow in the UCLA Division of Geriatrics and is now at the University of Tokyo. “But no one, until now, has combined bone density, which is the traditional measure of osteoporosis, with bone size and body size to get at a more uniform way of assessing osteoporosis that applies across racial lines and does away with the need to know the person’s race or racial mixture.”
     
    The researchers noted that further study is needed to determine if the same strength measures will work in men. Their findings also do not show how well these measures will continue working as women age. The results of the study do, however, point toward a new approach for assessing fracture risk, they say.
     
    Other researchers included Drs. Gail Greendale, Carolyn Crandall and Mei-Hua Huang of UCLA and Drs. Jane A. Cauley and Michelle E. Danielson of the University of Pittsburgh.
     
    National Institute on Aging grants (NR004061; AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495) to SWAN; a National Institute on Aging grant (AG026463) to the Hip Strength Through the Menopausal Transition Substudy; the Veterans Affairs Greater Los Angeles Healthcare System Geriatric Research, Education and Clinical Center, and a Veterans Affairs Advanced Geriatrics Fellowship supported 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 that strive 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 memory loss and dementia, falls and immobility, urinary incontinence, arthritis, arthritis, high blood pressure, heart disease, osteoporosis, and diabetes. As a result of their specialized training, 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 and follow us on Twitter.

  • UCLA’s heart transplant program ranked among nation’s best

    The heart transplant program at Ronald Reagan UCLA Medical Center has again been recognized as one of highest ranking in the nation by an agency of the U.S. Department of Health and Human Services.
     
    UCLA’s program is one of only seven heart transplant centers nationwide — and the only one in California — to be ranked at the silver level by the Health Resources and Services Administration (HRSA), which has federal oversight of the nation’s organ donation and transplantation network.
     
    The HRSA survey measures the performance of organ transplant centers by assessing transplant rates, post-transplant survival rates and mortality rates for patients after they are placed on organ-donation waiting lists. To earn silver status, a program must achieve better-than-expected performance in at least two of those categories. Only one center — a liver transplant program in Florida — earned a gold ranking for achievements in all three.  
     
    UCLA, which also earned silver status in 2010, when the HRSA organ transplant center survey was inaugurated, is the only heart transplant program in the U.S. to have earned a silver ranking twice.
     
    “As the only two-time silver-level heart transplant program, we are incredibly proud of our team’s hard work in providing the very best care for our patients who undergo this lifesaving treatment,” said Dr. Abbas Ardehali, a professor of cardiothoracic surgery and director of UCLA’s heart transplant program. “This recognition acknowledges that patients in the UCLA heart transplant program have a better chance of survival.”
     
    The HRSA awards were presented Oct. 4 at ceremony held in Grapevine, Texas.
     
    In addition, Ronald Reagan UCLA Medical Center received the Department of Health and Human Services’ Bronze Medal of Honor for Organ Donation for achieving and sustaining national goals for organ donation, including a donation rate of 75 percent or more of eligible donors.
     
    “We are so proud of our health care professionals who reach out with great compassion and sensitivity to explain and inspire individuals and families to save lives as organ and tissue donors during emotionally difficult times,” said Dr. J. Thomas Rosenthal, the medical center’s chief medical officer. “Every life touched by organ and tissue donation crosses a bridge between death and life, grief and meaning, hope and healing. This award is a true honor.”
     
    The Medal of Honor awards were presented for work done between April 1, 2010, and March 31, 2012.
     
    The HRSA leads federal efforts to increase organ and tissue donation and transplantation and supports the Donation and Transplantation Community of Practice, which brings together donation and transplantation professionals, hospital staff and other professionals involved in the donation process to identify and share best practices. For more information, visit www.organdonor.gov.
     
    One of the nation’s busiest transplant centers, Ronald Reagan UCLA Medical Center offers heart, lung, liver, kidney, intestinal, pancreas, cornea, auto islet, bone marrow, hand and face transplant services. For more information, visit www.transplants.ucla.edu.
     
    For more news, visit the UCLA Newsroom and follow us on Twitter.

  • New University of Wisconsin-led NSF Center for Chemical Innovation taps PNNL expertise

    Nanoparticles hundreds times smaller than the width of a hair are more and more a part of people’s daily lives. Used in everything from car coatings to clothes to cosmetics, little is known about their safety in the environment.

    Chemist Robert Hamers at the University of Wisconsin-Madison is leading a multi-institutional effort to gain new understanding about nanomaterials, especially how they get into cells and tiny organisms such as those found in freshwater lakes.

    A Department of Energy’s Pacific Northwest National Laboratory scientist, Galya Orr has been using and improving high resolution microscopy at EMSL, DOE’s Environmental Molecular Sciences Laboratory at PNNL. She will be applying the expertise she’s gained from studying how nanoparticles enter lung cells found lining our airways.

    Orr is also a member of PNNL’s NIEHS Center for Nanotoxicology, one of five NIH-funded groups nationally that seeks to understand how manmade nanomaterials interact with biological tissues.

    Read more about the $1.75 million project here.

  • Earth sunblock only needed if planet warms easily

    An increasing number of scientists are studying ways to temporarily reduce the amount of sunlight reaching the earth to potentially stave off some of the worst effects of climate change. Because these sunlight reduction methods would only temporarily reduce temperatures, do nothing for the health of the oceans and affect different regions unevenly, researchers do not see it as a permanent fix. Most theoretical studies have examined this strategy by itself, in the absence of looking at simultaneous attempts to reduce emissions.

    Now, a new computer analysis of future climate change that considers emissions reductions together with sunlight reduction shows that such drastic steps to cool the earth would only be necessary if the planet heats up easily with added greenhouse gases. The analysis, reported in the journal Climatic Change, might help future policymakers plan for a changing climate.

    The study by researchers at the Department of Energy‘s Pacific Northwest National Laboratory explored sunlight reduction methods, or solar radiation management, in a computer model that followed emissions’ effect on climate. The analysis shows there is a fundamental connection between the need for emissions reductions and the potential need for some sort of solar dimming.

    “It’s a what-if scenario analysis,” said Steven Smith with the Joint Global Change Research Institute in College Park, Md,, a joint venture between PNNL and the University of Maryland. “The conditions under which policymakers might want to manage the amount of sun reaching earth depends on how sensitive the climate is to atmospheric greenhouse gases, and we just don’t know that yet.”

    The analysis started with computer-based virtual worlds, or scenarios, that describe different potential pathways to reduce greenhouse gas emissions, which limits the amount of heat in the earth system due to greenhouse gas accumulation. The researchers combined these scenarios with solar radiation management, a type of geoengineering method that might include shading the earth from the sun’s heat by either brightening clouds, mimicking the atmospheric cooling from volcanic eruptions or putting mirrors in space.

    “Solar radiation management doesn’t eliminate the need to reduce emissions. We do not want to dim sunlight over the long term — that doesn’t address the root cause of the problem and might also have negative regional effects. This study shows that the same conditions that would call for solar radiation management also require substantial emission reductions in order to meet the climate goals set by the world community,” said Smith.

    How much sun blocking might be needed depends on an uncertain factor called climate sensitivity. Much like beachgoers in the summer, the earth might be very sensitive to carbon dioxide, like someone who burns easily and constantly slathers on the sunscreen, or not, like someone who can get away with SPF 5 or 10.

    Scientists measure climate sensitivity by how many degrees the atmosphere warms up if the concentration of carbon dioxide doubles. Smith said if the climate has a medium sensitivity of about 3 degrees Celsius (5.4 degrees Fahrenheit) per doubling of carbon dioxide, “it’s less likely we’d need solar radiation management at all. We’d have time to stabilize the climate if we get going on reducing emissions. But if it’s highly sensitive, say 4.5 degrees Celsius (8.1 degrees Fahrenheit) per doubling, we’re going to need to use solar radiation management if we want to limit temperature changes.”

    According to NOAA’s August report, the earth’s temperature has already risen about 0.62 degrees Celsius (1.12 degrees Fahrenheit) since the beginning of the 20th century as the carbon dioxide in the atmosphere has grown from 290 parts per million to 379 parts per million.

    But the atmosphere hasn’t reached equilibrium yet — even if humans stopped putting more carbon dioxide into the air, the climate would still continue to change for a while longer. Scientists do not know what temperature the earth will reach at equilibrium, because they don’t know how sensitive the planet is to greenhouse gases.

    Further, the study showed that, when coupled with emission reductions, the amount of solar radiation management needed could be far less than the amount generally considered by researchers so far.

    “Much of the current research has examined solar radiation management that is used as the sole means of offsetting a doubling of carbon dioxide concentrations. What we showed is that when coupled with emissions reductions, only a fraction of that amount of ‘solar dimming’ will be needed. This means that potential adverse impacts would be that much lower,” said Smith. “This is all still in the research phase. We do not know enough about the impacts of potential solar radiation management technologies to use them at this time.”

    The study will also help decision-makers evaluate solar reduction technologies side-by-side, if it comes to that. Smith and his coauthor, PNNL atmospheric scientist and Laboratory Fellow Phil Rasch, devised a metric to quantify how much solar radiation management will be needed to keep warming under a particular temperature change threshold. Called degree-years, this metric can be used to evaluate the need for potential sunlight dimming technologies.

    Whether such technologies will be needed at all, time will tell.

    This work was supported by the non-profit Fund for Innovative Climate and Energy Research.

    Reference: Steven J. Smith and Philip J. Rasch, 2012. The Long-Term Policy 1 Context for Solar Radiation Management, Climatic Change, doi: 10.1007/s10584-012-0577-3. (http://www.springerlink.com/content/31674q46k61p86h7/)

  • Dishing out curry to fund scholarships at UCLA in memory of paramedic son

    Emiko Sekine will serve up her famous oishi curry, a specialty from her former E&E Café in the San Fernando Valley, during an Oct. 14 fundraiser in memory of her son. The event will raise money to provide scholarships that allow individuals to pursue a career as a paramedic, a job that her son loved.
     
    Emiko’s son Mitch served five years in the emergency medical services, first as an emergency medical technician and then a paramedic. He was killed in 2007 in a traffic collision on the way to his shift. He was 28.
     
    Led by his mom, his family and friends established the Mitch Sekine Memorial Scholarship Fund in 2010. In each new class, a selected student at Mitch’s alma mater, the UCLA Paramedic Education Program, receives $2,000 in funding to help with tuition. Four scholarship recipients have now graduated and work as paramedics.
     
    A dynamo, Emiko raised her two sons as a single mother, and she and her sister Etsuko opened the E&E Café in Northridge, using their first initials for the name. Their dishes quickly became local favorites, especially the curries. The restaurant closed in 2007 after 14 years in business — the same year Mitch died. 
     
    Emiko says that as a full-time working mother, cooking was a special part of her relationship and bonding with her sons. When she cooks today, she remembers the smiles and compliments Mitch, her younger son, used to give her for those home-cooked meals. A cookbook of Mitch’s favorite recipes will also be available for sale at the fundraiser.
     
    “Compiling the cookbook and working with the scholarship fund has helped me create a new beginning, and I’ve started to heal,” Emiko said. “I take comfort that Mitch will live on in the hearts and minds of the patients and families that the scholarship touches.”
     
    Brenda Robinson, 27, is the most recent scholarship recipient. She just graduated as a paramedic and will attend the fundraising event, along with other recipients.  
     
    “I am so grateful to the Sekine family for helping me achieve my dreams,” she said. “The scholarship has helped me to truly make a difference and help others in the community.”
     
    Robinson tells of a recent paramedic run when, as an intern, she held the hand of a man who suffered a gunshot wound as an innocent bystander. As they rushed to the hospital in the ambulance, she told him to hold on and that he would be OK. A few weeks later, the man and his family came to the fire station to thank her. Robinson’s kind words, he said, helped save his life.
     
    “We are grateful for the family’s support of our paramedic students — what a tremendous way to honor Mitch’s memory,” said Dr. Baxter Larmon, professor of emergency medicine at the David Geffen School of Medicine at UCLA and director of the UCLA Center for Prehospital Care, which administers the Paramedic Education Program.
     
    The goal is to raise funds for six more scholarships, and Emiko’s delicious cooking will be the lynchpin. The fundraiser will take place Sunday at the San Fernando Valley Japanese American Community Center in Pacoima, from noon to 3 p.m.
     
    All proceeds from the event and sales of the cookbook will go to the scholarship fund. The Japanese curry meal, with drink, is $15, and there are other meal options for kids. For more information about the event and scholarship fund, please visit http://mitchliveson.com and http://ucla.in/SOzjXF. 
     
    The UCLA Center for Prehospital Care is an international leader in prehospital education and research and an innovator and advocate for the development of quality emergency medical services (EMS) systems. The center is part of the David Geffen School of Medicine at UCLA.
     
    For more news, visit the UCLA Newsroom and follow us on Twitter.