SFVAHCS nephrologists Michael Shlipak and Michelle Estrella are teaming up to improve kidney care for Veterans by making the cystatin C test available across the VA system. The test is much more accurate in detecting kidney disease than one that has long been used in standard medical practice. Shlipak is co-founder and scientific director and Estrella is co-director of the Kidney Health Research Collaborative, a joint program of UCSF, NCIRE and the SFVAHCS.

An opinion piece in the JAMA Neurology-- co-authored by Bruce Ovbiagele, MD, an NCIRE supported scientist -- highlights the complex role of racism in stroke and suggests a framework for understanding its effects. Ovbiagele, who is Chief of Staff at SFVAHCS and UCSF Associate Dean for SFVAHCS, researches evidence-based behavioral interventions to improve stroke outcomes among vulnerable patient populations.

In a significant advance, UCSF researchers working toward a brain-controlled prosthetic limb have shown that machine learning techniques helped a paralyzed individual learn to control a computer cursor using their brain activity without requiring extensive daily retraining, which has been a requirement of all past brain-computer interface (BCI) efforts. “Adapting an artificial learning system to work smoothly with the brain’s sophisticated long-term learning schemas is something that’s never been shown before in a paralyzed person," said study senior author Karunsesh Ganguly, MD, PhD, UCSF associate professor of neurology. He is also a Staff Physician, Neurology and Rehabilitation Service, SFVAHCS and an NCIRE-supported scientist.

In the first known study to examine population-based gender differences in exposure to potentially morally injurious events (PMIEs), researchers led by NCIRE-supported scientist Shira Maguen, report that moral injury contributes to psychological and functional problems among a significant minority of military veterans, although effects vary based on PMIE type and gender. The study in the Journal of Psychiatric Research highlights the importance of increasing conceptual clarity in the moral injury literature, especially by identifying distinct types of exposure to perceived transgressions. Dr. Maguen is Associate Clinical Professor of Psychiatry, UCSF, and Mental Health Director OEF/OIF Integrated Care Clinic, SFVAHCS.

In a study of nearly 2,700 middle-aged people in the journal Neurology, NCIRE-supported researchers found that cardiovascular risk factors – especially hypertension, diabetes and smoking -- are common and associated with accelerated cognitive decline at midlife. Study authors, including Kristine Yaffe and Tina D. Hoang, noted that the “results identify potential modifiable targets to prevent midlife cognitive decline and highlight the need for a life course approach to cognitive function and aging.”

Long-Sought Blood Test for Alzheimer’s in Reach, New Study Finds

A newly developed blood test for Alzheimer’s has diagnosed the disease as accurately as methods that are far more expensive or invasive, scientists reported. The test, which could be available in a few years, has the potential to make diagnosis simpler, more affordable and widely available. In the New York Times, Michael Weiner, NCIRE-supported scientist and UCSF professor, commented: “It’s not a cure, it’s not a treatment, but you can’t treat the disease without being able to diagnose it. And accurate, low-cost diagnosis is really exciting, so it’s a breakthrough."

Seniors who can identify smells like roses, turpentine, paint-thinner and lemons, and have retained their senses of hearing, vision and touch, may have half the risk of developing dementia as their peers with marked sensory decline, finds a study by UCSF and SFVAHCS researchers. Kristine Yaffe – who is UCSF Professor of Psychiatry, Neurology and Epidemiology, Director of the Memory Disorders Clinic at SFVAHCS and an NCIRE Board member – was senior author of the study, published in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association. Instead of looking at individual senses, the study focused on the effects of multiple impairments in sensory function, which are a stronger indicator of declining cognition.

A VA clinic study led NCIRE-supported scientist Dieter J. Meyerhoff used World Health Organization risk drinking levels and quantitative brain imaging to measure the degree of relapse to alcohol use after treatment and their correlated frontal brain volume measures. The study found that even relapsers who consumed high levels of alcohol several times after initial treatment had frontal lobe gray matter volumes comparable to those of complete abstainers. The study was published in journal Alcoholim Clinical and Experimental Research.    

For people with cancer who have a mental health disorder, getting mental health treatment may help them live longer. In a study of more than 55,000 Veterans with lung cancer, those who received mental health treatment lived substantially longer than those who did not. Survival was also better among Veterans who received housing or employment support. Co-authors of the study in the JAMA Oncology included NCIRE-supported investigators Beth Cohen and Sunny Wang. Authors said “investment in mental health and social needs can improve health outcomes and (the study) highlights the importance of further research to identify, evaluate, and implement interventions to improve outcomes for patients with MHDs who are diagnosed with cancer.”

Older men who have a weak or irregular circadian rhythm guiding their daily cycles of rest and activity are more likely to later develop Parkinson’s disease, according to UCSF scientists who analyzed 11 years of data for nearly 3,000 independently living older men. “The strength of the circadian rhythm activity seems to have a really important effect on health and disease, particularly in aging,” said senior author Kristine Yaffe, the Roy and Marie Scola Endowed Chair, vice chair of the Department of Psychiatry at UCSF, and Director of the Memory Disorders Clinic at SFVAHCS and an NCIRE Board member. “We found that even small changes in circadian rhythm in older men were associated with a greater likelihood of getting Parkinson’s down the line.”

In a study of 155 Veterans, whose average age was 79, NCIRE-supported researchers found that increased levels of blood-based biomarkers associated with TBI and cognitive impairment can be detected, even decades after injury. The study in the journal Neurology was led by NCIRE-supported researchers Carrie Peltz, Kristine Yaffe and Raquel Gardner. Yaffe and Gardner, who are both UCSF scientists and SFVAHCS physicians, are members of the NCIRE Board of Directors.

The long-term risks of head injuries are poorly understood, with some studies suggesting severe consequences and others no consequence at all. Two major challenges exist when trying to understand the long-term nature of traumatic brain injuries (TBIs). First is the lack of large and well-characterized datasets. The second major challenge is finding high quality, objective data like medical images or blood tests that can tell us more about the biological nature of an individual TBI. Recent research by NCIRE supported researcher, Duygu Tosun-Turgut, Ph.D, in conjunction with the U.S. Department of Veterans Affairs (VA), San Francisco VA Health Care System; and University of California San Francisco, addresses these issues.

NCIRE Principal Investigator, Michael Weiner, MD, has co-authored an article, “The Late Contributions of Repetitive Head Impacts and TBI to Depressions Symptoms and Cognition,” published in the latest issue of the journal, “Neurology.”  Through their study, Dr. Weiner and his colleagues were able to conclude that RHI (Repetitive Head Injury) and TBI (Traumatic Brain Injury) independently contributed to mid- to worse mid- to later-life neuropsychiatric and cognitive functioning.  Dr. Weiner is a Professor in Residence in Radiology and Biomedical Imaging, Medicine, Psychiatry, and Neurology at the University of California, San Francisco, and former Director of the Center for Imaging of Neurodegenerative Diseases (CIND) at the San Francisco Veterans Affairs Medical Center.

This article by Alex Dang, an NCIRE-supported scientist and co-director of UCSF’s Center for Advanced 3D+ Technologies, describes how his UCSF team solved a recurring problem of broken clips in Personal Air Powered Respirator helmets. “By utilizing 3D printing, we were able to fix nearly all of the broken helmets in our hospitals’ current supply, and with our new supply of clips, we will be able keep these helmets readily available for our clinical teams,” said Dang in the article posted by the UCSF Library.   Below you will find an article about his use of digital printing technology to create the three-dimensional face shields that are a crucial part of healthcare workers PPE (Personal Protective Equipment).

VA and non-VA cardiac rehabilitation programs offer similar benefits, found a VA Quality Enhancement Research Initiative (QUERI) study. “Eligible patients with ischemic heart disease should participate in cardiac rehabilitation programs regardless of where they are provided,” said study author and NCIRE supported researcher Dr. Mary A. Whooley of the San Francisco VA Health Care System and the University of California, San Francisco.  Previous studies have shown that cardiac rehab after a heart attack or bypass surgery lowers risk of death.  Despite these recommendations, participation in VA cardiac rehab programs has been low.The main  reasons are that many Veterans live far from VA facilities, and not all VA centers offer cardiac rehab.   The results of the study show that quality of rehab is similar across VA and outside health care systems.

Alex Dang, an NCIRE-supported scientist and co-director of UCSF’s Center for Advanced 3D+ Technologies, is part of a multidisciplinary team aiming to produce thousands of protective face shields for frontline care workers. Because all elective orthopedic surgeries have been postponed due to the COVID-19 pandemic, Dang and colleagues have focused their energies on the personal protective equipment (PPE) effort, re-purposing their 3D printers and providing about 90 percent of the plastic filament being used as the material for the headband pieces.

Kristine Yaffe, Vice Chair of Clinical and Translational Research in the UCSF Department of Psychiatry and Director of the Memory Disorders Clinic at SFVAHCS, was elected to the National Academy of Medicine, one of the highest honors in the fields of health and medicine. Yaffe, an NCIRE-supported scientist and board member, is a leading expert in the modifiable risk factors of dementia, including research that has linked low physical activity and concussions to cognitive decline later in life.

Moisturizers and other products may be doing as much harm as good, especially for people with sensitive skin. A solution may lie in a lotion that is formulated for skin repair and contains key “mortar ingredients,” according to a study by UCSF dermatology professor Peter Elias and research scientist Mao-Qiang Man, MD, both affiliated with the SFVAHCS and NCIRE.

On World’s Alzheimer’s Day, Kristine Yaffe, is interviewed by MSNBC about the link between traumatic brain injuries in Veterans and the risk of Alzheimer’s and dementia. Yaffe, an NCIRE-supported is UCSF professor of psychiatry, neurology and epidemiology and Chief of Geriatric Psychiatry at SFVAHCS