Test results impact lung cancer screening adherence; Axillary ultrasound may be unnecessary in diagnostic screening for breast cancer; Using AI to checking endotracheal tube placement

 Deep-brain stimulation during sleep strengthens memory New research led by scientists at UCLA Health and Tel Aviv University provides the first physiological evidence from inside the human brain supporting the dominant scientific theory on how the brain consolidates memory during sleep. The researchers also found that targeted deep-brain stimulation during a critical time in the sleep cycle appeared to improve memory consolidation. This was achieved by a novel “closed-loop” system that delivered electrical pulses in one brain region precisely synchronized to brain activity recorded from another region. The research, published June 1 in Nature Neuroscience, could offer new clues for how deep-brain stimulation during sleep could one day help patients with memory disorders like Alzheimer’s disease, said study co-author Itzhak Fried, MD, PhD.

Negative test results impact adherence to lung cancer screening Screening with low-dose computed tomography (LDCT) has been shown to reduce mortality from lung cancer by at least 20% in large randomized clinical trials but with an important caveat: those reductions show up as long as patients show up for annual screening. Failing to maintain annual adherence to recommended screening may diminish the lifesaving ability of these tests to achieve the same mortality benefits found in large clinical trials. A new study led by UCLA investigators aimed to identify factors associated with risk for patient nonadherence to screening recommendations. The findings suggest that patients with consecutive negative screening results are more likely to become nonadherent to screening over time. The authors say individuals who have consecutive negative results are potential candidates for tailored outreach to improve adherence to recommended annual lung cancer screening. Read the May 25 study in JAMA Network Open.

Axillary ultrasound may be unnecessary in diagnostic screening for breast cancer Adding axillary scanning –scanning under the armpits—in patients undergoing a diagnostic breast ultrasound had minimal impact on cancer detection in a large retrospective study. Only a single cancer, a lymphoma, was incidentally found during a two-year period with 19,692 diagnostic ultrasounds performed. No otherwise occult breast cancers were found. Axillary ultrasound is often used to evaluate the lymph nodes in the axilla, the area under the arm or armpit, as it has the potential to provide important information about the presence or spread of breast and other cancers. Studies have shown it does not provide additional cancer detection in women undergoing routine screening, but the effectiveness of axillary scanning in diagnostic testing–in women with mammographic findings—remains unknown, even as some hospitals use the test routinely. A new study, led by Dr. Iris Chen, radiology resident at the David Geffen School of Medicine at UCLA, is the first to evaluate routine axillary scanning on all diagnostic breast ultrasounds in a large patient population. The authors say the results demonstrate that decreasing unnecessary axillary scanning would lead to fewer false positives without missing any occult breast cancers. “Omitting routine scanning of the axilla for all diagnostic breast ultrasounds may save time and reduce patient anxiety related to unnecessary follow-up and biopsies, without adversely affecting patient care,” they write. Read the study in Clinical Imaging.

Using AI to checking endotracheal tube placement Despite the many papers published on artificial intelligence (AI) for radiology, there are very few systems in routine clinical use. Systems have limited experimental testing and very few undergo evaluation in real-world use. In a previous study, UCLA researchers developed and tested an AI system that can assist in checking endotracheal tube placement and issue alerts to physicians if the tip is not correctly positioned. This new study deployed AI to assist in checking endotracheal tube placement in clinical practice and evaluate its real-world performance with user feedback to determine if broader usage is appropriate. The clinical evaluation showed good performance of the chest x-ray AI system and consistency with previous experimental testing. The user survey results indicated overall agreement with the AI outputs and appropriateness of the alerts by both radiologists and ICU physicians. In terms of the usefulness of the system, user ratings suggest that while the AI does not save them time, it does increase their confidence and works the way they would expect AI to in their workflow. The variability among user responses suggests that larger surveys of more users are warranted. Read the April 25 study in the Journal of Medical Imaging.

UCLA psychiatrist’s opera delivers hopeful message on living with mental illness A new opera focuses on the true story of an acclaimed law professor’s remarkable recovery. UCLA Health psychiatrist and researcher Dr. Kenneth Wells wrote the inspirational true-life tale based on the life of his friend, USC professor Elyn Saks, a brilliant law student who struggled with schizophrenia, defying expectations to become a renowned legal and psychiatry scholar with a rich life full of family and friends. The opera is based on Saks’ acclaimed 2007 memoir, “The Center Cannot Hold: My Journey Through Madness,” which details her lifelong experience with schizophrenia, from her first psychotic experiences in high school to ascending the ranks of academia at a prestigious law school. It will be performed in June at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA and is the fourth written by Wells. “I think it's important for people to know that even with a serious mental illness there are paths to having meaningful and rich lives,” said Wells, a professor at UCLA’s David Geffen School of Medicine, Semel Institute and Fielding School of Public Health.

Turning medicine caps into mosaics It started with a desire to be more environmentally conscious, by diverting plastic waste from landfills. Anesthesiologist Zhuang T. Fang, MD, and nurse Cody Kaufman, MSN, RN, in 2021, started collecting the hundreds of discarded plastic caps from vials of propofol, lidocaine, midazolam, ondansetron and other anesthetics used in the operating room each day. The co-workers at the UCLA Stein Eye Institute wanted to be more environmentally sensitive. And before long, they’d filled dozens of giant Ziploc bags with thousands of red, yellow, orange, green and blue plastic circles. Both artists in their free time, they wanted to turn these caps into something beautiful, says Dr. Fang, interim medical director of the Stein Eye Institute and a clinical professor at the David Geffen School of Medicine at UCLA. Reads more and see some of the art here.