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Six UC members elected to IOM

Members elected from four UC campuses: Berkeley, UCLA, San Diego, San Francisco.

UCLA's James Economou is one of six UC members newly elected to the Institute of Medicine.

Six University of California members have been elected to the National Academies’ Institute of Medicine.

They join a class of 70 new members and 10 foreign associates announced today (Oct. 19). Since 1970, the IOM has elected more than 200 members affiliated with UC.

Membership in the Institute of Medicine is considered one of the highest honors in the fields of medicine and health. Chosen by current active members, candidates undergo a highly selective process and are nominated based on their professional achievements and commitment to service.

The Institute of Medicine includes a diversity of talent, as its charter requires that at least one quarter of the membership selected be from outside the health professions, in fields such as law, engineering, social sciences and the humanities.

The newly elected UC members are:

UC Berkeley

  • Randy Schekman, Ph.D., UC Berkeley professor of cell and developmental biology and Howard Hughes Medical Institute investigator

UCLA

  • James Economou, M.D., Ph.D., vice chancellor for research and Beaumont Professor of Surgery

UC San Diego

  • Richard Kronick, Ph.D., UC San Diego professor of family and preventive medicine, on leave serving as director of the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services

UC San Francisco

  • Eric Goosby, M.D., professor of medicine and director, Institute of Global Health Delivery and Diplomacy, UCSF School of Medicine, Global Health Sciences
  • Deepak Srivastava, M.D., director, Gladstone Institute of Cardiovascular Disease, and UCSF professor of pediatrics and biochemistry & biophysics
  • Ronald Vale, Ph.D., UCSF professor of cellular and molecular pharmacology and Howard Hughes Medical Institute investigator

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UC med centers named health care equality leaders

LGBT survey honors four UC med centers.

The nation’s largest lesbian, gay, bisexual and transgender civil rights organization has again named four University of California medical centers as “Leaders in Healthcare Equality.” UC Davis, UCLA, UC San Diego and UC San Francisco medical centers earned top marks for their commitment to equitable, inclusive care for LGBT patients and their families, who can face challenges in accessing adequate health care.

UCSF Medical Center became the only institution in the United States to have received a perfect score on the national Healthcare Equality Index for seven consecutive years.

The Human Rights Campaign Foundation’s 2014 Healthcare Equality Index designated 426 health care facilities as leaders for meeting key criteria for equitable care, including non-discrimination policies for LGBT patients, non-discrimination policies for employees, a guarantee of equal visitation for same-sex partners and parents, and training for staff in LGBT patient-centered care.

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Smoking’s $18B toll on California

Despite declines in numbers of smokers, related diseases account for 1 in 7 deaths in state.

Read the full report (click image to view)

By Carolyn McMillan, UC Newsroom

Fewer Californians smoke today than 10 years ago, yet smoking continues to take an enormous toll on the state and its residents, triggering $18.1 billion in health care costs and lost productivity from illness and premature death.

In the first comprehensive analysis of the financial and health impacts of tobacco in more than a decade, UC San Francisco researchers found that smoking accounted for 1 in 7 deaths in the state — more than from AIDS, influenza, diabetes, or many other causes.

While the number of smokers in California declined from a decade ago, nearly 4 million people still smoke, including an estimated 146,000 adolescents, the UCSF study found.

Far too many smoking deaths

“We found that while the California tobacco control program has led to reductions in tobacco use in the state over the last decade, smoking is still far too prevalent and results in far too many deaths and high health care costs,” said principal investigator Wendy Max, Ph.D., professor of health economics at the UCSF School of Nursing and director of the UCSF Institute for Health & Aging.

The research was conducted at the institute, with grant funding from the Tobacco-Related Disease Research Program of the University of California’s Office of the President.

The findings offer a snapshot of tobacco use throughout the state drawn from 2009 data, the most recent available when the study began.

UCSF researchers profiled each of the state’s 58 counties with total costs, costs per resident and per smoker, expenditures for each type of health care, smoking prevalence and mortality measures. The same investigators conducted similar statewide studies in 1999 and 1989.

The report found that smoking prevalence was higher in some parts of the state than others, and that males — whether teens or adults — were far more likely to smoke than females.

“This kind of detailed data helps us target our limited smoking cessation resources where they are needed most,” said Dr. Michael Ong, chair of the California Tobacco Education and Research Oversight Committee and a UCLA physician. “We also see clearly from this report that tobacco — despite declines in its prevalence — remains a major threat to public health and a drain on health care resources.”

An extraordinary economic burden

The cost to California, its counties and its residents from smoke-related diseases remains significant. In Los Angeles County, for example, smoking carried a $4.4 billion price tag in 2009 — the highest of any county in the state. That total included $2.3 billion in direct health care costs and $2.1 billion for indirect costs, of which $1.7 billion was due to premature deaths.

“Smoking exacts an extraordinary economic burden on our county,” said Dr. Paul Simon, director of the LA County Public Health’s division of Chronic Disease and Injury Prevention. “The dollar amount is staggering, and it does not take into account the untold emotional costs on family members and friends.”

UC President Janet Napolitano said the study exemplifies the ways in which university research informs the work of public health offices around the state. UC campuses conduct a wide range of research each year aimed at improving the lives of Californians and people around the world — often in partnership with state and federal agencies looking to understand and address important health issues.

“In partnership with the state, we’ve made great strides in educating people about the risks of smoking, but as this important study shows, there is much more to do,” Napolitano said.

As the former Arizona attorney general, Napolitano was heavily involved in implementing the Master Settlement Agreement and represented the nation’s attorneys general on the Board of the Legacy Foundation, the largest national nonprofit public health organization devoted to tobacco control.

Statewide, smoking represented $6.8 billion in lost productivity and about 587,000 years of potential life lost from 34,363 deaths, or 17.1 years per death, the researchers found.

More deaths than AIDS, diabetes or Alzheimer’s

Smoking also was found to be a leading cause of death in 2009. The 34,363 total deaths from smoking were 17 times the number from AIDS; five times the deaths from diabetes, influenza and pneumonia; and three times the number of deaths from Alzheimer’s disease and unintentional injuries.

Cancer was the primary cause of smoking-attributable death, accounting for 13,514 deaths, followed by cardiovascular disease with 10,490 deaths, and respiratory diseases with 10,331. Pediatric disease accounted for 27 deaths, and secondhand smoke exposure was attributed to 794 adult deaths.

The direct health care costs of smoking accounted for 54.4 percent of the total $18.1 billion cost of smoking, or $9.8 billion. Lost productivity due to illness comprised 7.9 percent ($1.4 billion), and lost productivity from premature death comprised 37.6 percent ($6.8 billion).

Hospital care of current and former smokers cost $4.3 billion of the $9.8 billion total health care costs of smoking. Ambulatory care services were $2.1 billion; nursing home care, $1.5 billion; prescription drugs, $1.1 billion; and home health care, $794 million.

The report found that the state’s tobacco control efforts have been effective in reducing smoking-attributable deaths, reducing the prevalence of smoking and cutting the real costs of smoking, as compared to a decade ago.

Nonetheless, costs remain high and the wide variation in smoking costs across the counties suggests that many geographic areas would benefit from targeted efforts to reduce smoking.

“County-level estimates of the costs of smoking help to identify geographic disparities in the economic burden of tobacco use. These data are useful for local governments and policy makers to develop more effective tobacco control policies at the local level,” said co-author Hai-Yen Sung, Ph.D., professor of health economics at the UCSF School of Nursing and the UCSF Institute for Health & Aging.

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NIH invests in big data to advance biomedical research

Grants awarded to 3 UC campuses: UCLA, UC San Diego and UC Santa Cruz.

The National Institutes of Health has awarded three University of California campuses a total of more than $31 million to develop new strategies for mining and understanding the surge in complex biomedical data sets known as “big data.”

The grants are part of the NIH’s $656 million Big Data to Knowledge, or BD2K, initiative.

UCLA and UC Santa Cruz each were awarded $11 million to form big data computing centers — two of 11 such centers nationwide.

UCLA’s Center of Excellence for Big Data Computing will create analytic tools to address the daunting challenges facing researchers in accessing, standardizing and sharing scientific data to foster new discoveries in medicine. Investigators also will train the next generation of experts and develop data science approaches for use by scientists. The center’s principal investigator will be Peipei Ping, a professor of physiology, medicine and bioinformatics at the David Geffen School of Medicine at UCLA.

The Center for Big Data in Translational Genomics, a multi-institutional partnership based at UC Santa Cruz, will help the biomedical community use genomic information to better understand human health and disease. The center will be led by David Haussler, professor of biomolecular engineering and director of the UC Santa Cruz Genomics Institute.

In addition, UC Irvine assistant professor of psychiatry & human behavior Theo van Erp is co-chair of the schizophrenia working group for the Enhancing Neuro Imaging Genetics Through Meta-Analysis project. Led by the University of Southern California, the ENIGMA Center for Worldwide Medicine, Imaging and Genomics received an $11 million Big Data to Knowledge grant. UCLA also is particpating in the ENGIMA consortium, with its research led by Carrie Bearden, professor of psychiatry and psychology at the UCLA Semel Institute for Neuroscience and Human Behavior, and Eleazar Eskin, professor of computer science and human genetics.

Also, researchers at the UC San Diego School of Medicine have been awarded a $9.2 million grant to help modernize and transform how researchers share, use, find and cite biomedical datasets. UC San Diego professor of medicine Lucila Ohno-Machado will be lead investigator on the Biomedical and healthCAre Data Discovery and Indexing Ecosystem (BioCADDIE), a 3-year project, in collaboration with The University of Texas Health Science Center at Houston.

“Data creation in today’s research is exponentially more rapid than anything we anticipated even a decade ago,” said NIH Director Francis S. Collins. “Mammoth data sets are emerging at an accelerated pace in today’s biomedical research and these funds will help us overcome the obstacles to maximizing their utility. The potential of these data, when used effectively, is quite astounding.”

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UC will lead effort to create library of brain cell activity

NIH program will advance fight against ALS, other neurodegenerative diseases.

Leslie Thompson, UC Irvine

UC Irvine will receive $8 million from the National Institutes of Health to establish one of six national centers dedicated to creating a database of human cellular responses that will accelerate efforts to develop new therapies for many diseases.

Leslie M. Thompson, UCI professor of psychiatry & human behavior and neurobiology & behavior, will partner with researchers from Cedars-Sinai Medical Center’s Regenerative Medicine Institute, the Gladstone Institute of Neurological Disease, UC San Francisco, Johns Hopkins University and the Massachusetts Institute of Technology.

They will study brain cell activity in motor neuron disorders including ALS and build a detailed archive of these disease “signatures” that identifies cell targets for new drug treatments. ALS, or amyotrophic lateral sclerosis, also called Lou Gehrig’s disease, attacks motor neurons, cells that control the muscles.

Overall, the NIH is awarding $64 million to six research groups to establish centers that support the Library of Integrated Network-Based Cellular Signatures program. The UC Irvine-based center will be called NeuroLINCS.

The goal of the LINCS program is to utilize the latest cutting-edge technology and scientific methods to catalog and analyze cellular function and molecular activity in response to perturbing agents – such as drugs and genetic factors – that have specific effects on cells. LINCS researchers will measure the cells’ tiniest molecular and biochemical responses and use computer analyses to uncover common patterns – called signatures. LINCS data will be freely available to any scientist.

“Human brain cells are far less understood than other cells in the body,” said Thompson, who’s affiliated with the Sue & Bill Gross Stem Cell Research Center and UCI MIND. “The collective expertise of NeuroLINCS investigators provides a unique opportunity to increase our knowledge of what makes brain cells unique and what happens during neurodegenerative diseases – with a strong focus toward effective treatments. We feel this will have broad application to a number of human brain diseases.”

She and her colleagues will study the effects, or signatures, of perturbing agents on induced pluripotent stem cell-derived neurons and glial cells from “unaffected” cells and those exhibiting the pathology of motor neuron diseases.

At UC Irvine, Thompson will work closely with the UCI Genomics High-Throughput Facility to explore gene expression patterns in these brain cells, which is expected to yield novel insights into pathways and gene networks that guide the development of cell signatures.

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NIH awards high-risk, high-reward research grants

UC researchers receive 17 of 85 awards aimed at innovative approaches to biomed research.

UC Berkeley's Michi Taga, one of 16 UC recipients of NIH High Risk, High Reward program grants, plans to use her grant to develop methods to selectively kill disease-causing bacteria.

The National Institutes of Health awarded 85 grants under its High Risk-High Reward program, of which 17 will go to University of California researchers. The awards support scientists proposing highly innovative approaches to major contemporary challenges in biomedical research.

UC researchers received 11 of 50 New Innovator awards, which support projects by early-career biomedical researchers with the potential to transform scientific fields and accelerate the translation of research into new ways to improve human health.

UC scientists also received:

  • One of 10 Pioneer awards for groundbreaking approaches that have the potential to make an unusually high impact on a broad area of biomedical or behavioral research;
  • Two of eight Transformative Research awards for cross-cutting interdisciplinary approaches that could potentially create or challenge existing paradigms; and
  • Three of 17 Early Independence awards that provide an opportunity for exceptional junior scientists to skip traditional postdoctoral training and move immediately into independent research positions.

“Supporting innovative investigators with the potential to transform scientific fields is a critical element of our mission,”’ said NIH Director Francis S. Collins. “This program allows researchers to propose highly creative research projects across a broad range of biomedical and behavioral research areas that involve inherent risk but have the potential to lead to dramatic breakthroughs.”

The total funding for the 85 grants is approximately $141 million.

UC recipients include:

UC Berkeley

  • Nicholas Ingolia (New Innovator)
  • Michi Taga (New Innovator)
  • Roberto Zoncu (New Innovator)

UC Davis

  • Lin Tian (New Innovator)

UC Irvine

  • Weian Zhao (New Innovator)

UCLA

  • Reza Ardehali (New Innovator)
  • Elissa Hallem (New Innovator)
  • Sriram Kosuri (New Innovator)
  • Lili Yang (New Innovator)

UC San Francisco

  • Adam Abate (New Innovator)
  • Robert Judson (Early Independence)
  • Wendell Lim (Transformative Research)
  • Michael McManus (Transformative Research)
  • Michael Rosenblum (New Innovator)
  • Glenn-Milo Santos (Early Independence)

UC Santa Barbara

  • Denise Montell (Pioneer)

Lawrence Livermore National Laboratory

  • Amanda Randles (Early Independence)

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Four UC scientists awarded National Medal of Science

Three recipients from UC Berkeley, one from UCSF.

Bruce Alberts, UC San Francisco

Four University of California scientists were awarded the 2014 National Medal of Science — the nation’s highest honor for achievement and leadership in advancing the field of science.

Recipients include Bruce Alberts, professor emeritus of biochemistry, UC San Francisco; and Judith Klinman, professor emerita of chemistry, and Alexandre Chorin, University Professor emeritus of mathematics, UC Berkeley. The late David Blackwell, mathematician and statistician at UC Berkeley, was awarded the medal posthumously.

The National Medal of Science was created by statute in 1959 and is administered for the White House by the National Science Foundation. Awarded annually, the medal recognizes individuals who have made outstanding contributions to science and engineering.

“These scholars and innovators have expanded our understanding of the world, made invaluable contributions to their fields, and helped improve countless lives,” President Obama said of the 2014 medalists. “Our nation has been enriched by their achievements, and by all the scientists and technologists across America dedicated to discovery, inquiry, and invention.”

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A global health powerhouse

UCSF Global Health Sciences marks 10th anniversary with symposium, Mission Hall opening.

Jaime Sepulveda, executive director, UCSF Global Health Sciences (Photo by Elisabeth Fall)

International health research at UCSF got its start in the late 1980s, with a small AIDS program in Uganda. A quarter-century later, it is a global research enterprise, with 600 UCSF investigators working in 190 countries.

UCSF’s Global Health Sciences now embraces all that the university has to offer: basic science, social science and clinical care, along with education and emerging areas that incorporate policy and diplomacy.

This month, Global Health Sciences celebrates the 10-year anniversary since its founding as a formal program with two major events: the opening of Mission Hall, where global health faculty will be gathered under one roof for the first time, and an international symposium on global health, featuring many of the giants in the field.

The goal of the conference is to explore what is coming next in global health, so that scientific efforts are targeted in the best way.

“As an academic health sciences university, UCSF plays a critical role in helping to set the global health agenda,” said Jaime Sepulveda, M.D., D.Sc., M.P.H., executive director of Global Health Sciences. “That’s what we’re doing with this symposium and with our day-to-day work.”

The symposium agenda sprang, in part, out of the recent Science special issue on global health. Sepulveda and UCSF Global Health Sciences were key partners in developing the issue, which includes a perspective from Sepulveda on the state of global health in 2014.

“UCSF has always been science-driven,” Sepulveda said. “That’s why our program is called Global Health Sciences. It’s an indication that we aim to bring the same rigor to this new field of knowledge that we have to all of the university’s other endeavors.”

UCSF scientists are working on major killers, like AIDS, tuberculosis and malaria, as well as lesser-known threats, like dengue, Chagas’ disease and River Blindness. They are studying how programs work – and why some work better in some places than others. And they are asking the tough questions about how to build health systems in countries that are only now becoming economically strong enough to support them.

Educators are training students at UCSF for global careers and helping clinicians around the world with massive online open enrollment courses, while researchers are mentoring young scientists abroad on research projects and training health workers through large community-based trials.

UCSF faculty are also contributing to major policy debates. Several played key roles in the Lancet Commission on Investing in Health, which laid out a 20-year plan to increase the amount spent on health in poor countries and improve access to care, while calling on the global community to expand research and development for diseases that disproportionately affect poor countries. Together, these efforts could save 10 million lives.

Most recently, Sepulveda and other UCSF faculty have added their voices to the debate over the United Nation’s Sustainable Development Goals for 2030 by urging that the sole health goal now planned for inclusion be practical, concrete and include measurable targets, such as a 40 percent reduction in premature mortality.

These efforts show the strength of Global Health Sciences as it enters its second decade. The program has attracted the leading minds in the field – most recently Eric Goosby, M.D., President Barack Obama’s former global AIDS coordinator, and Harvey Fineberg, M.D., Ph.D., former head of the Institute of Medicine – to join a growing powerhouse of global health influencers at UCSF.

“We are having a real influence in shaping global health priorities,” Sepulveda said. “It would be hard to find the same concentration of high-caliber global health leaders anywhere else in a single university.”

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Study: Hospital mergers, acquisitions leading to increased patient costs

Counterintuitive findings published in Journal of the American Medical Association.

The trend of hospitals consolidating medical groups and physician practices in an effort to improve the coordination of patient care is backfiring and increasing the cost of patient care, according to a new study led by a UC Berkeley health policy expert.

The counterintuitive findings, published today (Oct. 21) in the Journal of the American Medical Association, come as a growing number of local hospitals and large, multi-hospital systems in this country are acquiring physician groups and medical practices.

“This consolidation is meant to better coordinate care and to have a stronger bargaining position with insurance plans,” said study lead author James Robinson, professor and head of health policy and management at UC Berkeley’s School of Public Health. “The movement also aligns with the goals of the Affordable Care Act, since physicians and hospitals working together in ‘accountable care organizations’ can provide care better than the traditional fee-for-service and solo practice models. The intent of consolidation is to reduce costs and improve quality, but the problem with all this is that hospitals are very expensive and complex organizations, and they are not known for their efficiency and low prices.”

Robinson teamed up with study co-author Kelly Miller, program analyst at Integrated Healthcare Association, a nonprofit organization that promotes health care quality improvement, accountability and affordability in California.

The researchers analyzed four years of data, from 2009 to 2012, on 158 major medical groups and 4.5 million patients in California. Groups were put into three categories: owned by physicians, owned by a local hospital or hospital system, or owned by a large hospital system that spans multiple geographic markets in the state.

The measure of costs included physician visits, inpatient hospital admissions, outpatient surgery and diagnostic procedures, drugs, and all other forms of medical care except for mental health services. (The researchers did not have data on mental health services since they are paid for separately.)

After controlling for such factors as the mix of severely ill patients and geographic differences in cost, the researchers found that per patient expenditures were 19.8 percent higher for physician groups in multi-hospital systems compared with physician-owned organizations. Groups owned by local hospitals were better, but per patient costs still ran 10.3 percent higher compared with physician-owned groups.

Why would consolidation lead to increased costs? It could be that once a medical group has been acquired, physicians in those groups are expected to admit their patients to the high-priced hospital, Robinson said.

“Hospital-owned medical groups usually are expected to conduct ambulatory surgery and diagnostic procedures in the outpatient departments of their parent hospital, but hospital outpatient departments are much more costly and charge much higher prices than freestanding, non-hospital ambulatory centers,” he said.

Robinson said that public policy should not encourage mergers and acquisitions as a means of promoting collaboration. Instead, he said, policymakers should consider supporting the use of bundled payments for hospitals and physicians to improve coordination of care.

“Hospitals are an essential part of the health care system, but they should not be the center of the delivery system,” said Robinson. “Rather, physician-led organizations based in ambulatory and community settings are likely to be more efficient and provide cheaper care.”

The study authors noted that their findings are limited to California, and that further studies should be done using data from other states.

“Nevertheless, these findings are important since California is the nation’s leader in terms of having physicians participate in large medical groups that already perform the functions ascribed to ‘accountable care organizations’ by the Obama administration,” said Robinson.

The Robert Wood Johnson Foundation provided support for this research.

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In the media: Week of Oct. 19

A sampling of news media stories involving UC Health:

A lifetime of sugary sodas may be 4.6 years  shorter, The Washington Post

You knew that drinking sugary sodas could lead to obesity, diabetes and heart attacks — but, according to a study published in the American Journal of Public Health, it may also speed up your body’s aging process. As you age, caps on the end your chromosomes called telomeres shrink. In the past several years, researchers at the University of California at San Francisco, have analyzed stored DNA from more than 5,300 healthy Americans in the National Health and Nutrition Examination Survey (NHANES) from some 14 years ago. And they discovered that those who drank more pop tended to have shorter telomeres.

Did a son’s autism drive a woman to murder?, Newsweek

This story about autism and a mother’s struggles with her son, who had severe autism, highlights the work of UC Davis’ Judy van de Water, Irva Hertz-Picciotto and Sally Rogers and UC San Francisco’s Robert Hendren. The Koegel Autism Center at UC Santa Barbara also is mentioned.

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Stem cell science takes bold step at UC San Diego

Three first-in-human clinical trials are underway.

A 26-year-old woman paralyzed after a motor vehicle accident a year ago has successfully undergone a first-in-human experimental procedure to test whether neural stem cells injected at the site of a spinal cord injury is safe and could be an effective treatment.

The procedure, conducted on Sept. 30 under the auspices of the Sanford Stem Cell Clinical Center at UC San Diego Health System and in collaboration with Neuralstem Inc., a Maryland-based biotechnology firm, is the first of four in the phase one clinical trial. Post safety testing, it’s hoped that the transplanted neural stem cells will develop into new neurons that bridge the gap created by the injury, replace severed or lost nerve connections and restore at least some motor and sensory function.

The patient, whose identity remains confidential for privacy reasons, has been discharged and is recovering without complication or adverse effects at home, said Joseph Ciacci, M.D., principal investigator and neurosurgeon at UC San Diego Health System.

The spinal cord injury trial is one of three recent groundbreaking stem cell efforts at UC San Diego, supported by the Sanford Stem Cell Clinical Center, to make the significant leap from laboratory to first-in-human clinical trials.

Last month, researchers at UC San Diego Moores Cancer Center and the Sanford Stem Cell Clinical Center launched a novel phase one trial to assess the safety of a monoclonal antibody treatment that targets cancer stem cells in patients with chronic lymphocytic leukemia, the most common form of blood cancer.

And later this month, the first patient is scheduled to receive an unprecedented stem cell-based therapy designed to treat type 1diabetes in another phase one clinical trial at UC San Diego.

“What we are seeing after years of work is the rubber hitting the road,” said Lawrence Goldstein, Ph.D., director of the UC San Diego Stem Cell program and Sanford Stem Cell Clinical Center at UC San Diego Health System. “These are three very ambitious and innovative trials. Each followed a different development path; each addresses a very different disease or condition. It speaks to the maturation of stem cell science that we’ve gotten to the point of testing these very real medical applications in people.”

To be sure, Goldstein said, the number of patients involved in these first trials is small. The initial focus is upon treatment with low doses to assess safety, but also with hope of patient benefit. As these trials progress – and additional trials are launched – Goldstein predicts greater numbers of patients will be enrolled at UC San Diego and the Sanford Stem Cell Clinical Center and elsewhere.

“Clinical trials are the safest way to pursue potential therapies. You want to prove that a new therapy will work for more than just a single, random patient.”

While stem cell-based trials are beginning to emerge around the country, Goldstein noted that San Diego continues to assert itself as a stem cell research hub and a leading force for translating basic discoveries into medical applications, now and in the future.

“These innovative trials are the result of some truly rare features you find at UC San Diego and in the region,” he said. “There is a unique sense of collaboration and communication here among scientists in academia, clinical medicine and the biotechnology industry. An enterprise like the Sanford Center can promote and accelerate the very complex processes of research, development and testing so that the right people make the right connections and the right ideas and trials get fast-tracked, but in a way that ensures fundamentally the safety of patients while striving for benefit.”

More about the three trials:

Neural stem cell transplants and spinal cord injuries
The Neuralstem phase one clinical trial, conducted over five years with four patients, is designed to assess the safety and efficacy of an approach that might, it is hoped, someday be a treatment for paralyzing spinal cord injuries.

In preclinical studies, Ciacci and Martin Marsala, M.D., a professor in the Department of Anesthesiology at UC San Diego School of Medicine and the Sanford Consortium for Regenerative Medicine, and colleagues grafted human neural stem cells into rats with spinal cord injuries. The introduced cells showed extensive growth and connected to remaining nerve cells near the injury site, resulting in significantly improved motor function with minimal side effects in animal models.

The goal now is to determine whether similar effects occur in human patients. The researchers will also test for possible therapeutic benefits, such as reduced paralysis and improvements in motor and sensory function, bowel and bladder function and pain levels.

VC-01 and Type 1 diabetes
In collaboration with ViaCyte Inc., a San Diego-based biotechnology firm specializing in regenerative medicine, UC San Diego researchers led by principal investigator Robert Henry, M.D., professor of medicine in the Division of Endocrinology and Metabolism at UC San Diego and chief of the Section of Endocrinology, Metabolism & Diabetes at the Veterans Affairs San Diego Healthcare System, have launched the first-ever phase one-two clinical trial of a stem cell-derived therapy for patients with Type 1 diabetes. The first procedure is planned for later this month, with a second tentatively scheduled in mid-November.

Type 1 diabetes mellitus is a life-threatening chronic condition in which the pancreas produces little or no insulin, a hormone needed to allow glucose to enter cells to produce energy. It is typically diagnosed during childhood or adolescence, but can also strike adults. Though far less common than Type 2 diabetes, which occurs when the body becomes resistant to insulin, Type 1 may affect up to 3 million Americans with emotionally and financially devastating consequences. Standard treatment involves daily injections of insulin and rigorous management of diet and lifestyle. Currently, there is no cure.

The two-year trial will involve approximately 40 study participants at four to six testing sites, with San Diego being first. The trial will assess the safety, tolerability and efficacy of varying doses of VC-01, which involves implanting specially encapsulated embryonic stem cell-derived cells under the skin of patients where it’s hoped they will safely mature into pancreatic beta and other cells able to produce a continuous supply of needed insulin and other substances.

Development and testing of VC-01 is funded, in part, by the California Institute for Regenerative Medicine (CIRM), Sanford Stem Cell Clinical Center and JDRF, formerly known as the Juvenile Diabetes Research Foundation. Clinical testing and coordination is provided by UC San Diego Clinical and Translational Research Institute.

Cirmtuzumab and leukemia
Researchers at UC San Diego Moores Cancer Center and the Sanford Stem Cell Clinical Center have launched a phase one human clinical trial to assess the safety and efficacy of a new monoclonal antibody for patients with chronic lymphocytic leukemia (CLL), the most common form of blood cancer in adults.

The drug, called cirmtuzumab, targets a molecule called ROR1 that normally is used only by embryonic cells during early development, but which is abnormally exploited by cancer cells to promote tumor growth and spread, otherwise known as metastasis. Metastasis is responsible for 90 percent of all cancer-related deaths.

Because ROR1 is not used by normal adult cells, scientists believe it is a unique marker of cancer cells in general and cancer stem cells in particular. ROR1 appears to drive tumor growth and disease spread and scientists think that presents an excellent novel target for anti-cancer therapy.

Cirmtuzumab was developed at Moores Cancer Center in the laboratory of Thomas Kipps, M.D., Ph.D., who led this effort as one of six projects initially funded through CIRM’s HALT leukemia grant to co-principal investigators Dennis Carson, M.D., and Catriona Jamieson, M.D., Ph.D.  The drug’s name acknowledges CIRM’s continued support in a “Disease Team III” award, which provides some of the resources needed for a clinical trial. The Leukemia and Lymphoma Society has also provided additional support.

The trial will involve patients with relapsed or refractory CLL receiving an intravenous infusion every 14 days at Moores Cancer Center, followed by regular monitoring and clinic visits to assess efficacy and identify and manage any adverse effects. Initial treatment is planned for two months.

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In the media: Week of Oct. 12

A sampling of news media stories involving UC Health:

Hospitals rethinking precautions in wake of nurse’s Ebola infection, San Francisco Chronicle

At the urging of federal health officials, U.S. hospitals, including some in the Bay Area, are rethinking the protocols they have in place even while assuring the public they are prepared to deal with an Ebola patient. News that a 26-year-old nurse at Texas Health Presbyterian Hospital had contracted Ebola after treating a patient has unsettled hospital administrators and health care workers because it seemingly contradicts assurances from federal health officials that U.S. hospitals are well equipped to treat and contain the disease, which has killed more than 4,000 people, primarily in West Africa. “Unnerving” is how Dr. Josh Adler, chief medical officer of UCSF Medical Center, described the transmission of the disease to the nurse, “who presumably was doing her best to protect herself and yet was still infected.” “It tells us this is a fairly contagious virus and really requires every bit of infection control and training that we can muster,” Adler said. Read UC coverage.

Ebola safeguards are being taken, Southland health officials say, Los Angeles Times

Amid news of the first Ebola death in the U.S. — that of Thomas Eric Duncan, who died in a Dallas hospital that initially misdiagnosed him and sent him away — local officials say they are working to get medical providers ready, should an Ebola case emerge in Southern California. So far, there have been no confirmed or suspected Ebola cases in Los Angeles County, and officials say they do not expect a major outbreak. Infection control experts at UCLA medical centers in Westwood and Santa Monica have provided emergency departments with Ebola kits containing recommended protective gear such as suits, masks, gloves and booties. UCLA has an Ebola response team that will take the lead should a case arise and designated areas that are equipped to handle waste disposal, said infectious disease specialist Dr. Daniel Uslan, who is part of the effort. The hospital is also drilling medical workers on procedures.

UCLA Medical Center preparing for Ebola (video), ABC 7

Ronald Reagan UCLA Medical Center is taking steps to prepare in the event that an Ebola patient is admitted. Dr. Zachary Rubin, head of the medical center’s Infection Prevention, says personnel are equipped what they call an “Ebola kit.” Every step in using the kit must be followed exactly to the letter, but Rubin says it can be tricky if a member of the staff has never done it before.

See additional coverage: Los Angeles Daily News; CBS Los Angeles: Oct. 17 (video), Oct. 13 (video); Fox Los Angeles (video); NBC Los Angeles: Oct. 17 (video), Oct. 14 (video)

Ebola scare prompts two Sacramento hospitals to ramp up preparedness, The Sacramento Bee

UC Davis Medical Center’s chief medical officer briefed the public on the hospital’s preparedness Thursday, after an Ebola scare earlier in the week tested the response of its emergency department workers and revealed some areas in need of improvement. “This is a very fluid process,” Dr. J. Douglas Kirk said of the Sacramento hospital’s protocols for treating infectious diseases such as the notorious Ebola virus. “We’ve stepped up education and training for our staff and set new guidelines for front-line staff.”

See additional coverage: Fox 40 (video)KCRA 3 (video)KFBK

California health officials seek to assure public amid Ebola scare, The Sacramento Bee

California’s top health officials tried to assure an increasingly nervous public on Wednesday that they are ramping up readiness to fight the deadly Ebola virus, including seeking screening at all of the state’s international airports. UC Davis Health System spokeswoman Karen Finney is quoted.

Editorial: Hospitals need to give facts, not spin on Ebola, The Sacramento Bee

Even as the messy facts from Dallas were emerging, hospital systems here were stonewalling this week when asked for their strategies on Ebola. Only after Rep. Doris Matsui, D-Sacramento, explicitly demanded their plans for informing the public did a couple of local hospital chiefs step up and start sharing information. And the news, unsurprisingly, was that preparedness is evolving. Or, as the chief medical officer at UC Davis Medical Center termed it after a false Ebola alarm there, “a good learning experience.” Learning is good. Even the CDC has done some. At Kaiser, a video on proper use of protective equipment has been issued, and training sessions for hospital workers were ramped up this week. We hope hospital systems will continue to learn – and keep us posted. Good information will be so reassuring if, as in Dallas, the emergency isn’t a drill someday.

Bay Area scientists work on test to find Ebola virus early (video), CBS San Francisco

It will take a monumental effort to stop the Ebola outbreak in its tracks, but scientists in the Bay Area are working on a new way to detect the virus before it can spread. Imagine, at any port of entry into the U.S., being able to quickly identify travelers infected with Ebola before they show any symptoms. “This is actually an area that we’re currently working on in my laboratory,” said Dr. Charles Chiu, an expert in infectious diseases at UCSF. His team is currently analyzing samples from Ebola patients. “The goal is eventually to use this information, if we can, to establish and make available a rapid diagnostic test for diagnoses of the Ebola virus,” Chiu said.

Ebola nurse in Dallas: Why one Texas hospital couldn’t contain Ebola, International Business Times

The United States has the most expensive health care system in the world, its gleaming hospitals outfitted with the latest technologies and equipment, and yet health care professionals couldn’t prevent a Texas nurse treating an Ebola patient from contracting the disease last week. The spread of Ebola at the Dallas hospital has raised questions about the U.S. health care system’s ability to contain the contagious virus and protect medical workers amid a growing outbreak poised to soon claim 4,500 lives worldwide. Art Reingold, head of epidemiology at UC Berkeley’s School of Public Health, is quoted.

Op-ed: Nurses shouldn’t be guinea pigs, Slate

John Villasenor, professor of public policy in the UCLA Luskin School of Public Affairs and a professor of electrical engineering in the Henry Samueli School of Engineering and Applied Science, as well as a nonresident senior fellow at the Brookings Institution, recommends more rigorous training protocols to protect those charged with treating people who are sick. He suggests using big data to help protect health workers from Ebola exposure.

California investments could reap 5-to-1 return, HealthData Management

A University of California center that fosters health care innovation at UC’s five medical centers is proving to be a boon to both patient health and the bottom line. Grants made by UC’s Center for Health Quality and Innovation to fund projects that improve patient care and satisfaction at UC hospitals are paying off with positive results, including fewer blood clots and better post-surgical care at UC hospitals.

See additional coverage: California Healthline

Study: Tobacco use toll drops in California, but smoking still more deadly than AIDS, San Francisco Examiner

Smoking is more fatal and its associated health care costs are likely much more expensive in California than AIDS, Alzheimer’s or diabetes, according to a study published today by UC San Francisco researchers. However, the toll of smoking in the state actually decreased between 1999 and 2009 after rising the previous decade, from 1989 to 1999, said Wendy Max, the study’s principal investigator and a professor of health economics at the UCSF School of Nursing and director of the UCSF Institute for Health and Aging. The study is the third in a series of reports published every 10 years on costs attributed to smoking in California. It was conducted over three years at the Institute for Health and Aging thanks to a grant from the Tobacco-Related Disease Research Program of the University of California’s Office of the President.

In hopes of fixing faulty genes, one scientist starts with the basics (audio), NPR

Whether they admit it or not, many (if not most) scientists secretly hope to get a call in October informing them they’ve won a Nobel Prize. But I’ve talked to a lot of Nobel laureates, and they are unanimous on one point: None of them pursued a research topic with the intention of winning the prize. That’s certainly true for Jennifer Doudna. She hasn’t won a Nobel Prize yet, but many are whispering that she’s in line to win one for her work on something called CRISPR/Cas9 — a tool for editing genes. The idea came when she and her colleagues at the University of California, Berkeley, were in essence trying to figure out how bacteria fight the flu. The goal was really more of a basic science question, Doudna says.

Soda may age you as much as smoking, study says, Time

Nobody would mistake sugary soda for a health food, but a new study published in the American Journal of Public Health just found that a daily soda habit can age your immune cells almost two years. Senior study author Elissa Epel, professor of psychiatry at UC San Francisco, wanted to look at the mechanisms behind soda’s storied link to conditions like diabetes, heart attack, obesity, and even higher rates of death. She studied telomeres, the caps at the end of chromosomes in every cell in our body, from white blood cells. Shorter telomeres have been linked to health detriments like shorter lifespans and more stress, cardiovascular disease, diabetes and cancer, the study notes.

See additional coverage: CBS San Francisco (video), The Guardian

UCLA plans behavioral health center, California Healthline

A ceremony Oct. 14 at UCLA officially unveiled plans for a research center devoted to behavioral health, a $7.5 million investment that mirrors a sister effort at UC Davis in Sacramento. Together, they are called the Centers for Excellence in Behavioral Health, funded by $15 million over three years from the Mental Health Services Act, created in 2004 when California voters passed Proposition 63. “The idea is to take what we do here at the UC [system] and … translate the science into policy and bring it to evidence-based practice in the community,” said Peter Whybrow, director of UCLA’s Semel Institute for Neuroscience and Human Behavior, where the behavioral health center will be.

New UCLA telehealth program part of national trend, California Healthline

A new consumer service launched by UCLA is part of a growing national trend of using telehealth technology to let patients and physicians connect using mobile phones, tablets and computers. LiveHealthOnline, launched last month by UCLA Health System, is one of about 200 telemedicine networks in the U.S., according to the American Telemedicine Association. Like many remote physician services, the goal is to provide convenience to busy patients with minor ailments who don’t have time to get into a doctor’s office. “For population health, it gives us the ability to expand our reach but in a convenient way,” said Peter Kung, director of strategic technologies for the UCLA Health System. “People don’t have to drive in Los Angeles traffic for a cold and cough and we can uphold quality.”

Study backs use of stem cells in retinas, The New York Times

Since they were first isolated 16 years ago, human embryonic stem cells have been thought to have the potential to replace the body’s worn-out tissues and treat a wide variety of diseases. The progress has been slow. But now researchers are reporting an encouraging step. A therapy for eye diseases that was derived from stem cells appeared to be safe and might have improved the vision of some patients, according to a new study. The results, published on Tuesday evening by the journal The Lancet, represent the most extensive human data yet on any treatment derived from such embryonic stem cells. The 18 patients in the study were followed for a median of 22 months, two of them for more than three years.  Dr. Steven D. Schwartz, a retina specialist at UCLA and the lead author of the paper, is quoted.

UCLA study shows why one of the biggest Obamacare fears may not come to pass, California Healthline

Something like 10 million Americans — give or take a few million — have gained health coverage thanks to the Affordable Care Act. And here’s one way to put that in perspective: In just six months between late 2013 and early 2014, the nation’s persistently high uninsured rate fell by a staggering 25%. So does this mean that the nation’s already busy emergency departments are about to bust at the seams, as some Obamacare critics suggest? That states still nixing the Medicaid expansion are right to worry it would overcrowd their hospitals? Not necessarily, says UCLA’s Gerald Kominski. Kominski, director of UCLA’s Center for Health Policy Research, and colleagues looked at what happened when hundreds of thousands of Californians signed up for a proto-version of Obamacare: the Low Income Health Plan, better known as the LIHP. And UCLA’s new study — released on Wednesday — tracks nearly 200,000 enrollees in the LIHP between 2011 and 2013.

Dance medicine workshop at Davis conference engages younger crowds, The Sacramento Bee

Dozens cycled in and out of a UC Davis classroom this weekend to hear the story of Isha Loyd, a seven-year cast member of the Sacramento Ballet who was forced to leave the stage earlier this year because of a ganglion cyst in her right foot. Raising the next crop of physicians was the main focus of the 12th annual UC Davis Pre-medical and Pre-health Professions National Conference held Saturday and Sunday for high school, college and post-graduate students interested in the medical field.

Email hacking source of UC Davis breach, Clinical Innovation+Technology

The University of California Davis Health System has notified 1,326 patients that their protected health information was compromised when a physician’s email account was hacked.

See additional coverage: Healthcare IT News

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