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UCSF launches a healthy beverage initiative

Health sciences campus will focus sales on zero-calorie and nutritious drinks.

By Kristen Bole, UC San Francisco

UC San Francisco is launching a healthy beverage initiative in an effort to align campus food and drink sales with the growing science about the negative impact of excess sugar consumption on health.

Starting July 1, UCSF will start phasing in a program to sell only zero-calorie beverages or non-sweetened drinks with nutritional value, such as milk and 100 percent juice, and will phase out the sale of sugar-sweetened beverages in its onsite cafeterias and food vendors, vending machines and retail locations.

The program will begin at UCSF’s Mission Bay campus site, where UCSF Medical Center piloted the project when it opened its three new specialty hospitals in February. It will roll out across further campus sites throughout the summer, culminating at the Parnassus campus site in October.

Sugar-free trend

UCSF and its affiliated hospitals are among more than 30 health systems nationwide that have begun to eliminate the sale of sugary beverages on campus in response to the growing evidence of their roles in metabolic and chronic disease, including obesity, diabetes, heart disease, liver disease and dental caries.

“The science behind the impact of excessive sugar on chronic disease, particularly in the form of sweetened beverages, is already strong and growing,” said UCSF Chancellor Sam Hawgood, M.B.B.S. “As a health sciences university and leading medical center, we see it as our responsibility to do our part to help reduce this impact on our own community.”

Health leaders worldwide have begun to identify recommended limits of sugar consumption based on research implicating sugar in a growing number of diseases and conditions. The American Heart Association (AHA) recommends that women consume no more than 6 teaspoons (25 g) of added sugar per day and men no more than 9 teaspoons (38 g), due to its impact on cardiovascular disease. The World Health Organization recommends a similar level of no more than 10 percent of daily calories from added sugar, with greater benefit from reducing it to 5 percent of calories, due to dental caries. The U.S. departments of Agriculture and of Health and Human Services also are considering a 10 percent recommendation in the upcoming dietary guidelines.

Americans currently consume an average of 19.5 teaspoons of added sugar per day, of which 36 percent is in the form of sodas, sports drinks and energy drinks, according to research assessed by the UCSF-led SugarScience project. Over the past year, the SugarScience team reviewed more than 8,000 scientific papers on sugar’s impact on health. Studies show that one soda exceeds the AHA daily limit for added sugar and that drinking just one soda per day can increase the risk of dying from heart disease by nearly one-third and raise the risk of diabetes by 26 percent. New research from UC Davis also has shown a dose-related connection between sugar and metabolic disease, with higher consumption linked to worse health impacts.

“The average American consumes nearly three times the recommended amount of added sugar every day,” said Laura Schmidt, Ph.D., a UCSF professor in the Philip R. Lee Institute for Health Policy and the lead investigator on SugarScience. “The most common single source is sugar-sweetened beverages.”

Sugar overconsumption is implicated in most forms of metabolic and chronic disease, with growing evidence of links to some forms of cancer, premature aging and cognitive decline. These diseases are significant topics of UCSF research and clinical care.

Healthy choices

Research in behavioral economics and public health has shown that people tend to make food and drink choices based on convenience and accessibility. By making it easy to purchase healthy food and drinks, UCSF can support patients and employees who are trying to improve their health.

As of November, members of the UCSF community and visitors will be able to bring sodas or other sugary drinks with them to campus, but will only be able to purchase healthy beverages.

The average American consumes 45 gallons of sugary drinks per year. While sugary soda consumption has begun to decline in recent years, annual U.S. consumption of sugary drinks rose by 38.5 gallons per person between 1950 and 2000. Sugar-sweetened beverages include sodas, fruit drinks with added sugar, energy drinks, sweetened teas and sports drinks.

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Q&A: John Mazziotta on future of UCLA’s medical school, health system

New leader discusses his new roles and aspirations for the future.

John Mazziotta, UCLA (Photo by Ann Johansson)

By David Greenwald

Earlier in his life, Dr. John C. Mazziotta thought about becoming an architect. With a keen eye for form and function, he would apply his skills to the construction of great buildings. Instead, he chose medicine. Now, after more than 30 years at UCLA — where he has been chair of the Department of Neurology, an associate vice chancellor and executive vice dean, and founding director of the Ahmanson-Lovelace Brain Mapping Center — that style of visual thinking will serve him well in his new roles as vice chancellor for UCLA Health Sciences, dean of the David Geffen School of Medicine at UCLA and CEO of UCLA Health. “There are many parallels between architecture and construction and what we do in medicine and the building of a large medical enterprise,” he said. “And, on a purely administrative level, it doesn’t hurt to have some interest in the subject when you are managing millions of square feet of space and renovating a giant building. Having some interest and experience about how these things work is helpful.” Mazziotta spoke with U Magazine editor David Greenwald about his new roles and his aspirations for the future of the medical school and health system.

As vice chancellor, dean and CEO, you bridge the worlds of the health system and the medical school. How does each of these worlds inform the other?
We have one health organization with two big pieces to it: the health system — the hospitals, the clinics, the doctors and nurses and support staff — and the David Geffen School of Medicine at UCLA. The overarching goal of our medical enterprise is its academic purpose — to excel in research and education. To achieve that, we have to be excellent in all areas. We have to be good at the business of medicine — which has become very complicated over the years — in order to have the opportunities for our students, residents and fellows to have a place to train and to have the financial resources to support research and education. We have a responsibility to the citizens of California and Los Angeles, and to society in general, to produce great scientists and doctors and to develop new and effective treatments and, ultimately, cures for disorders of the human condition. Having one person over these arenas helps to ensure the correct balance and laser focus on our academic mission.

What are the opportunities that this presents?
When there is a significant change in leadership, involving more than one individual, as is the case now, there is the opportunity to actually review the governance structure of the organization. It is like starting with a clean slate and makes it possible to ask questions such as, “What are the functions we actually need?” and “How do we change the structure to become more effective, efficient and responsive?”

It has been perhaps 20 years since the overall structure of this organization has been examined, so this is a great opportunity for us to do just that. Chancellor Gene Block has assembled a task force to do exactly that, to look at the governance of the health sciences — not just medicine, but all of the health-science schools — as well as the health system. Change is healthy. It is good to have a chance to engage in self-examination and to think about whether or not we have the ideal approach to the governance structure. It is an exciting opportunity.

When Thomas Watson Jr. was the CEO of IBM, he said, in the early 1960s, “I believe that if an organization is to meet the challenges of a changing world, it must be prepared to change everything about itself, except its beliefs.” Like the business-machine and early computer industry of Watson’s time, today’s health care environment is undergoing dramatic change, and we need to be prepared to adapt without changing the beliefs that are embedded in our core academic missions.

As you assume your new roles, what are your priorities?
I’ve traveled all around the world in my career. What do you think is the first thing people mention when they identify someone as being from UCLA? Basketball. That is the one thing you will find that UCLA is known for pretty much anywhere in the world. So that makes me think we can work toward establishing a John Wooden-like dynasty of excellence in health science. In the future, people will say, “Basketball and medicine.” I believe that is possible.

We should strive to be the best in the world at the things we choose to do. We can’t be the best in the world at everything, but, when we pick a subset of those things, we should pick the ones in which we can be the very best. When I first became chair in neurology, the faculty said, “We want to be the best in research.” So we constructed a strategic plan, and we executed the plan down to the most minute detail, and in a short period of time, we were No. 1 in the United States in research funding, and we maintained that distinction for nine consecutive years. Five years ago, the faculty wanted to enhance philanthropy. So we developed an approach and implemented it. Last year, neurology raised more philanthropic dollars than any other department on campus.

The strategy worked well for the department. How would that be applied to achieve similar results on a broader scale?
We have a strategic plan for the health system and the medical school, and we will continue to implement the plan, particularly in this time of change. We have great teams in place. Our previous leadership left their legacy in the people who served with them. Our people are ready and, without question, able to execute on these plans to enhance our momentum. That is in the short term.

For the long term, we want to be the best in the world in specific areas. For the health system, that means being the role model nationally for enabling an academic medical center to truly deliver patient-centered and integrated care to heal humankind one patient at a time. Instead of being compartmentalized into the “department of the eyeball” and the “department of the nervous system,” where the patient must go from one center to another to receive care, we want to create a system where whatever is needed for the patient surrounds him or her in a cost-effective way. No one has done this in academic medicine. The first one to do it will be the role model for the rest of the country, perhaps for the rest of the world. I want UCLA to be that role model.

For the School of Medicine, we have identified six research themes in which we want to particularly invest and excel. These areas are nondepartmental. They are thematic: cancer; immunology; cardiovascular medicine; neuroscience; metabolism; and degeneration, regeneration and repair. In education, through the enormous generosity of David Geffen and the David Geffen Medical Scholarships, we attract the brightest medical-student applicants, and they can attend UCLA without financial burdens. Dr. Clarence H. Braddock, our vice dean for education and chief medical education officer, will continue to restructure our pre- and post-graduate medical training. Our new bioscience graduate program ensures optimal education for biomedical scientists. With this clear focus, we will be the future of medicine.

What are some examples of how we already excel in the research areas you have identified?
There are many, but let’s highlight one: cancer. Within this past year, three new cancer therapies developed at UCLA have been approved by the U.S. Food and Drug Administration. These therapies are the result of years of investigation led by UCLA researchers, and they offer new alternatives for patients with such cancers as melanoma, non-small–cell lung cancer and estrogen-receptor–positive breast cancer.

I will highlight one other. In the area of cardiovascular research, our scientists have developed an entirely novel therapeutic approach to fighting vascular plaques — a synthetic protein that is designed to mimic HDL, or “good cholesterol.” This therapy was brought to clinical trial, which resulted in a licensing agreement. These are just a couple of examples of the incredible work that is being done at UCLA, the kind of work we want to support and advance even further.

We are speaking in your office in the Center for the Health Sciences building — what used to be the old UCLA Medical Center before the hospital moved to Ronald Reagan UCLA Medical Center. This building has been undergoing a significant transformation. What is happening here?
This has been the single largest renovation project in the history of the University of California, to transform this building into a space for high-intensity research laboratories. The building has been seismically retrofitted, and now it is being reassembled into clean, open spaces with all new infrastructure. That phase is scheduled to be completed this June.

The final phase will be outfitting the labs, which will be customized to serve different purposes — there will be a floor devoted to each of the six research themes that I previously mentioned. That phase will take another six to nine months. Other areas will be used to facilitate different kinds of partnerships — public-private partnerships. We will partner with established organizations and businesses in the private sector to do joint research projects, possibly startup companies. As a university, we’re not a bottom-line organization that focuses only on the money that can be made from these opportunities. Rather, we will pursue intellectual property that can lead to societal benefit, even if it isn’t necessarily a financial winner. That’s going to be a very exciting activity.

What have been the most pivotal moments in your life and career leading up to where you are now?
I will go back to my childhood, growing up outside of New York City. My father was an individual who was a pretty structured guy. And whenever I would want something, for example, “Dad, I need a car,” his response was to say, “If you want it bad enough, you’ll figure out how to get it.” So, I would come up with a proposal for how to accomplish what I wanted. He would look at it and say, “You’re getting there. You’ll figure it out.”

I would have to be creative, knowing that I had a certain amount of money, and maybe I could borrow some from him and perhaps earn extra money doing more jobs. And he would just say, “You’ll figure it out.” That taught me perseverance and to try to think in a variety of different ways to solve a problem. Rather than to just say I want something and get it, I had to come at it from five or six different directions. Eventually I knew some combination of those different approaches would be successful. There’s a proverb that I like: “In the struggle between the river and the rock, the river always wins, not through strength, but through perseverance.” That was a good lesson for me to learn. I believe every problem has a solution.

This Q&A appears in U Magazine’s spring 2015 issue.

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UCSF names medical school dean

Noted lung specialist Talmadge King has been a leader at UCSF for nearly two decades.

Talmadge King, UC San Francisco (Photo by Elisabeth Fall)

By Laura Kurtzman, UC San Francisco

Talmadge E. King Jr., M.D., an international expert on lung disorders who has been a campus leader for nearly two decades, has been appointed dean of the School of Medicine and vice chancellor for medical affairs at UC San Francisco.

A physician-scientist, King’s research has focused on inflammatory and immunologic lung injury. He is best known for his pioneering work in the management of the interstitial pneumonias, a scarring process that often leads to death. His bibliography comprises more than 300 publications and he has co-edited eight books, including an acclaimed reference work on interstitial lung disease.

King has served as chair of the UCSF Department of Medicine, the largest department in the School of Medicine, for nine years.

As dean of UCSF School of Medicine, King will lead a premier medical school with a fourfold mission of education, research, patient care and public service. It is the only school in the nation ranked in the top five in both research and primary care education by U.S. News and World Report. It receives more competitive research funding from the National Institutes of Health (NIH) than any other school in the country, a measure of the quality of the research conducted by its investigators. UCSF has a distinguished faculty that includes five Nobel laureates.

In addition to overseeing the school’s education and research enterprises, King will lead the faculty at eight major sites in the San Francisco Bay Area and San Joaquin Valley, including UCSF Medical Center, UCSF Benioff Children’s Hospital San Francisco, San Francisco General Hospital and Trauma Center, San Francisco VA Medical Center and Fresno Medical Education Program.

King replaces interim Dean Bruce Wintroub, M.D., who was named to the post while a national search for a permanent dean was underway. Wintroub will continue as chair of the Department of Dermatology and vice dean at the UCSF School of Medicine.

“I want to thank Bruce for his tremendous stewardship of the school over the last year,” said UCSF Chancellor Sam Hawgood, M.B.B.S. “He’s been a critical colleague as we made the transition.

“I’m very excited for the School of Medicine as it moves forward. Talmadge brings extraordinary experience, intellect and vision to his new role, as well as humanity. He’s been elected to the most prestigious societies in science and medicine on the basis of his scientific accomplishments, and yet he remains an accessible and deeply trusted colleague.”

King, whose appointment was recommended by Hawgood and approved by UC President Janet Napolitano, assumes his new role on July 1. He will join Hawgood’s executive cabinet, consisting of the deans of the other professional schools – dentistry, nursing and pharmacy – and the Graduate Division, the CEO of UCSF Medical Center and UCSF Benioff Children’s Hospitals, the vice chancellors and other leaders of the university.

King was recruited to UCSF from the University of Colorado in 1997 to serve as vice chair of the Department of Medicine and chief of medical services at SFGH. He became chair, the first year as interim, in 2006. Under his leadership, the department increased its faculty from 521 to 602, grew its budget from $322 million to $454 million, and boosted the number of endowed chairs and distinguished professorships from 39 to 72. The department is the No. 1 recipient of research dollars from the NIH among all departments of internal medicine in the nation. U.S. News & World Report ranks six of its subspecialty clinical programs in the top 10 – AIDS, cancer, diabetes & endocrinology, geriatrics, nephrology, and rheumatology. Also, its residency training is among the top programs in the country.

As dean, King will lead the UCSF School of Medicine at a critical time, as it positions itself to achieve new levels of excellence in its core missions. UCSF’s School of Medicine, which includes 2,197 full-time faculty members, received $517 million from the NIH last year, reflecting its research strengths in a broad range of areas, including immunology, the neurosciences, neurosurgery, women’s health and stem cell research.

“At UCSF, we are privileged,” King said. “Our faculty, staff and students are outstanding. We are able to recruit the best and brightest from around the world and perform the highest level of biomedical research and patient care, and our faculty and alumni have a seat at the table in guiding health policy throughout the world.

“In that position, we have both the honor and the obligation to ensure the health of our community by strengthening health systems and addressing health inequities, whether they occur at home or across the world.”

King is a past president of the American Thoracic Society, a past secretary-treasurer of the American Board of Internal Medicine, and a current member of the boards of the American College of Physicians, the National Committee on Quality Assurance and Gustavus Adolphus College. He was elected to the Association of American Physicians, the Institute of Medicine, and the American Academy of Arts and Sciences, and was honored as a Master by the American College of Physicians. In 2007, King received the Trudeau Medal, the highest honor of the American Thoracic Society.

King, 67, grew up in Darien, Georgia, a small town on the Atlantic Coast. King graduated from Gustavus Adolphus College in Saint Peter, Minnesota, and earned his M.D. from Harvard University in Boston. He served an internal medicine residency at Emory University Affiliated Hospitals in Atlanta and a pulmonary fellowship at the University of Colorado Health Sciences Center in Denver. He lives in Oakland with his wife, Mozelle D. King, a retired teacher.

King will receive a base salary of $636,000, of which $187,200 is from state funds, with the remainder generated by revenue from the nonprofit clinical enterprise. He also will receive an additional $164,000 through the Health Sciences Compensation Plan (HSCP) and has the potential to receive up to 30 percent of base salary through HSCP, dependent upon achieving performance metrics, both of which are paid by the nonprofit clinical enterprise. King’s base salary falls just below the 60th percentile of medical deans in similar markets. King continues to be eligible for standard pension and health and welfare benefits and, with this appointment, senior leadership benefits.

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UC Davis unit aids wildlife rescue effort from oil spill

Oiled Wildlife Care Network among those responding in Santa Barbara.

Christine Fiorello of UC Davis’ Oiled Wildlife Care Network cleans a pelican harmed in the oil spill in Santa Barbara County. (Photo by Joe Proudman, UC Davis)

By Kat Kerlin, UC Davis

Update May 28: As of 6 p.m. on May 27, 39 live birds — mostly brown pelicans — had been rescued, with 18 birds collected dead. A total of 16 California sea lion and six Northern elephant seals were rescued, while four dead dolphins and six dead sea lions were collected. The number of oiled willdlife collected so far totals 89 individuals.

Team members from the Oiled Wildlife Care Network at UC Davis have joined crews responding to the oil spill in Santa Barbara County. They are coordinating the wildlife response effort as part of the unified command interagency emergency response team.

OWCN staff and faculty were called away from an oil spill conference in Alaska to respond today (May 21) to the spill that released 105,000 gallons of crude oil in Santa Barbara County, with an estimated 21,000 gallons entering the water.

Five pelicans, one sea lion being treated

Five live oiled pelicans and one oiled California sea lion have been rescued as of 2 p.m. today (May 21). The oiled birds are being transported to the Los Angeles Oiled Bird Care and Education Center, a facility roughly three hours south of Santa Barbara in the San Pedro community. The facility is designed to care for up to 1,000 birds that have been coated with, swallowed or inhaled oil.

Operated by International Bird Rescue, the 12,000 square-foot center has specialized areas for wildlife intake, holding, washing, drying, isolation and recovery, as well as for food preparation, medical care and necropsy.

The sea lion is being transferred to the Oiled Wildlife Care Center at SeaWorld San Diego. The 2,600 square-foot center, completed in 2000, is capable of housing up to 200 seabirds and 20 marine mammals and can accommodate pinnipeds, sea turtles and sea otters.

Too soon to know wildlife impact

While the OWCN team assesses the situation, it is too early to estimate the full wildlife impacts. Updates will be posted on the OWCN blog, https://owcnblog.wordpress.com, as well as announced at regular briefings provided by the Unified Command Center.

“Just because there’s a lot of oil in the environment doesn’t mean we will have huge numbers of animals,” said Mike Ziccardi, director of the Oiled Wildlife Care Network at UC Davis. “Sometimes there are small spills with large numbers of animals and huge spills with just a few animals.”

The 2007 Cosco Busan oil spill, for example, released more than 53,000 gallons of fuel oil into the San Francisco Bay. Ziccardi directed the care of 1,068 oiled birds at that time.

“Right now, with a worst-case estimate at 105,000 gallons released, this spill would be twice the size of Cosco Busan, but we’re not yet seeing large numbers of affected wildlife,” Ziccardi said. “It’s not necessarily a linear relationship.”

Can take days for wildlife to get sick

It can take days for oiled wildlife to get sick and weak from ingesting oil or getting it on their skin or plumage. For example, oiled birds typically ingest oil when they attempt to clean their feathers, which can affect their immune systems, internal organs and reproductive systems. Oil on bird’s feathers also affects their ability to insulate themselves. As they lose body heat, they become hypothermic, and their need for food increases. Yet, due to the oil on their plumage, they do not float or fly well. Wildlife responders who find them collect them and transfer them to a wildlife rescue facility for treatment.

Members of the public who spot oiled wildlife should not try to pick them up and “save” them, OWCN urges, as this can cause the animals further harm. Rather, they should report oiled wildlife immediately by calling (877) UCD-OWCN.

Oil funds for oiled wildlife rescue

The OWCN is managed by the UC Davis Karen C. Drayer Wildlife Health Center, which is part of the UC Davis School of Veterinary Medicine. The network is the world’s most advanced system of emergency centers for wild animals hurt in oil spills. It is funded by the California Department of Fish and Wildlife’s Office of Spill Prevention and Response. This funding comes from interest on the California Oil Spill Response Trust Fund, built from taxes levied on the oil industry.

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Four UC scientists among 26 new HHMI investigators

Two each from UC Berkeley, UCSF to get support to move research in creative directions.

Loren Frank, UC San Francisco

Two UC Berkeley and two UC San Francisco scientists have been named Howard Hughes Medical Institute (HHMI) investigators, joining 22 other top U.S. biomedical researchers, who will receive the flexible support necessary to move their research in creative new directions.

Loren Frank, Ph.D., professor in the Department of Physiology, and Yifan Cheng, Ph.D., an associate professor in the Department of Biochemistry and Biophysics, are the two honorees from UCSF. The new HHMI investigators – including four current HHMI early career scientists – were selected for their individual scientific excellence from a group of 894 eligible applicants. The scientists represent 19 institutions from across the United States.

Yifan Cheng, UC San Francisco

“Being chosen as an HHMI investigator is a tremendous honor for me,” said Frank, who leads a team of 12 people in his Frank Laboratory at UCSF. “I had honestly never thought that my our work would receive the level of recognition that this represents.”

“I am very excited about being selected as one of the 26 new HHMI investigators,” added Cheng, who leads a team of nine in his eponymously named lab. “It is a tremendous recognition of our work.”

At UC Berkeley, Britt Glaunsinger, an associate professor of plant and microbial biology, and Andreas Martin, an associate professor of molecular and cell biology, are the campus’s newest HHMI investigators, joining 19 other UC Berkeley faculty members whose salaries and a major part of their research are paid for by the Howard Hughes Medical Institute.

Britt Glaunsinger, UC Berkeley (Photo by Don Feria, HHMI)

HHMI will provide each investigator with his or her full salary, benefits, and a research budget over their initial five-year appointment. The institute also will cover other expenses, including research space and the purchase of critical equipment. Their appointment may be renewed for additional five-year terms, each contingent on a successful scientific review.

HHMI encourages its investigators to push their research fields into new areas of inquiry. Glaunsinger, for example, hopes to learn a lot about human biology by studying viruses that have evolved to infiltrate our cells. She searches for functions of mammalian cells that are exploited by viruses, then investigates how those functions aid the virus, as well as their normal roles in cells. She has focused on uncovering how viruses use or target RNA to manipulate gene expression.

Andreas Martin, UC Berkeley (Photo by Don Feria, HHMI)

Martin focuses on the proteasome, the molecular machine responsible for disposing of damaged or obsolete proteins that is so crucial to healthy cells that attempts to manipulate it inside cells inevitably kill them. Martin spent several years devising a production system in bacterial cells as well as assembly strategies in the test tube to reconstruct fully functional proteasomes, each of which has at least 34 different subunits, so he can examine their structure and function in detail. His work is offering a new framework for understanding how the proteasome is able to specifically degrade hundreds of different proteins in the cell.

“Scientific discovery requires original thinking and creativity,” said HHMI President Robert Tjian, a UC Berkeley professor of molecular and cell biology and one of the campus’s HHMI investigators. “Every scientist selected has demonstrated these qualities. One of the most important things we can do at HHMI is to continue to support and encourage the best discovery research. We don’t know this for certain, but the ideas that emerge from these labs might one day change the world, and it’s our privilege to help make that happen.”

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Q&A: UCLA search and rescue volunteer back from Nepal quake disaster

Dr. Attila Uner served on a U.S. search and rescue team that helped find survivors.

Members of Dr. Attila Uner's search and rescue task force looking for earthquake survivors in the mountain village of Singati. (Photo by Kashish Das/USAID/via AP)

Hours after a magnitude 7.8 earthquake struck Nepal on April 25, Dr. Attila Uner, a UCLA associate clinical professor of emergency medicine, got the call to assist in a search for survivors as a volunteer member of the California-based Urban Search and Rescue Task Force USA 2. Deployed by the U.S. Agency for International Development’s Office of U.S. Foreign Disaster Assistance, the team consisted of 52 firefighters and paramedics and six search dogs from the Los Angeles County Fire Department, as well as three civil engineers and two physicians. Uner, who also helped in New Orleans after Hurricane Katrina, spent 19 days in Kathmandu and the village of Charikot helping with rescues. Harbor-UCLA Medical Center’s Dr. Nicole Bosson was the second local doctor.

UCLA Newsroom senior writer Judy Lin talked to Uner for this edited Q&A shortly after he returned home last weekend.

How did your deployment unfold?
We got called Saturday morning [April 25, the day of the earthquake] and assembled in Pacoima with our medical supplies, drills, search cameras, gasoline, generators, radio equipment — tons and tons of equipment. We also brought along enough food and bottled water for three weeks, and six search dogs and all their food and water. We flew out of March Air Reserve Base [in Riverside] early Sunday afternoon on a C-130 military plan; 31 hours later we arrived in Kathmandu.

What did you find when you arrived?
I’d seen nothing like this before — collapsed buildings and quite a bit of devastation of world cultural heritage sites, all sorts of temples. We set up our base of operations on the grounds of the U.S. embassy with a command tent, medical and sleeping tents, and then we went to our assigned sector. Search and rescue teams from the United States, China, India and other nations were working in different sections of the city.

Dr. Attila Uner, a search and rescue team volunteer since 2002, also went to New Orleans after Hurricane Katrina.

Did you set up a medical clinic?
We’re not a medical team per se. It’s our job to take care of the medical needs of the person being rescued and transport them to a hospital. It’s also our job to keep the team healthy. If you go to Nepal as a tourist, you’re going to have diarrhea. But rescuers can’t afford to get that. So we’re all eating military food rations from a sterile pack and drinking bottled water. And we make sure that people aren’t getting too many mosquito bites, because there’s mosquito-borne encephalitis in Nepal.

I’m also responsible for the search dogs. Mostly Labradors, they’re trained to find only survivors and ignore dead bodies. The problem with the dogs is they’re really hyper — they want to please their masters by finding something. So they run and run and get dehydrated. Sometimes we need to give them fluid injections under their skin. The dogs are some of our most valuable search tools so we cannot lose them.

How do you decide where to search?
There’s a whole science to how buildings collapse in an earthquake. Ceilings collapse onto floors, floors onto ceilings. There might be somebody in the basement, in a little hole buried underneath all of that. Locals can’t dig with their hand tools. You have to tunnel in with drills and other tools through rock, walls and maybe even through a car or a washer and dryer — whatever’s in your way.

How do you look for survivors?
If they can, they scream because they’re terrified. Or they knock.  And people nearby usually know who’s missing. Someone will say, “My grandma’s in there,” or “I can’t find my kid.” If it’s a collapsed factory, they might realize that co-workers are missing. If they’re buried and don’t have any water, they won’t survive very long — maybe five days. If it rains and they have a little water to lick, they might live 10 days.

Do you have other ways to tell if someone’s in there?
We have search cameras — building endoscopes, basically a long stick with a camera on the end. The search dogs are very good at sniffing out the pile for survivors; “the pile” is what we call collapsed buildings. If a dog hits on something, we send out a second dog. If that dog hits on the same area, we start yelling to see if there’s someone down there. If we can’t see anything with our cameras, but the dogs keep (on it), we start digging.

What happens if you find a survivor?
Everybody’s happy, but we have to be really careful about pulling them out. They could die on the spot because of a condition called crush syndrome. If you have sustained pressure on a large muscle for over an hour, that muscle gets damaged and traps potassium and acid in it. The second you lift off the weight, blood flows back into the muscle. Then the blood with potassium and acid flows back to the heart, causing it to stop beating. To prevent that from happening, I put on all my protective gear and go down into the hole to give that patient medications before he is removed.

There were news stories about a 15-year-old boy who was rescued after being buried for five days. Were you part of that operation?
Yes. The local Nepali police force found him. They started digging and got close, but I think they needed tactical assistance, so the U.S. teams responded. The boy was entombed but not crushed, nothing heavy pinning him down, so no crush syndrome. He got some medications and was taken out.

Was your team also in Nepal when the second earthquake hit on May 12?
By that time, we were packing up because no one could still be alive in those buildings by then. We were waiting for our flight out to be arranged when the second earthquake hit. We all ran out of the hotel, which was shaking pretty badly. Then we got right back into rescue mode.

We were airlifted by military helicopters and taken 46 miles east to the small town of Charikot, which got hit hard. We dug out one lady whom we treated for crush syndrome, but we found no other survivors. They had about 40 dead in that town alone. The next day while we were waiting for our helicopter to get out, local rescuers started flying in survivors from a nearby town, so we had 26 people that we triaged. We finally got back to California on Friday, May 15.

What’s it like to take part in an operation like this?
It always feels good to help people who otherwise can’t be helped. I also learn a lot from the fire guys and engineers. I get a lot out of it. The other thing is that I’m an immigrant — I came here from Germany in 1993 looking for a better life — so this is me paying back for the fact that 300 million Americans took me in when I walked through that door.

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Neurobiologists restore youthful vigor to adult brains

Reactivated plasticity points to new treatments for developmental disorders.

UC Irvine neurobiologist Sunil Gandhi led the study that, in a sense, coaxed old brain processes to become young again. (Photo by Steve Zylius, UC Irvine)

By Tom Vasich, UC Irvine

They say you can’t teach an old dog new tricks. The same can be said of the adult brain. Its connections are hard to change, while in children, novel experiences rapidly mold new connections during critical periods of brain development.

UC Irvine neurobiologist Sunil Gandhi and colleagues wanted to know whether the flexibility of the juvenile brain could be restored to the adult brain. Apparently, it can: They’ve successfully re-created a critical juvenile period in the brains of adult mice. In other words, the researchers have reactivated brain plasticity – the rapid and robust changes in neural pathways and synapses as a result of learning and experience.

And in doing so, they’ve cleared a trail for further study that may lead to new treatments for developmental brain disorders such as autism and schizophrenia. Results of their study appear online in Neuron.

The scientists achieved this by transplanting a certain type of embryonic neuron into the brains of adult mice. The transplanted neurons express GABA, a chief inhibitory neurotransmitter that aids in motor control, vision and many other cortical functions.

Much like older muscles lose their youthful flexibility, older brains lose plasticity. But in the Gandhi study, the transplanted GABA neurons created a new period of heightened plasticity that allowed for vigorous rewiring of the adult brain. In a sense, old brain processes became young again.

In early life, normal visual experience is crucial to properly wire connections in the visual system. Impaired vision during this time leads to a long-lasting visual deficit called amblyopia. In an attempt to restore normal sight, the researchers transplanted GABA neurons into the visual cortex of adult amblyopic mice.

“Several weeks after transplantation, when the donor animal’s visual system would be going through its critical period, the amblyopic mice started to see with normal visual acuity,” said Melissa Davis, a postdoctoral fellow and lead author of the study.

These results raise hopes that GABA neuron transplantation might have future clinical applications. This line of research is also likely to shed light on the basic brain mechanisms that create critical periods.

“These experiments make clear that developmental mechanisms located within these GABA cells control the timing of the critical period,” said Gandhi, an assistant professor of neurobiology & behavior.

He added that the findings point to the use of GABA cell transplantation to enhance retraining of the adult brain after injury. Furthermore, this work sparks new questions as to how these transplanted GABA neurons reactivate plasticity, the answers to which might lead to therapies for currently incurable brain disorders.

Dario Figueroa Velez, Roblen Guevarra, Michael Yang, Mariyam Habeeb and Mathew Carathedathu of UCI contributed to the study, which was supported by a National Institutes of Health Director’s New Innovator Award (DP2 EY024504-01), a Searle Scholars award, a Klingenstein Fellowship and a postdoctoral training grant from the California Institute for Regenerative Medicine (TG2-01152).

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Drug, Device, Discovery and Development initiative moves forward

UC collaborative aims to speed the discovery, development of products that improve health.

By Carole Gan, UC Davis

On April 15, more than 40 scientists from across the University of California system and representatives from the biomedical industry met to discuss plans for strengthening UC’s position in drug, device and diagnostics development.

The meeting was part of the Drug, Device, Discovery and Development (D4) initiative, a collaborative effort among UC’s five medical campuses to pool resources and expertise to accelerate the discovery and development of products that improve health.

The full day event, held in San Francisco, consisted of panel discussions and breakout sessions, with the ultimate goal of creating an efficient model for multicampus collaborations with industry partners and setting up a UC Drug Discovery Alliance. D4 has been working in tandem with the University of California Biomedical Research Acceleration, Integration & Development (UC BRAID) program to define D4’s priorities.

“We have come a long way since the inception of D4 two years ago and are now in the position to take tangible steps forward on these priorities,” said June Lee, professor of medicine and director of early translational research at UCSF. “By bringing diverse stakeholders from all of our medical campuses together with leaders from the UC Office of the President and external stakeholders, we will be able to put together and execute on an informed plan.”

Michael Rogawski, professor of neurology, leads the D4 initiative for UC Davis. Other UC Davis representatives included Dushyant Pathak, associate vice chancellor for technology management and corporate relations, and Ahmad Hakim-Elahi, executive director for research administration and director of sponsored programs.

“The opportunities that we are addressing will greatly enhance translational research across the UC system and ensure that researchers’ promising discoveries achieve their potential for clinical impact,” Rogawski said. “All of our campuses have great science and unique strengths to offer, and working together, we will have an even more profound impact on the future of drugs, devices and diagnostics.”

Connecting with industry, stimulating drug discovery

The first panel addressed how to set up a successful collaboration between several UC institutions and an industry partner and featured representatives from UCSF, UC Irvine, UC Davis, MedImmune and Quest Diagnostics.

A number of topics generated robust discussions, including how to create a mechanism for connecting industry with academic researchers, streamlining the contracting process and managing complex collaborative projects. UC BRAID already has commenced work on multicampus agreements in the realm of clinical trials, and several suggestions were explored that would allow for the comparative advantages of each BRAID campus to be more readily apparent to the biopharmaceutical industry.

The second panel discussed enabling and stimulating early drug discovery in academia and debated models for the creation of the UC Drug Discovery Alliance. Representatives from UCSF, Gladstone Institutes, Takeda Pharmaceuticals, MedImmune and the National Institutes of Health participated.

Pharmaceutical companies are increasingly looking to academic institutions to supply de-risked drug targets and candidates. However, the challenges for an academic researcher to move from basic disease-related research to the identification and development of a drug candidate are immense. The UC Drug Discovery Alliance will support UC researchers by supplying expertise in drug development, access to UC core facilities and pilot funding, and will enable the translation of many more novel therapeutics projects from the lab to patients. The creation of quality data and robust intellectual property packages for projects  also will create significant value for the UC system.

The panel identified the need for institutional support, diverse sources of funding and partnerships within the life-science ecosystem as key areas of focus. There also was lively debate around the type of organizational model the UC Drug Discovery Alliance would adopt and how to engage industry partners.

Following the panel discussions, multiple breakout sessions were held to identify high priority action items and lay out next steps. Multicampus, cross-functional workgroups will now begin work to move specific initiatives forward. Next steps for the UC Drug Discovery Alliance include selecting a focus area, initiation of partnering and fundraising activities, and creating a business plan.

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Event showcases UC’s global health efforts

UC Global Health Day videos of presentations will soon be available on UCTV.

UC Global Health Institute Co-director Tom Coates and keynote speaker Patrick Soon-Shiong discuss the applications of new technologies in global health at the 2015 UC Global Health Day. (Photo by Margaret Molloy)

Nearly 300 people from across the 10 UC campuses attended the 2015 UC Global Health Day on April 18 at UCLA.

The fifth Global Health Day, sponsored by the UC Global Health Institute with support from UCLA, featured a keynote speech from Patrick Soon-Shiong, founder and CEO of NantHealth, chairman of the Chan Soon-Shiong Family Foundation, and chairman and CEO of the Chan Soon-Shiong Institute of Molecular Medicine. Plenary speakers included Claire Brindis (UC San Francisco), Michael Rodriguez (UCLA), Reshma Shamasunder (California Immigrant Policy Center) and Steven Wallace (UCLA).

Videos of the keynote and plenary presentations will soon be available on UCTV.

For more information, view a UC Global Health Day slideshow, poster presentations and submissions from the Video Challenge and Plenary Contest.

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Mentor Assistance Program launched

UC San Diego program to help high school students ‘MAP’ their academic future.

By Jan Zverina, UC San Diego

The San Diego Supercomputer Center (SDSC) at UC San Diego, in collaboration with the UC San Diego School of Medicine, has launched a new mentoring program designed to provide a pathway for high school student researchers to gain access to experts in their field of interest.

The Mentor Assistance Program (MAP), scheduled to run from October 2015 to May 2016, is focused on creating mentoring relationships that will enhance students’ desire to learn, teach and conduct research in a variety of humanities fields as well as areas of science, technology, engineering and mathematics (STEM).

On the mentoring side, MAP is open to all full-time academic and administrative faculty and postdoctoral fellows. Faculty in all of UC San Diego’s colleges and departments, including but not limited to biological sciences, computer science, electrical engineering, arts and humanities, international relations, health sciences, and visual and performing arts, are eligible to serve as mentors.

“The MAP program came out of a series of discussions about how we could provide a good degree of flexibility to faculty and post docs, who typically have very busy schedules, while providing a rewarding experience to the diverse high school student population across San Diego county,” said Ange Mason, SDSC’s education program manager, who co-founded the initiative with Kellie Church, an assistant professor in the Department of Reproductive Medicine within UC San Diego’s School of Medicine.

“We have designed this program so that UC San Diego faculty and postdoc mentors can decide their own level of involvement with the students, from mentoring over email and phone regarding students’ science fair or independent study projects, to mentoring involving laboratory and worksite visits,” added Mason. “After six months, the mentor may offer the student a summer internship if he or she desires.”

While mentors will participate on a volunteer basis, Mason and Church said the MAP program provides an opportunity for faculty and postdocs to fulfill the outreach, education and diversity component that is required by many funding agencies.

“We think this is an excellent way to help fulfill that requirement,” said Church. “This program is open to any UC San Diego department, and we’re eager to have a high level of involvement that spans the entire campus.”

More information about MAP can be found here, along with some key dates. The deadline for MAP mentor applications is July 1. High school students (grades 10-12) can apply to the program from Sept. 1 to Sept. 21.

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Restricting firearms access for people who misuse alcohol may prevent violence

Existing policies largely ineffective in restricting firearm access for people who misuse alcohol.

By Carole Gan, UC Davis

Restricting access to firearms for people who misuse alcohol could prevent firearm violence, but policies that more clearly define alcohol misuse should be developed to facilitate enforcement, according to a review of existing research and public policies by the UC Davis Violence Prevention Research Program.

The analysis, published online April 30 in the peer-reviewed journal Preventive Medicine, summarizes studies on binge drinking and other forms of alcohol misuse in association with firearm access and use, including firearm violence. It also describes the shortcomings of existing policies designed to restrict access to firearms among those who are at high risk for violence due to alcohol misuse — particularly people with multiple prior convictions for alcohol-related offenses such as driving while under the influence (DUI).

“Both acute alcohol intoxication and chronic alcohol misuse are strongly associated with risk for committing firearm violence, whether that violence is directed at others or at oneself,” said Garen J. Wintemute, professor of emergency medicine, founding director of the UC Davis Violence Prevention Research Program and expert on gun violence as a public health problem.

“In any given month, an estimated 8.9 million to 11.7 million firearm owners binge drink. Both binge drinking and heavy chronic drinking are more common among firearm owners than in the general population. For men, there are as many alcohol-associated deaths from firearm violence as from motor vehicle crashes,” he said.

The article cites numerous studies that link aggressive firearm behaviors and alcohol misuse. These include a nationally representative study in which people who reported threatening others with a firearm were more likely than others to meet Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for alcohol abuse or dependence, and another that found people who misused alcohol were substantially more likely than others to exhibit a combination of angry behavior and either carry firearms outside the home or have firearms at home.

Similarly, many studies have linked suicide by firearm and alcohol intoxication, including a 2011 study that found the excessive consumption of alcohol was associated with an 86-fold increase (an increase of 8,600 percent) in the risk of firearm suicide or near-suicide.

Federal and state policies are largely ineffective in restricting firearm access for people who misuse alcohol, Wintemute writes. Federal statute prohibits individuals who are unlawful users of or addicted to any controlled substance from the purchase or possession of firearms, but the statute specifically excludes alcohol from its definition of a “controlled substance” and leaves alcohol-related restrictions for individual states to consider.

“While 37 states with jurisdiction over 65 percent of the U.S. population have some restrictions on acquiring, possessing or using firearms by those who are intoxicated or have a history of alcohol misuse, many of these policies are unenforceable because they rely on vague, inherently subjective definitions of intoxication or misuse, such as ‘habitual drunkard,’  ‘habitually in an intoxicated condition,’ ‘chronic alcoholic’ and ‘addicted to alcohol,’” Wintemute said.

Wintemute noted that in the few locations that more specifically define alcohol misuse by number of convictions for DUI or other alcohol-related offenses over time (Maryland, Pennsylvania, Indiana, and the District of Columbia), the data on enforcement are unavailable or suggest that enforcement is lacking.

“Policies that restrict firearm access by persons with other risk factors for violence have been shown to be effective,” said Wintemute, who also is the first Susan P. Baker-Stephen P. Teret Chair in Violence Prevention at UC Davis Health System.

“In California, prohibiting persons convicted of violent misdemeanors for 10 years following their convictions reduced their risk of arrest for a firearm-related or violent offense. The evidence strongly suggests that properly-crafted and well-enforced policies, like modern laws for drinking and driving, would help prevent firearm-related violence,” he said.

Research for the article, “Alcohol misuse, firearm violence perpetration, and public policy in the United States,” was funded in part by the California Wellness Foundation (grant no. 2013-159). The foundation played no role in study design or conceptualization; in the collection, analysis and interpretation of the data; in the writing of the report; or in the decision to submit the article for publication.

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Unnecessary chemo? Many women don’t know risk of breast cancer recurrence

UCLA-led study finds that Latino women are twice as likely to have unnecessary treatment.

By Venetia Lai, UCLA

Although 90 percent of women with early-stage breast cancer said they were aware they took a genomic test that identified their level of risk for a recurrence of the disease, 1 in 5 didn’t know the results of that analysis, according to a new fact sheet by the UCLA Center for Health Policy Research.

The test, called gene expression profiling, or GEP, is used by physicians to help guide treatment decisions and can potentially help people avoid unnecessary chemotherapy. One of a number of emerging “precision medicine” genomic technologies, the GEP estimates the activity of specific genes in breast cancer cells, which can help predict whether there is a greater chance for breast cancer to return. Those with a high risk for cancer growth benefit by having chemotherapy as part of their treatment, the authors write, but chemo has no added value for those with a low risk.

The report is based on a national study of nearly 900 women younger than 65 who were diagnosed with early stage estrogen-receptor–positive, lymph-node–negative breast cancer. The Center for Health Policy Research collaborated with researchers from Harvard University’s Brigham and Women’s Hospital and Aetna.

The study also found that 15 percent of Hispanic women with a low risk for recurrence of breast cancer had unnecessary chemotherapy as part of their treatment, more than double the rate for the group as a whole (7 percent).

“No one should have to go through the stress and discomfort of chemo without understanding the personal risks and benefits,” said Ninez Ponce, the center’s associate director and senior author of the study. “At the very least, patients should know their options. Right now, some women may be making treatment decisions based on incomplete information.”

Although 9 in 10 women surveyed said they were aware that they had taken a test that would determine their risk profile, the percentage who knew about the test varied significantly by racial and ethnic group. Only 78 percent of Hispanic women and 85 percent of African-American women were aware of the test, compared with 94 percent of white women and 98 percent of Asian-American women.

Additionally, approximately 20 percent of those surveyed said they still did not know whether the test result indicated a high or low risk for recurrence of cancer — a significant information gap. Nearly 10 percent of Hispanics and 6 percent of African Americans said their doctors did not discuss the test or test results with them, compared with just 3 percent of whites and 2 percent of Asian Americans.

Among the high-risk patients, all of the Hispanic and Asian-American women and 81 percent of African-American and white women had chemotherapy, according to the report.

One in eight women will be diagnosed with breast cancer in her lifetime. The authors write that women who know they have a low risk for recurrence have the opportunity to avoid overtreatment and the side effects of chemotherapy, which include fatigue, hair loss, nausea, vomiting, diarrhea, bruising and bleeding.

The research was funded by Aetna.

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