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UCSF celebrating 150 years in health and science

Campus honors past, focused on future.

Hugh Toland joined a California-bound wagon train in 1852 with visions of striking it rich in the Gold Rush.

It only took a few months before the South Carolina surgeon abandoned prospecting, seeing a better opportunity in providing health care to a raucous and booming San Francisco. By 1864, Toland Medical College was born, and less than a decade later, it became the “medical department” of a fledgling University of California.

Though Toland might not have found the exact fortune he was seeking out West, he left a legacy that has enriched future generations in ways far greater than he could have imagined.

Today UC San Francisco is one of the top health sciences universities, encompasses more than 20 locations throughout San Francisco and is leading a charge to advance health worldwide. From its humble beginnings in the Wild West to this year’s 150th anniversary celebration, UCSF has been a testament to how the best research, the best education and the best patient care can converge to create life-changing breakthroughs.

UCSF’s sesquicentennial, which officially launches on Founders Day on April 10 and continues through May 2015, will be a yearlong celebration filled with special events on campus and in the community.

While anniversaries are a time to look back at accomplishments, the goal of this celebration also will be to recognize that UCSF has always been focused on the future, says Mary Anne Koda-Kimble, Pharm.D., chair of the 150th Celebration Committee and dean emeritus of the UCSF School of Pharmacy.

“The culture of the place is about excellence, moving forward and seeking new frontiers,” she says.

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Bone marrow stem cells show promise in stroke treatment

UC Irvine analysis reveals that they trigger repair mechanisms, limit inflammation.

Steven Cramer, UC Irvine

Stem cells culled from bone marrow may prove beneficial in stroke recovery, scientists at UC Irvine’s Sue & Bill Gross Stem Cell Research Center have learned.

In an analysis of published research, neurologist Dr. Steven Cramer and biomedical engineer Weian Zhao identified 46 studies that examined the use of mesenchymal stromal cells – a type of multipotent adult stem cells mostly processed from bone marrow – in animal models of stroke. They found MSCs to be significantly better than control therapy in 44 of the studies.

Importantly, the effects of these cells on functional recovery were robust regardless of the dosage, the time the MSCs were administered relative to stroke onset or the method of administration. (The cells helped even if given a month after the event and whether introduced directly into the brain or injected via a blood vessel.)

“Stroke remains a major cause of disability, and we are encouraged that the preclinical evidence shows [MSCs’] efficacy with ischemic stroke,” said Cramer, a professor of neurology and leading stroke expert. “MSCs are of particular interest because they come from bone marrow, which is readily available, and are relatively easy to culture. In addition, they already have demonstrated value when used to treat other human diseases.”

He noted that MSCs do not differentiate into neural cells. Normally, they transform into a variety of cell types, such as bone, cartilage and fat cells. “But they do their magic as an inducible pharmacy on wheels and as good immune system modulators, not as cells that directly replace lost brain parts,” he said.

In an earlier report focused on MSC mechanisms of action, Cramer and Zhao reviewed the means by which MSCs promote brain repair after stroke. The cells are attracted to injury sites and, in response to signals released by these damaged areas, begin releasing a wide range of molecules. In this way, MSCs orchestrate numerous activities: blood vessel creation to enhance circulation, protection of cells starting to die, growth of brain cells, etc. At the same time, when MSCs are able to reach the bloodstream, they settle in parts of the body that control the immune system and foster an environment more conducive to brain repair.

“We conclude that MSCs have consistently improved multiple outcome measures, with very large effect sizes, in a high number of animal studies and, therefore, that these findings should be the foundation of further studies on the use of MSCs in the treatment of ischemic stroke in humans,” said Cramer, who is also clinical director of the Sue & Bill Gross Stem Cell Research Center.

The analysis appears in the April 8 issue of Neurology. Quynh Vu, Kate Xie and Mark Eckert of UC Irvine contributed to the project, which received support from UC Irvine’s Institute for Clinical & Translational Science through the National Center for Research Resources (grant 5M011 RR-00827-29) and the National Institutes of Health (grants K24HD074722 and R01 NS059909).

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UCSF launches online registry to drive brain disease research

Brain Health Registry brings promise of speeding advances.

A new online project led by researchers at UC San Francisco promises to dramatically cut the time and cost of conducting clinical trials for brain diseases, while also helping scientists analyze and track the brain functions of thousands of volunteers over time.

With easy online registration, the Brain Health Registry is designed to create a ready pool of research subjects for studies on neurological diseases, such as Alzheimer’s and Parkinson’s, as well as depression, post-traumatic stress disorder and many other brain ailments. About one third of the cost of running a clinical trial comes from having to recruit patients, and many trials fail or are delayed because of it.

Michael Weiner, UC San Francisco

The Brain Health Registry is the first neuroscience project to use the Internet on such a scale to advance clinical research, according to Michael Weiner, M.D., founder and principal investigator of the initiative and a professor of radiology, biomedical engineering, medicine, psychiatry and neurology at UCSF. One of his roles is serving as principal investigator of the Alzheimer’s Disease Neuroimaging Initiative, the largest observational study of Alzheimer’s.

“This registry is an innovative 21st century approach to science with tremendous potential,” Weiner said. “The greatest obstacles to finding a cure for Alzheimer’s and other brain disorders are the cost and time involved in clinical trials. This project aims to cut both and greatly accelerate the search for cures.”

Leading funders for the project include the Rosenberg Alzheimer’s Project, the Ray and Dagmar Dolby Family Fund and Kevin and Connie Shanahan. The initial focus will be on the San Francisco Bay Area, and the goal is to recruit 100,000 people by the end of 2017. Nearly 2,000 people already signed up during the online registry’s beta phase.

Volunteers will provide a brief personal history and take online neuropsychological tests in an online game format. The games give the Brain Health Registry scientific team a snapshot of the participant’s brain function. The data collected will help scientists study brains as they age, identify markers for diseases, develop better diagnostic tools to stop disease before it develops and increase the ready pool of pre-qualified clinical trial participants.

A select number of volunteers will be asked by researchers to do more, such as providing saliva or blood samples, or participating in clinical trials to test potential cures. Volunteers can participate as little or as much as they like. All information will be gathered in accordance with federal privacy laws under the Health Insurance Portability and Accountability Act (HIPAA), as well as the highest standards of medical ethics.

“For those of us who know people suffering from Parkinson’s, Alzheimer’s, PTSD and other brain disorders, this is a way we can be involved in the search for a cure,” said Douglas Rosenberg, of the Rosenberg Alzheimer’s Project, which is helping to fund the project. “We’ve worked to make the process very easy and very fulfilling for our volunteers.”

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Spinal stimulation helps four paraplegic men move their legs

UCLA involved in study of breakthrough therapy.

Patient Kent Stephenson voluntarily raises his leg.

Four young men who have been paralyzed for years achieved groundbreaking progress — moving their legs — as a result of epidural electrical stimulation of the spinal cord, an international team of life scientists reports today in the medical journal Brain.

The study, conducted by researchers from the University of Louisville, UCLA and the Pavlov Institute of Physiology, was funded in part by the Christopher and Dana Reeve Foundation and the National Institutes of Health.

All four participants were classified as suffering from chronic, motor complete spinal cord injuries and were unable to move their lower extremities prior to the implantation of an epidural stimulator. The stimulator delivers a continuous electrical current to the participants’ lower spinal cords, mimicking signals the brain normally transmits to initiate movement.

The research builds on an initial study, published in May 2011 in the journal The Lancet, that evaluated the effects of epidural stimulation in the first participant, Rob Summers of Portland, Ore., who recovered a number of motor functions as a result of the intervention.

Now, three years later, the key findings documented in Brain detail the impact of epidural stimulation in a total four participants, including new tests conducted on Summers. Summers was paralyzed after being struck by a vehicle, and the other three participants were paralyzed in auto or motorcycle accidents.

What is revolutionary, the scientists said, is that the second, third and fourth participants — Kent Stephenson of Mt. Pleasant, Texas; Andrew Meas of Louisville, Ky.; and Dustin Shillcox of Green River, Wyo. — were able to execute voluntary movements immediately following the implantation and activation of the stimulator.

The participants’ results and recovery time were unexpected, which led researchers to speculate that some pathways may be intact post-injury and therefore able to facilitate voluntary movements.

“Two of the four subjects were diagnosed as motor and sensory complete injured with no chance of recovery at all,” said lead author Claudia Angeli, a senior researcher with the Human Locomotor Research Center at Frazier Rehab Institute and an assistant professor at University of Louisville’s Kentucky Spinal Cord Injury Research Center (KSCIRC). “Because of epidural stimulation, they can now voluntarily move their hips, ankles and toes. This is groundbreaking for the entire field and offers a new outlook that the spinal cord, even after a severe injury, has great potential for functional recovery.”

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UC statement on contract ratification by AFSCME

Patient care technical employees vote to ratify contract with UC.

The University of California was informed today (March 28) that members of the American Federation of State, County and Municipal Employees (AFSCME) voted to ratify a contract agreement with UC. In response to the ratification, Dwaine Duckett, UC’s vice president for human resources, released the following statement:

We are pleased that our dedicated patient care technical employees voted to ratify a contract agreement with the University of California. This follows two years of difficult negotiations focused on the complex issue of pension reform. The negotiations concluded with both sides responding to the other’s key concerns and ultimately compromising.

We are disappointed that this process took as long as it did and became so contentious. The university’s agreement with AFSCME 3299 is very similar to ones UC reached months ago with CNA, a union representing nurses, and UPTE, which represents other hospital workers. These contracts were achieved in less time and with significantly less stress and uncertainty for workers at our hospitals.

From the beginning, the primary issue in our negotiations with AFSCME was pension reform, with the union asserting that no change was needed and choosing to strike over the issue. We’ve successfully bargained through this key issue for the university, and have put the pension plan on a fiscally sound path by addressing this head-on.

Regarding annual wage increases, the union’s initial demands were eventually adjusted from more than 10 percent a year over 3 years to approximately 6 percent a year over 4 years, which includes across-the-board raises and experience-based step increases that we believe are fair and appropriate for these skilled health-care jobs.

Fortunately, settling this agreement spared AFSCME patient care technical workers who wanted to come to work from having to cross a picket line. It also ensured that patients who have come to rely on our top-rated medical facilities for care could continue to receive that care without disruption. We value the work of our respiratory therapists, surgical perfusionists and radiation technicians (who provide cancer treatment), along with many other critical AFSCME patient care employees, and are pleased they are staying on the job. The prospect of yet another strike — even though it was averted at the 11th hour — was a disservice to our patients, employees and the public at large.

With this agreement settled, the university can move forward with our employees and continue to meet UC’s mission of teaching, research and public service at our campuses, medical centers and national labs.

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Medical students celebrate their matches

Graduating students learn where their careers as doctors will start.

UC Davis medical student Alexis Gaskin matched to Howard University.

Jumps for joy. Hugs for happiness.

March 21 was a day to celebrate for more than 650 University of California medical students: Match Day 2014, when future doctors found out which hospital accepted them for residency to get advanced training in their chosen specialty.

“This day is like all my dreams come true,” said Alexis Gaskin, a fourth-year UC Davis medical student from Vacaville, who matched in orthopedics at Howard University in Washington, D.C.  “Being able to visualize it [the match letter], to see it in my hand is really a dream come true.”

UC Irvine medical student Givenchy Manzano is embraced by his mother, Mary Jane Manzano, as his brother Wilfred looks on.

At UC Davis, 96 graduating medical students matched. At UC Irvine, 100 students matched. At UCLA, 183 students matched. UC San Diego had 116 students match. UC San Francisco had 157 students match.

This year, more than 16,000 U.S. allopathic medical school seniors matched to first-year residency positions – a match rate of 94.4 percent. A computer algorithm from the National Resident Matching Program matches the preferences of applicants with the preferences of residency programs at teaching hospitals throughout the country. The students from allopathic schools such as UC apply for the available residency positions along with thousands of independent applicants, including osteopathic students and graduates of foreign medical schools. Overall, more than 40,000 individuals applied for nearly 30,000 residency slots across the country.

UCLA's Sarah Neyssani will do her residency at Harbor-UCLA Med Center.

While UC students matched with residency programs across the country, around two-thirds will stay in California for their training, including at UC medical centers, helping to address local needs for physicians. More than 69 percent of the physicians who do residency training in California remain in the state to practice – the nation’s highest retention rate.

“I could not be happier with where I matched, and am so excited to go on this adventure with these amazing people,” said UC San Francisco graduating medical student Gabe Sudario, who will continue at UC San Francisco for his residency.

UC San Diego medical students pinpoint their matches

“We are all nervous about Match Day,” said Inga Wilder, a senior at UC San Diego School of Medicine. “It’s the uncertainty. You can’t plan anything. But I am graduating. I am going to be a doctor in a couple months. I can’t complain.”

Wilder, 30, has reason to be proud. She grew up in Compton, and she and her brother, who joined her at Match Day, were the first in their family to graduate from college. Wilder, a high school valedictorian, went to UC Berkeley and originally planned to get a Ph.D. in microbiology before experience in a lab convinced her she was “more of a people person.”

To break up the tension of the day, many of UCSF's medical students dressed up in costumes, including Gabe Sudario (center in green) who landed a residency at UCSF.

Standing beside her brother, she opened her envelope and smiled: “I got my first choice,” she beamed, a residency in full-spectrum family medicine at the Ventura County Medical Center, helping underserved communities.

For more coverage of Match Day, view these links:

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New DNA-editing technology spawns bold UC initiative

$10M gift will support the UC Berkeley, UCSF effort.

Jennifer Doudna, UC Berkeley

The University of California, Berkeley, and UC San Francisco are launching the Innovative Genomics Initiative (IGI) to lead a revolution in genetic engineering based on a new technology already generating novel strategies for gene therapy and the genetic study of disease.

The Li Ka Shing Foundation has provided a $10 million gift to support the initiative, establishing the Li Ka Shing Center for Genomic Engineering and an affiliated faculty chair at UC Berkeley. The two universities also will provide $2 million in startup funds.

At the core of the initiative is a revolutionary technology discovered two years ago at UC Berkeley by Jennifer A. Doudna, executive director of the initiative and the new faculty chair. The technology, precision “DNA scissors” referred to as CRISPR/Cas9, has exploded in popularity since it was first published in June 2012 and is at the heart of at least three start-ups and several heavily-attended international meetings. Scientists have referred to it as the “holy grail” of genetic engineering and a “jaw-dropping” breakthrough in the fight against genetic disease. In honor of her discovery and earlier work on RNA, Doudna received last month the Lurie Prize of the Foundation for the National Institutes of Health.

“Professor Doudna’s breakthrough discovery in genomic editing is leading us into a new era of possibilities that we could have never before imagined,” said Li Ka-shing, chairman of the Li Ka Shing Foundation. “It is a great privilege for my foundation to engage with two world-class public institutions to launch the Innovative Genomics Initiative in this quest for the holy grail to fight genetic diseases.”

In the 18 months since the discovery of this technology was announced, more than 125 papers have been published based on the technique. Worldwide, researchers are using Cas9 to investigate the genetic roots of problems as diverse as sickle cell anemia, diabetes, cystic fibrosis, AIDS and depression in hopes of finding new drug targets. Others are adapting the technology to re-engineer yeast to produce biofuels and wheat to resist pests and drought.

“We now have a very easy, very fast and very efficient technique for rewriting the genome, which allows us to do experiments that have been impossible before,” said Doudna, a professor of molecular and cell biology in the California Institute for Quantitative Biosciences (QB3) and an investigator in the Howard Hughes Medical Institute at UC Berkeley. “We are grateful to Mr. Li Ka-shing for his support of our initiative, which will propel ground-breaking advances in genomic engineering.”

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Related link:
Crispr goes global

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UC Global Health Day registration opens

Event will be April 26 at UC Davis.

The 2014 UC Global Health Day is a showcase of the research, training and outreach in global health being undertaken across the University of California. This event is a unique opportunity to hear from University of California faculty, students and staff about the diversity of global health work they are doing around the world. The day will feature plenary sessions, posters and several concurrent breakout sessions covering a broad range of global health topics. Learn more about this event.

Online registration is now open. Please click here to register. Space is limited so register today.

The registration fee is $50 for general admission, $25 for students (Registration is non-refundable; one ticket per person, per transaction) Note: If you are a poster presenter or breakout session presenter, you will receive complimentary registration, so please do NOT register online.

Keynote speakers for the 2014 UC Global Health Day include:

  • Janet Napolitano, president, University of California
  • Jonathan M. Samet, director, USC Institute for Global Health; Distinguished Professor and Flora L. Thornton Chair, Department of Preventive Medicine, University of Southern California Keck School of Medicine
  • Andrew Hargadon, Charles J. Soderquist Chair in Entrepreneurship; professor of technology management; founding director, Center for Entrepreneurship, UC Davis Graduate School of Management
  • Jonna Mazet, executive director, One Health Institute; professor of epidemiology and disease ecology, UC Davis School of Veterinary Medicine

The deadline for the UC Global Health Day Video Challenge is soon approaching (March 31). This video challenge is your chance to share your passion for global health and showcase your work in the field. For details, click here.

Visit the UCGHI website for more information.

Related link:
Global health videos on UCTV

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In the media: Week of April 13

A sampling of news media stories involving UC Health:

The cure to doctor shortage? Another med school, The Riverside Press-Enterprise

Plans were announced Monday for a new medical school in San Bernardino County to be funded by $40 million from a non-profit foundation headed by the owner of a nationwide hospital chain. The California University of Science and Medicine — Cal Med — would admit the first 50 students in 2016, said founder Dr. Dev GnanaDev, chief of surgery and former medical director at Arrowhead Regional Medical Center in Colton. Cal Med would be the second new medical school to open in the Inland region recently. When UC Riverside’s long-awaited School of Medicine opened in August 2013, it was the first new public medical school in California in 40 years. UCR medical school Dean G. Richard Olds is quoted.

Op-ed: The killers underfoot, The New York Times

Matthew Lewin, a doctor of emergency medicine and the director of the Center for Exploration and Travel Health at the California Academy of Sciences, writes about the need to address venomous snakebites. He has been testing a nasal spray that could help address the issue. Last April, in collaboration with researchers at UC San Francisco, and under the strict supervision of anesthesiologists and an emergency medicine doctor, he tested the nasal spray on himself.

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Breaking bad mitochondria

Mechanism helps explain persistence of hepatitis C virus.

Researchers at the UC San Diego School of Medicine have identified a mechanism that explains why people with the hepatitis C virus get liver disease and why the virus is able to persist in the body for so long.

The hard-to-kill pathogen, which infects an estimated 200 million people worldwide, attacks the liver cells’ energy centers – the mitochondria – dismantling the cell’s innate ability to fight infection. It does this by altering cells mitochondrial dynamics.

The study, published in today’s (April 15) issue of the Proceedings of the National Academy of Sciences, suggests that mitochondrial operations could be a therapeutic target against hepatitis C, the leading cause of liver transplants and a major cause of liver cancer in the U.S.

“Our study tells us the story of how the hepatitis C virus causes liver disease,” said Aleem Siddiqui, Ph.D., professor of medicine and senior author. “The virus damages mitochondria in liver cells. Cells recognize the damage and respond to it by recruiting proteins that tell the mitochondria to eliminate the damaged area, but the repair process ends up helping the virus.”

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SSRI use during pregnancy associated with risk of autism in boys

Highest association found during first-trimester exposure for autism.

Irva Hertz-Picciotto, UC Davis

Prenatal exposure to selective serotonin reuptake inhibitors (SSRIs), medications frequently prescribed to treat depression, anxiety and other mental health disorders, is associated with a higher incidence of autism spectrum disorder (ASD) and developmental delays (DD) in male children, a study of nearly 1,000 mother-child pairs has found.

Published online today (April 14) in the journal Pediatrics, the study involved 966 mother-child pairs from the Childhood Autism Risks from Genetics and the Environment (CHARGE) study, a population-based, case-control study at the UC Davis MIND Institute led by professor Irva Hertz-Picciotto, chief of the Division of Environmental and Occupational Health in the UC Davis Department of Public Health Sciences.

“This study provides further evidence that in some children, prenatal exposure to SSRIs may influence their risk for developing an autism spectrum disorder,” Hertz-Picciotto said. “It also highlights the challenge for women and their physicians, to balance the risks vs. benefits from taking these medications, given that a mother’s underlying mental health conditions may also pose a risk to both herself and her child.”

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Community-based HIV prevention can boost testing

Prevention efforts also can help reduce new infections, study shows.

Thomas Coates, UCLA

Communities in Africa and Thailand that worked together on HIV-prevention efforts saw not only a rise in HIV screening but a drop in new infections, according to a new study in the peer-reviewed journal The Lancet Global Health.

The U.S. National Institute of Mental Health’s Project Accept — a trial conducted by the HIV Prevention Trials Network to test a combination of social, behavioral and structural HIV-prevention interventions — demonstrated that a series of community efforts boosted the number of people tested for HIV and resulted in a 14 percent reduction in new HIV infections, compared with control communities.

Much of the research was conducted in sub-Saharan Africa, which has particularly high rates of HIV. The researchers were interested not just in how the clinical trial participants’ behavior changed, but also in how these efforts affected the community as a whole, said Thomas Coates, Project Accept’s overall principal investigator and director of UCLA’s Center for World Health.

“The study clearly demonstrates that high rates of testing can be achieved by going into communities and that this strategy can result in increased HIV detection, which makes referral to care possible,” said Coates, who also is an associate director of the UCLA AIDS Institute. “This has major public health benefit implications — not only suggesting how to link infected individuals to care, but also encouraging testing in entire communities and therefore also reducing further HIV transmission.”

These findings were previously presented at the 2013 Conference on Retroviruses and Opportunistic Infections in Atlanta.

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Match Day at UC San Diego School of Medicine

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UC Davis: Investigating liver cancer disparities

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