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Robotic surgery technique developed to treat head and neck cancer

Pioneering method, developed at UCLA, gives patients new hope to live cancer-free lives.

By Peter Bracke, UCLA

In a groundbreaking new study, UCLA researchers have advanced a robotic surgical technique to successfully access a previously unreachable area of the head and neck.

This pioneering method can now be used safely and efficiently in patients to remove tumors that many times were previously considered inoperable, or that necessitated the use of highly invasive surgical techniques in combination with chemotherapy or radiation therapy.

Abie Mendelsohn, UCLA

Developed by Dr. Abie Mendelsohn, UCLA Jonsson Comprehensive Cancer Center member and director of head and neck robotic surgery at UCLA, this new approach provides the surgical community with a leading-edge technology roadmap to treat patients who had little or no hope of living cancer-free lives.

“This is a revolutionary new approach that uses highly advanced technology to reach the deepest areas of the head and neck,” said Mendelsohn, lead author of the study. “Patients can now be treated in a manner equivalent to that of a straightforward dental procedure and go back to leading normal, healthy lives in a matter of days with few or even no side effects.”

The parapharyngeal space is pyramid-shaped area that lies near the base of the human skull and connects several deep compartments of the head and neck. It is lined with many large blood vessels, nerves and complex facial muscles, making access to the space via traditional surgical options often impossible or highly invasive.

Current surgical techniques can necessitate external incisions be made to the patient’s neck, or the splitting of their jaw bone or areas close to the voice box. Chemotherapy and radiation therapy are also often required, further complicating recovery and potentially putting patients at risk for serious (or even lethal) side effects.

Approved by the U.S. Food and Drug Administration in 2009, Trans Oral Robotic Surgery (or TORS) utilizes the Da Vinci robotic surgical system, the state-of-the-art technology that was developed at UCLA by the specialized surgical program for the head and neck. TORS uses a minimally invasive procedure in which a surgical robot, under the full control of a specially trained physician, operates with a three-dimensional, high-definition video camera and robotic arms.

These miniature “arms” can navigate through the small, tight and delicate areas of a person’s mouth without the need for external incisions. A retraction system allows the surgeon to see the entire surgical area at once. While working at an operating console just steps away from the patient’s bed, every movement of the surgeon’s wrists and fingers are transformed into movements of the surgical instruments.

Over the course of the robotic program’s development, Mendelsohn refined, adapted and advanced the TORS techniques to allow surgical instruments and the 3-D imaging tools to at last reach and operate safely within the parapharyngeal space and other recessed areas of the head and neck.

Currently, Mendelsohn’s new procedure largely benefits patients with tumors located in the throat near the tonsils and tongue, but it continues to be adapted and expanded in scope and impact.

“We are tremendously excited about the possibilities for the surgical community with this new advancement of TORS,” said Mendelsohn. “Now patients have options they never had before, and we can even develop potential applications for the procedure beyond the surface of the head and neck.”

The study was published online ahead of print in the journal Head and Neck.

David Alpern: one patient’s story

UCLA patient David Alpern and son. Alpern is now cancer-free after his throat tumor was removed using Dr. Abie Mendelsohn’s breakthrough robotic surgery technique.

In 2012, David Alpern received devastating news. He was diagnosed with throat cancer, and the treatment options given to him by his doctors sounded worse than the disease.

“They described a procedure where your face is split in half and it’s basically reconstructive surgery. I was completely freaked out,” said Alpern, a husband and father of two.

After careful examination and imaging at UCLA, Mendelsohn determined that Alpern was a perfect candidate for TORS. Alpern was up and about just days after the procedure. Like the more than 100 similar TORS surgeries performed with Mendelsohn at the controls, Aplern’s tumor was removed and he’s now cancer free.

“I try not to get too cocky or excited that I beat cancer, but I think I did,” Alpern said. “There are no side effects at this point. My hopes are just to watch my kids grow up and enjoy my family and my life.”

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UC president starts $10M research awards initiative

First recipients selected.

University of California President Janet Napolitano today (Dec. 10) announced the first recipients of the President’s Research Catalyst Awards, chosen from a pool of almost 200 proposals. The projects involve multicampus, multidisciplinary efforts, incorporating research, teaching and learning for undergraduate and graduate students. The awards are designed to stimulate UC research in areas that could benefit California and the world.

The President’s Research Catalyst Awards will channel $10 million over three years to fund research in areas of strategic importance, such as sustainability and climate, food and nutrition, equity and social justice, education innovation, and health care.

“The President’s Research Catalyst Awards will spur UC research and offer our faculty and students new opportunities for cross-campus, multidisciplinary collaboration,” Napolitano said. “We want to support research endeavors that have real-world impact in areas with critical needs.”

The President’s Research Catalyst Awards will strengthen UC’s research enterprise by promoting projects that take advantage of the shared facilities, expertise and economies of scale available through UC’s 10 campuses and five medical centers. Faculty will benefit from expanded research support, and students will have access to additional training opportunities.

Recipients were chosen through the highly selective Multicampus Research Programs and Initiatives grants process. The award recipients are:

  • Understanding how California ecosystems will be affected by climate change, led by Barry Sinervo, UC Santa Cruz ($1.9 million). UC is home to the world’s largest system of university-administered natural reserves, offering an opportunity to model how climate change will affect California ecosystems. UC’s nine undergraduate campuses will study the ecological effects of climate change, involving both graduate students and citizen scientists.
  • Helping California address the prison health care crisis, led by Brie Williams, UC San Francisco ($300,000). California, with the nation’s largest prison population, faces serious challenges in providing adequate health care to inmates, who often suffer from mental illness, addiction and other chronic diseases. The UC Consortium on Criminal Justice Healthcare will bring together experts in medicine, psychology, law, sociology, economics and public policy to develop cost-effective solutions that can also serve as a national model.
  • Advancing physics, materials science and computing through quantum emulation, led by David Weld, UC Santa Barbara ($300,000). Quantum emulation uses small collections of ultra-cold atoms, ions and molecules to understand the physical properties of the smallest matter in the universe. Through the California Institute for Quantum Emulation, UC will mobilize the theoretical and experimental expertise of early-career faculty at five campuses, enhancing California’s position as a technological leader and advancing research vital to the development of novel materials.
  • Tapping big data to inform questions of health, poverty and social justice, led by Sean Young, UCLA ($300,000). Social media offers a rich trove of data about human behavior, beliefs and actions. Experts in computer, social and health sciences from four UC campuses will study how to use this information to address public health issues, poverty and inequality.
  • Using music to better understand the human brain, led by Scott Makeig, UC San Diego ($300,000). The UC Music Experience Research Community Initiative brings together UC experts on music listening, performance, neuroscience, brain imaging and data science to understand the transformative potential of music for health and cognition.

UC faculty will be invited to apply for the next round of the President’s Research Catalyst Awards funding, with an RFP process beginning later this winter. More details will be posted here.

The awards will be funded through an existing president’s fund used to support systemwide initiatives.

Media contact:
University of California Office of the President
(510) 987-9200

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Making an ‘IMPACT’ on childhood obesity

UC San Diego, San Diego Unified School District partner to get kids active.

UC San Diego student-athlete Kyra Scott shares the pull-up bar with a student from Toler Elementary. (Photo by Erika Johnson, UC San Diego)

By Jade Griffin and Gabriella Clark, UC San Diego

“I like to get out here and sweat,” said Dalton, an elementary student at Toler Elementary, as he began a series of stretches and exercises led by UC San Diego student-athletes volunteering their time at his elementary school in Clairemont.

Dalton and his classmates are benefiting from a program called IMPACT (Increasing Movement and Physical Activity in Class Time), which is designed to keep local elementary students moving despite the lack of recess and physical education classes in some schools, particularly in underserved areas of San Diego.

IMPACT was established by the San Diego Unified School District in partnership with UC San Diego Athletics and the UC San Diego School of Medicine Center for Community Health to promote healthy activity and battle the growing national epidemic of obesity among children. According to the Centers for Disease Control and Prevention, in 2012, more than one third of children and adolescents in the U.S. were overweight or obese.

Each week as part of IMPACT, UC San Diego student-athletes set up a series of circuits, including jump ropes, hula-hoops, monkey bars, stretching and more. The student-athletes assist and cheer on the students as they rotate through the stations for approximately 20 minutes. Each of the activities are designed to be fun for the students, while getting them moving and raising their heart rates — a key intention of the program.

“The IMPACT program was created to help students reach fitness standards at schools that otherwise would not have funding to maintain certain physical education programs,” said Kate McDevitt, senior manager of School Wellness Programs at UC San Diego’s Center for Community Health.

Many of the UC San Diego student-athletes who participate are members of the Triton Athletes’ Council (TAC), an organization of students from the university’s 23 intercollegiate teams who initiate campus and community service efforts. The IMPACT program was an ideal match for Triton Athletes’ because of the group’s focus on making a positive impact on the community.

Scott Acton, a member of the Triton Athletes’ Council who is also on the track and field and cross country teams, has helped coordinate UC San Diego Athletics’ role in the program this year. “It is great to see the elementary students get out and be active,” said Acton, a structural engineering major. “Word is spreading among student-athletes about what a great program this is, so more and more from UC San Diego are getting involved.”

“Having educated and physically fit athletes attend these sessions shows the children that with hard work and dedication, they can reach any goal they wish to attain in athletics, but the first step is being physically active,” said Lynn Barnes-Wallace, physical education resource teacher at San Diego Unified School District and creator of IMPACT. “The students from UC San Diego really get involved with the program and motivate the kids even more.”

IMPACT began at Edison Elementary in City Heights last spring. The program was such a success—as evidenced by the smiles and squeals of delight from the students—that it was expanded to Toler and will likely be implemented at other elementary schools in the future.

According to Peggy Lewis, principal of Toler Elementary, the program is a hit with her young students. “The kids love it,” said Lewis. “They need activity during the day. We have already seen improved student focus and concentration as a result of the program.”

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Ebola crisis

UC helps battle the outbreak: See list of experts, travel guidelines, preparedness information.

Credit: iStock

(Note: Updated as of Dec. 19)

The Ebola virus outbreak centered in West Africa has claimed more than 6,000 lives thus far, including a Liberian man who fell ill and died in Texas — the first case of Ebola diagnosed in the United States.

Physicians and researchers with the University of California are actively involved in battling the epidemic. Some are treating patients in Africa; others are helping to protect the American public; others still are involved in the urgent quest for effective treatment and a possible vaccine.

UC medical center preparedness

UC medical centers have been preparing — and continue to prepare — for the possibility of a patient with Ebola symptoms. Though there have been no confirmed cases of Ebola in California, on Oct. 24 the UC Office of the President informed the California Department of Public Health (CDPH) that all five UC medical centers are positioned to provide in-patient care for Californians who have confirmed cases of Ebola if necessary. CDPH continues working with health officials to prepare for potential cases of Ebola in California and the Division of Occupational Safety and Health is providing updated, specific guidelines on the protective equipment, training and other measures that must be in place to protect workers’ health and safety. As of Dec. 18, all five of UC’s medical centers have received a visit from a U.S. Centers for Disease Control and Prevention Ebola preparedness team and have been named among the designated U.S. hospitals with Ebola treatment centers. Read joint UC-CDPH announcement and related UC Davis article, UC Davis news release, UCSF Medical Center statement on Ebola preparationsU.S. Health and Human Services announcement and updated CDC list of hospitals with Ebola treatment centers, UC announcement about Ebola treatment center designation, UC Davis news release about the CDC designation, UCSF coverage of its CDC visit, and UCSF news release about the CDC designation.

UC Regents received an update Nov. 20 on UC Health’s preparedness for Ebola. UC Davis hosted a media briefing Oct. 16 on  preparations for Ebola at UC Davis Medical Center and hosted another Ebola preparedness media briefing Nov. 6. UCLA, which has created an Ebola information page, hosted an Ebola preparedness exercise Oct. 17. UCSF, which has created an Ebola resource page, hosted a town hall meeting (read coverage) Oct. 24 to discuss its Ebola treatment preparations and provided an update Oct. 31 on preparations and training. UC Irvine hosted a panel discussion about Ebola on Oct. 27 and hosted a panel discussion on the constitutional implications of Ebola on Nov. 19, with panelists including the Rev. Jesse Jackson and UC Irvine law school Dean Erwin Chemerinsky. UCLA hosted an informational forum about Ebola on Oct. 28. UC San Diego hosted a tour of its Ebola isolation unit Oct. 31. UC Riverside immunologist Ilhem Messaoudi discussed facts and myths about Ebola on Nov. 4.

Read more:

Travel guidelines

UC students, faculty, staff and others considering travel to or from affected areas of West Africa should make themselves aware of local conditions and take appropriate precautions. The Centers for Disease Control and Prevention have compiled guidelines specifically for colleges and universities. UC campuses have distributed these guidelines and other information via their websites and campus health facilities.

Faculty experts

The following are faculty experts and their areas of expertise:

UC Berkeley

Art Reingold, School of Public Health. Expertise: epidemiology, emerging and re-emerging infections in the United States and in developing countries

UC Davis

  • Stuart Cohen, professor and chief, Division of Infectious Diseases. Expertise: infectious disease
  • J. Douglas Kirk, chief medical officer, UC Davis Medical Center. Expertise: hospital procedures
  • Jonna Mazet, One Health Institute and UC Global Health Institute. Expertise: epidemiology and disease ecology

UC Irvine

  • Brandon Brown, Global Health Research, Education, and Translation Program (GHREAT), UCI Program in Public Health. Expertise: infectious diseases in developing countries
  • Shruti Gohil,  UC Irvine Medical Center. Expertise: infectious disease
  • Kristi Koenig, UC Irvine School of Medicine. Expertise: disaster medicine, public health preparedness
  • Carl Schultz, UC Irvine Medical Center: Expertise: disaster medical services

UCLA

  • David Eisenman, David Geffen School of Medicine and Fielding School of Public Health. Expertise: bioterrorism, disaster preparedness and response
  • Peter Katona, David Geffen School of Medicine. Expertise: bioterrorism, infectious disease
  • Mark Morocco, David Geffen School of Medicine. Expertise: emergency medicine, infectious disease
  • Anne Rimoin, UCLA Fielding School of Public Health. Expertise: epidemiology, infectious disease, Ebola
  • Zachary Rubin, UCLA Health. Expertise: infectious disease
  • Daniel Uslan, UCLA Health. Expertise: infectious disease

UC Riverside

G. Richard Olds, dean, UC Riverside School of Medicine. Expertise: tropical diseases, international health

UC San Diego

Julia Ponomarenko, San Diego Supercomputer Center. Expertise: data analysis

UCSF

  • Charles Chiu, UCSF School of Medicine. Expertise: infectious disease, genomics, diagnostics, Ebola
  • George Rutherford, UCSF School of Medicine. Expertise: public health, international disease surveillance, infectious disease epidemiology, disease control

UC Santa Cruz

Jim Kent, UC Santa Cruz Genome Browser Project. Expertise: bioinformatics

See the accompanying links below for more on UC’s role in combating Ebola and providing information:

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Traffic’s toll on the heart

Clogged interstates aggravate clogged arteries, according to UC Irvine research.

Credit: Jess Wheelock, UC Office of the President

By Nicole Freeling, UC Newsroom

Anyone who has experienced Los Angeles gridlock likely can attest that traffic may cause one’s blood pressure to rise. But UC Irvine researchers have found that, beyond the aggravation caused by fellow drivers, traffic-related air pollution presents serious heart health risks — not just for rush hour commuters, but for those who live and work nearby.

Research by UC Irvine joint M.D./Ph.D. student Sharine Wittkopp contributes to evidence that the increased air pollution generated by vehicle congestion causes blood pressure to rise and arteries to inflame, increasing incidents of heart attack and stroke for people who reside near traffic-prone areas.

“While the impact of traffic-related pollution on people with chronic lung diseases is well known, the link to adverse heart impacts has been less described,” said Wittkopp.

UC Irvine M.D./Ph.D. student Sharine Wittkopp is investigating genetic factors that make some people more vulnerable to pollution’s negative effects. (Photo courtesy of Sharine Wittkopp)

Her research project, funded by the National Institute of Environmental Health Sciences, focused on residents of a Los Angeles senior housing community who had coronary artery disease.

Study participants spend the vast majority of their time at home, which meant they had prolonged exposure to traffic-related air pollution at the site. Because of their age and pre-existing heart conditions, they were thought to be more vulnerable to small, day-to-day variations in air quality.

“They are really in the thick of it,” Wittkopp said. “They are the ones that are going to suffer the most, and who are the least likely to be resilient.”

Up to now, most studies on the impacts of air pollution have focused on its effects over much larger populations, with difficulty capturing accurate exposures and short-term changes. Wittkopp and her team wanted to look at how daily fluctuations in traffic and air quality would affect those residing in the immediate vicinity of congested roadways.

The research team, led by adviser Ralph Delfino, associate professor and vice chair for research and graduate studies in the Department of Epidemiology at UC Irvine’s School of Medicine, set up air quality monitors at the residences of the study participants. They looked for daily and weekly changes in traffic-related pollution such as nitrogen oxides, carbon monoxide, and particulate matter.

What they found: “Blood pressure went up with increased traffic pollutants, and EKG changes showed decreased blood flow to the heart,” Wittkopp said.

Uncovering a genetic link

Just how susceptible a person is to these negative impacts appears to depend not just upon age and proximity to traffic, but also upon genetics, the research team found.

They uncovered what they believe is the first epidemiological evidence that a person’s mitochondrial DNA could affect their susceptibility to adverse health effects related to air pollution.

“When our cells are exposed to toxins, they respond by making more proteins that enable them to detoxify pollutants,” Wittkopp said. “We can actually monitor how the protein levels are going up and down and how the gene readouts change as people are exposed.” Looking at traffic-related pollution, they discovered that a person’s ability to produce the proteins that combat pollutants varied dramatically based on their DNA.

By identifying the genetic variables that place people at greater risk, health care providers could help account for these impacts and prescribe proactive treatments — such as antioxidants that reduce inflammation — that would make people less vulnerable.

But Wittkopp also stresses such treatment would simply be a Band-Aid on the greater problem.

Impetus to improve infrastructure, lessen exposure

“Understanding the health problems that traffic-related pollution causes helps us understand why we need to change things and improve our infrastructure to reduce exposure,” said Wittkopp, who believes this research can provide policymakers and the public with a fuller picture of the impact of pollution.

“This kind of information can help us quantify the cost of traffic-related air pollution in terms of health care costs, lives lost and quality of life diminished.”

While genetic factors may make some more vulnerable than others, Wittkopp points out, “There’s no one who’s not susceptible in some way. No one gets better when they are exposed to these pollutants.”

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UC Davis awarded $100M to lead program to predict, prevent pandemic threats

Second phase of program will help attack problems like Ebola before they start.

The PREDICT program helps detect emerging viruses that move among people, livestock and wildlife, such as this macaque in Nepal. (Photo by One Health Institute, UC Davis)

The U.S. Agency for International Development has awarded up to $100 million for the second phase of the PREDICT project based at the UC Davis School of Veterinary Medicine. PREDICT is part of the Emerging Pandemic Threats, or EPT, program — an unprecedented international campaign to rapidly detect and respond to emerging viruses such as Ebola and SARS that move among people, wildlife and livestock.

PREDICT is managed by the school’s One Health Institute. The new award is one of the largest extramurally funded projects in UC Davis history.

“PREDICT and its partners have enabled a platform for effective collaboration across disciplines and geographic borders to promote global health problem solving,” said Jonna Mazet, director of the One Health Institute and principal investigator of the new award. “We can now attack problems, like Ebola, before they start — reducing fear and improving response and control.”

The award for the PREDICT project opens a second phase for the EPT program. Building on its long-standing efforts in disease surveillance and response, USAID is developing multiple initiatives to help prepare the world for emerging infectious diseases like pandemic influenza, SARS and Ebola. Other partners within USAID’s EPT program include the PREPAREDNESS & RESPONSE and ONE HEALTH WORKFORCE projects, the U.S. Centers for Disease Control and Prevention, the Food and Agriculture Organization, and the World Health Organization.

Building on success

For the past five years, the One Health Institute has led a global consortium of implementing partners in conducting pathogen surveillance, viral discovery and global health capacity strengthening in more than 20 countries. In that time, the PREDICT team:

  • Equipped, supplied and trained staff in 32 diagnostic laboratories around the world to safely and properly process and test wildlife samples for viruses of pathogenic potential.
  • Trained 2,500 government personnel, physicians, veterinarians, resource managers, laboratory technicians, hunters and students in biosafety, surveillance, laboratory techniques and outbreak investigations.
  • Discovered more than 800 novel viruses at high-risk pathogen transmission interfaces.
  • Responded to 24 disease outbreaks, including multiple Ebola outbreaks in central Africa.

The new award will build on the success of the first phase of PREDICT, funded in 2009. In collaboration with other U.S. government, international and host country partners, it will continue to strengthen health capacity and to intensify pathogen surveillance and risk assessment activities in geographic areas and animal-human interfaces identified as high-risk for the emergence and spread of disease.

Ebola response

Tragically, the world is currently responding to the worst Ebola outbreak in history. The extreme challenges faced in this response are amplified by the lack of public knowledge on the virus and its potential hosts and transmission. Unfortunately, the countries in West Africa were not expecting or prepared for this epidemic, primarily because there was previously no evidence that the Ebola virus was present in that region of Africa.

In contrast, during a separate Ebola outbreak in this same time period in the Democratic Republic of Congo, where the PREDICT team and other partners were actively engaged with the government and inserted into the public health infrastructure, sick individuals were detected much more quickly. Samples were tested and control measures implemented all within just days of the first signs of illness. The rapid response and significantly reduced death toll in DRC illustrate what can be achieved when a One Health workforce is trained, employed and able to be activated in the face of extreme health challenges.

In this second and new phase, PREDICT will continue to focus surveillance on viral families of epidemic and pandemic potential. These include coronaviruses, the viral family to which SARS and MERS belong, influenza viruses, and filoviruses, such as Ebola.

This second phase also will increase focus on the effects of human behavior and other drivers for disease emergence and spread, with a focus on livestock and people living in high-risk areas for disease spillover and transmission. By working with social and behavioral scientists in a transdisciplinary approach, PREDICT will integrate virus detection with investigations of human-animal interactions and the social and cultural reasons for those interactions. This One Health approach is designed to improve our understanding of the dynamics of zoonotic disease spillover, evolution, amplification and spread in order to inform future prevention and control measures.

Identifying and controlling emerging diseases

The One Health Institute will execute the project in a coordinated consortium with EcoHealth Alliance, Metabiota, Smithsonian Institution and the Wildlife Conservation Society, along with valued technical partners at Columbia University’s Center for Infection and Immunity, HealthMap at Boston Children’s Hospital, International Society for Infectious Disease, and UC San Francisco’s Viral Diagnostics and Discovery Center.

“Our work has shown that emerging diseases are on the rise and represent a growing threat to our health, our economies, and our global security,’ said Peter Daszak, president of EcoHealth Alliance, a partner in the PREDICT consortium. “This next phase of funding allows us to identify the activities that cause diseases to emerge in high-risk disease ‘hotspots’ so that we can minimize the impacts of a new virus spilling over and infecting people.”

The consortium will continue to work closely with partner organizations in each country, as well as with a network of laboratories, universities, government ministries and agencies in these global hotspots. PREDICT is engaged in the Africa, South Asia, and Southeast Asia regions, working in Bangladesh, Cambodia, Cameroon, China, Democratic Republic of Congo, Gabon, Indonesia, Laos, Malaysia, Myanmar, Nepal, Republic of Congo, Rwanda, Tanzania, Thailand, Uganda and Vietnam, along with a new focus in West Africa in response to the Ebola outbreak.

The consortium is united by its belief in the One Health approach, which employs the knowledge that the health of animals, people and the environment are inextricably linked to solve global health problems.

“The new funding for PREDICT will allow our One Health Institute investigators and their partners to continue to identify pandemic threats and build capacity in developing regions worldwide,” said Mazet. “The UC Davis School of Veterinary Medicine has an extensive history of excellence in public health programs that address societal needs. This new funding will ensure our research teams’ continued contributions to enhance capabilities to prevent future pandemics.”

“Attempts to date to control deadly viruses have been almost entirely reactionary due to structural and technological limitations,” Mazet said. “The world is now poised to be able to identify the key processes influencing the evolution, spillover, amplification and spread of pathogen threats in order to halt them at their source.”

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UCSF contributes to $28B health sector in San Francisco

Health sector generates more to economy than tourism and technology.

By Lisa Cisneros, UC San Francisco

UC San Francisco is part of the city’s thriving health sector that collectively generates $28.4 billion to the economy – more than tourism and technology – according to a new economic impact report released on Tuesday.

As a nearly $5 billion enterprise and the second largest employer in San Francisco, next to the city and county itself, UCSF plays a major role in San Francisco’s vast and vibrant health care sector that not only contributes to the economy and quality of life, but advances health worldwide through its scientific discoveries.

Read the report (click image to view)

Among the highlights of the 2014 San Francisco Health Sector Impact Report:

  • The health sector directly generates 121,677 jobs – 20 percent of all jobs in San Francisco – more job creation than in tourism (76,834) technology (53,319) in 2013;
  • Nearly $5 billion will be invested in the construction of five new medical centers, including UCSF Medical Center at Mission Bay, before this decade is over; and
  • Charity care in San Francisco has increased from $155 million in 2009 to $203.7 million in 2012.

The entire report, produced by the San Francisco Section of the Hospital Council of Northern & Central California, is posted online here.

A video touting the impact of the health sector debuted during the Silver SPUR Awards Luncheon honoring individuals whose goals and achievements contribute to the well being of the community.

Health care begins during the Gold Rush

The health sector impact report highlights how healing began in 1854 when eight Sisters of Mercy arrived in San Francisco from Ireland to begin caring for the poor. By the following year, just in time for a cholera epidemic, they opened St. Mary’s Medical Center, the oldest continually operating hospital in the city.

UCSF’s story begins a decade later in 1864 when South Carolina surgeon Hugh Toland ventured to San Francisco and founded Toland Medical College in North Beach. Now celebrating its 150th anniversary, UCSF is credited in the report for its legacy of leadership in the life sciences.

“Many San Francisco health institutions have developed innovations that have contributed to the health of people around the world, nation and state. Of particular note, UCSF is one of the world’s leading health and science research universities, and is responsible for many innovations and discoveries that have impacted health care worldwide,” the report states. “The mavericks who discovered proto-oncogenes, normal genes that can be converted to cancer by genetic damage; prions, an infectious agent that causes neurodegenerative diseases; and recombinant DNA – birthing the modern biotech industry – all came to UCSF for a culture of collaboration that was more adventurous than the staid institutions of the east.”

Today, the health care marketplace in the city is large. In addition to UCSF Medical Center and UCSF Benioff Children’s Hospitals, San Francisco is home to Sutter Health California Pacific Medical Center, Chinese Hospital, Jewish Home of San Francisco, Laguna Honda Hospital and Rehabilitation Center, Saint Francis Memorial Hospital, St. Mary’s Medical Center, San Francisco General Hospital and Trauma Center and the San Francisco Veterans Affairs Medical Center.

UCSF also is recognized for its catalytic role spinning off biotech companies at Mission Bay, where QB3, a consortium run by UCSF, UC Berkeley and UC Santa Cruz, is a pioneering magnet for the burgeoning biotech boom. UCSF, which broke ground at Mission Bay in 1999, has served as the centerpiece of this thriving innovation zone. UCSF Mission Bay is now a $30.6 billion, 60-acre campus, representing the largest single redevelopment project in the city.

“San Francisco boasts an explosion of more than 100 biotechnology companies, bringing the region’s genius to bear on some of the most vexing medical problems known to humanity,” the report states. “The city’s health sector serves as the epicenter of global innovation, where advanced science is translated into innovative care that ultimately improves health worldwide.”

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UCLA’s Healthy Campus Initiative helps inspire nationwide college program

Partnership for a Healthier America launches Healthier Campus Initiative.

An “instant recess” at UCLA dovetails with the Healthy Campus Initiative.

By Rebecca Kendall, UCLA

Less than two years after UCLA launched its groundbreaking Healthy Campus Initiative, a prominent organization is introducing a national health and wellness program for colleges and universities.

The Partnership for a Healthier America, which works with the private sector and Michelle Obama to make healthier choices easier, announced its Healthier Campus Initiative today (Nov. 16) in New Orleans at the American Public Health Association’s annual conference. UCLA is one of 20 colleges and universities that are part of the program, which will reach more than 500,000 students and 126,000 faculty and staff. UCLA is the only postsecondary institution in California that is participating.

According to the organization’s CEO, UCLA was one of the important inspirations for the program. “The Healthier Campus Initiative was born out of a collaboration between the Partnership for a Healthier America and the nation’s leading nutrition, physical activity and campus wellness experts, including leaders at UCLA,” said Lawrence Soler.

“Over the past few years, UCLA has become a leader in the movement to create a healthier environment for its students, faculty and staff, and this initiative would not have been possible without UCLA’s early insights, input and support.”

UCLA’s Healthy Campus Initiative is a campuswide effort that draws upon the campus’s world-renowned research and teaching to find new and innovative ways to promote healthy living at UCLA and share that education and research with other communities.

Each of the participating universities has pledged to adopt guidelines for food and nutrition, physical activity and programming over the next three years.

“The PHA agreement gives us an opportunity to help evaluate our progress toward our goals,” said Dr. Wendy Slusser, associate vice provost for the HCI and a clinical professor at the David Geffen School of Medicine at UCLA and the UCLA Fielding School of Public Health. “It will also introduce us to other university leaders across the U.S. and enhance our learning of best practices and our ability to leverage resources to promote health and wellness on our campuses and in our communities.”

Slusser attended the announcement joined by UCLA colleagues and philanthropist Jane Semel, who with her husband, Terry Semel, envisioned and supported UCLA’s Healthy Campus Initiative.

PHA’s Healthier Campus Initiative comprises 23 guidelines, many of which UCLA has already implemented as part of its campus mandate. Others were new initiatives prompted by PHA discussions. Among them are offering a minimum of one “wellness meal,” which meets nutritional guidelines set by PHA, at each mealtime; offering a minimum of five types of fruits, five types of vegetables and two 100 percent whole grain products at both lunch and dinner; and implementing a program at dining venues to encourage healthier food consumption.

UCLA has also moved to add more local and sustainable food as part of its commitment to the PHA program. Currently, UCLA serves 17 percent locally sourced food in its dining operations; the campus’s goal is to achieve 20 percent by 2020.

The focus on healthy, sustainable food at UCLA is in line with the University of California Global Food Initiative, which was also shaped in part by leaders of UCLA’s HCI. The systemwide initiative was introduced by UC President Janet Napolitano in July at an event held at UCLA’s student-run community garden.

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UCLA medical school receives unrestricted $50M gift

Bequest from Irma and Norman Switzer estate creates new fund to advance medicine, health.

UCLA Chancellor Gene Block said the gift stands as “an enduring legacy of two people who clearly cared about the future of medicine and science.”

An unrestricted gift of $50 million to the David Geffen School of Medicine at UCLA from the estate of Irma and Norman Switzer was announced Nov. 12 at a gathering of faculty, staff members, the school’s board of visitors and friends of the Switzer family.

“This exceptionally generous gift is an enduring legacy of two people who clearly cared about the future of medicine and science,” said UCLA Chancellor Gene Block. “The university is honored to be the steward of such a transformative bequest.”

As a tribute to the couple, the UCLA Center for Health Sciences Plaza, where the announcement was made, was renamed the Irma and Norman Switzer Plaza.

“The Switzers’ extraordinary gift will immediately strengthen the work of our faculty and eventually benefit countless patients,” said Dr. A. Eugene Washington, vice chancellor of UCLA Health Sciences and dean of the David Geffen School of Medicine at UCLA.

“The Switzers, who were very humble people, would be gratified to know that the proceeds from their estate are going to advance medicine and health in such a profound way — and that this beautiful plaza, through which so many patients, physicians, scientists and students pass on a daily basis, will bear their names,” said Theodore Wolfberg, the Switzers’ attorney and friend.

Norman Switzer passed away in 2011 at the age of 84, and Irma died in 2013 at the age of 93. The couple were longtime residents of Pacific Palisades.

A veteran of the Korean War, Norman Switzer devised the concept of adding benches to bus stops throughout Los Angeles. In exchange for funding the bus benches, the city awarded his company, Norman Bench Advertising, a 20-year exclusive on advertising. He later sold the business and became a real estate investor. Irma Switzer, an accomplished weaver and member of the Palisades Weavers group, physically built two homes in Manhattan Beach with a friend. The couple was involved with the Fowler Museum at UCLA and the Natural History Museum of Los Angeles County.

“The Switzers’ selflessness manifested in many ways; UCLA’s recognition of their remarkable philanthropy in this vibrant and dynamic space is the highest honor they could ever have imagined,” said Arlynne Siegel, managing director and Los Angeles regional director of the personal trust department of MUFG Union Bank and trustee of the Switzers’ trust.

The bequest will advance medicine and health and will count toward The Centennial Campaign for UCLA, a $4.2 billion fundraising campaign, which was formally launched in May 2014 and is scheduled to conclude in 2019, the campus’s 100th year.

“The forethought the Switzers demonstrated by including UCLA Health Sciences in their estate plans illustrates the generosity that is their legacy,” said Kathryn Carrico, UCLA’s assistant vice chancellor for health sciences development.

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UC scientists named Breakthrough Prize winners

UC Berkeley’s Jennifer Doudna, Saul Perlmutter join Terence Tao of UCLA.

UC Berkeley scientists Jennifer Doudna and Saul Perlmutter were named 2015 Breakthrough Prize winners.

By Robert Sanders, UC Berkeley

Two UC Berkeley scientists — structural biologist Jennifer Doudna and physicist Saul Perlmutter — were named 2015 Breakthrough Prize winners in life sciences and physics, respectively, at a star-studded gala in Silicon Valley on Sunday (Nov. 9).

Doudna accepted the award Sunday along with her research colleague Emmanuelle Charpentier and the other new winners. The 2015 Breakthrough Prize winners in all three categories — life sciences, physics and mathematics — will be celebrated today (Monday, Nov. 10) in a series of three symposia taking place at Stanford University and streamed live to UC Berkeley from 9 a.m. to 5 p.m., with social media conversations through the Twitter hashtag #BreakthroughPrize.

The other recipients of the 2015 Breakthrough Prize in Life Sciences are Alim Louis Benabid of Joseph Fourier University, C. David Allis of The Rockefeller University, Victor Ambros of the University of Massachusetts Medical School and Gary Ruvkun of  Massachusetts General Hospital and Harvard Medical School.

Perlmutter received the 2015 Breakthrough Prize in Physics with the two colleagues who shared the 2011 Nobel Prize in physics with him: Brian P. Schmidt of Australian National University and Adam Riess of Johns Hopkins University and the Space Telescope Science Institute.

Recipients of the 2015 Breakthrough Prize in Mathematics, announced in June, are Simon Donaldson of Stony Brook University and Imperial College, London, Maxim Kontsevich of the Institut des Hautes Études Scientifiques, Terence Tao of UCLA and Richard Taylor of the Institute for Advanced Study.

Doudna and Charpentier received the award for their discovery of a revolutionary DNA-editing technique that has upended the world of genetics, finally making possible dreams of gene therapy. Perlmutter and his colleagues received the award for their discovery of the accelerating expansion of the universe and dark energy.

Doudna is a professor of molecular and cell biology and chemistry as well as a Howard Hughes Medical Institute investigator and Lawrence Berkeley National Laboratory scientist, while Charpentier is at the Helmholtz Center for Infection Research and Umeå University. Perlmutter is a UC Berkeley professor of physics and faculty scientist at Lawrence Berkeley National Laboratory.

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Bridging the gap in precision medicine

UCSF takes steps to solve the ‘last mile’ problem.

By Pete Farley, UC San Francisco

For entertainment giants such as Netflix and HBO, there’s an oft-cited concept known as “the last mile.”

It refers to the performance bottleneck that can arise in the short, final stretch of cable that links their vast, sophisticated server farms to the humble jack on a subscriber’s wall.

More than a decade after the immense promise unleashed by the completion of Human Genome Project, precision medicine has struggled with its own “last mile.” Despite major leaps in the field as a whole, the technical work needed to integrate a patient’s genomic information into the day-to-day practice of medicine has lagged far behind.

This month, UCSF is unveiling its bridge across that persistent gap.

Through its Genomic Medicine Initiative (GMI), UCSF has integrated data from a comprehensive cancer genetic testing program into the electronic medical records of patients at the Helen Diller Family Comprehensive Cancer Center. Not only does it allow for continuity of care with all testing and treatment results tied to the same electronic record, but it also allows physicians and researchers to identify larger patterns in the data that can lead to the development of better treatments.

“Many major medical institutions, including UCSF, have long had the science and the technology to generate genomic test results,” said Kristen McCaleb, Ph.D., program manager for the GMI. “The problem we’ve had is a lack of IT infrastructure to return those results to the clinicians who order the tests in a clearly actionable, doctor-friendly format.

This new project is a powerful new cloud-based software platform built in partnership with Palo Alto-based Syapse that seamlessly unites genomic testing and analysis, personalized treatment regimens, clinical data, and outcomes data, and –  crucially – integrates all of these features directly into APeX, UCSF Medical Center’s Epic-based electronic medical record (EMR) system.

“Genomics has the potential to dramatically improve patient care in oncology, but the full promise of precision medicine cannot be realized without a software platform to bring genomics to the point of care,” said Jonathan Hirsch, who founded Syapse six years ago as a 23-year-old Stanford University graduate student. “It is critical that genomic data be integrated with the patient’s medical history and presented to the clinician within the workflow of their EMR.”

One of the most comprehensive genetic tests for cancer

A major feature of the UCSF-Syapse partnership is that, beginning in the spring of 2015, UCSF oncologists will be able to order the “UCSF 500,” a panel of more than 500 gene mutations that have been implicated in a range of cancers. The test results will automatically feed into their adult and pediatric patients’ EMRs.

The assembly of the UCSF 500 wouldn’t have been possible without UCSF’s medical oncologists collaborating with Syapse to define which genomic alterations in which cancer types can be best treated with targeted therapies,” he said.

“The collaboration between the UCSF Helen Diller Family Comprehensive Cancer Center and Syapse is just one example of what the UCSF Genomic Medicine Initiative, launched two years ago, is doing to bring genomics to bear on clinical medicine,” said Robert Nussbaum, M.D., director of the GMI. “We are excited with the results and look forward to using it to improve the care of our patients here in the Cancer Center.”

When completed, test results from the UCSF 500 will automatically appear in a Syapse-powered window in the EMR, and from there, physicians can trigger consultation by a newly formed Molecular Tumor Board, a group of expert physicians and researchers that can recommend customized treatment plans for each patient.

These recommendations are recorded in Syapse alongside the physician’s decisions, and the patient’s clinical course will be continuously tracked. The resulting information is displayed to the physician in an easy-to-understand graphical format, and clinical notes and summaries are automatically populated in the EMR.

Learning from the data

Because the Syapse system is cloud-based, on Amazon Web Services (AWS), physicians and members of the Molecular Tumor Board can query a patient’s test results in real time against the latest entries in UCSF’s knowledge-base, which is also drawn from public genetics, oncology and clinical trial databases, as well as the current scientific literature. AWS was selected for its robust security, support for compliance with medical information privacy laws, scalability and redundancy, Hirsch said.

A de-identified version of each patient’s clinical history from APeX and information on how patients respond to treatments is simultaneously added to a dedicated clinical research knowledge-base within Syapse, so future recommendations of the Molecular Tumor Board for any patient’s case will always be informed by the latest clinical experience.

Because APeX is based on Epic, a widely used EMR system, the new platform is easily scalable, and could easily capture clinical data from many medical centers in a consistent, easily accessible form, said Hirsch.

“Our top priority is benefitting our patients today, but if we can begin to collect and leverage the knowledge we gain from each positive patient outcome, and combine our experience with that of others doing similar work worldwide, future patients may be able to sidestep conventional therapies and go directly to the best targeted therapy as a first-line treatment,” McCaleb said.

“And that would be truly powerful.”

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Bay Area Science Festival’s grand finale draws large crowd

Free extravaganza at AT&T Park caps 10-day festival.

UC President Janet Napolitano examines a brain at a science booth staffed by UCSF graduate students.

Ten days of the Bay Area Science Festival activities culminated in the Discovery Days event at AT&T Park, a huge display of science interactive exhibits, experiments and games. About 30,000 people attended the free science extravaganza.

The event was filled with over 150 different booths and exhibits, staffed by volunteer UCSF scientists and students eager to share their science with the public. Children and their families could see and handle pieces of animal brain to learn about neuroscience, watch a partial dissection of different sea creatures, pilot an underwater remotely operated vehicle (ROV) and take part in experiments to learn about basic science concepts like the effects of heating and cooling on water.

This year marks the 4th annual Bay Area Science Festival, which was created by the Bay Area’s scientific, cultural and educational institutions, including Science & Health Education Partnership (SEP) at UCSF. Other partners include UC Berkeley, Lawrence Berkeley National Laboratory and Lawrence Livermore National Laboratory.

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