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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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Ebola crisis

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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 Nov. 24)

The Ebola virus outbreak centered in West Africa has claimed more than 5,000 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. At UC’s request, a team of experts from the U.S. Centers for Disease Control and Prevention is visiting all five UC medical centers to review and provide consultation on the medical centers’ preparedness in the event they receive a patient infected with Ebola. Read joint UC-CDPH announcement and related UC Davis article, UC Davis news release, UCSF Medical Center statement on Ebola preparations, and UCSF coverage of its CDC visit.

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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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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UC is economic catalyst for California

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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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Microscopic monsters and more at the Bay Area Science Festival

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Stem cell therapy coming of age

With first clinical trials, UC San Diego pushes stem cell therapies into new era.

Photos by Erik Jepsen, UC San Diego

In 2004, the therapeutic potential of stem cells persuaded more than 7 million Californians to approve Proposition 71, which allocated a whopping $3 billion for research and development of stem cell-based drugs and therapies that might someday address a medical dictionary’s worth of diseases and conditions.

Now, stem cell research is being put to the test in full force as years of cellular and animal studies make the leap to human clinical trials—a requisite step before any new drug or therapy is approved for market. Nowhere is this progress more visible than at UC San Diego, which in recent weeks has launched the three first stem-cell-based clinical trials in patients to pursue potential treatments for spinal cord injury, Type 1 diabetes and chronic lymphocytic leukemia.

And last week, the California Institute for Regenerative Medicine (CIRM), the state stem cell agency established by Prop.71, named the Sanford Stem Cell Clinical Center at UC San Diego Health System one of three “alpha clinics,” a highly sought-after designation that comes with an $8 million grant to further speed stem cell clinical development. The other two alpha clinic sites are City of Hope hospital near Los Angeles and UCLA, which is partnering with UC Irvine.

“A UC San Diego alpha clinic will provide a vital infrastructure for establishing a comprehensive regenerative medicine clinical hub that can support the unusual complexity of first-in-human stem cell-related clinical trials,” said Dr. Catriona Jamieson, deputy director of the Sanford Stem Cell Clinical Center, director of the UC San Diego Moores Cancer Center stem cell program and the alpha clinic grant’s principal investigator.

“The designation is essential in much the same manner that comprehensive cancer center status is an assurance of scientific rigor and clinical quality. It will attract patients, funding agencies and study sponsors to participate in, support and accelerate novel stem cell clinical trials and ancillary studies for a range of arduous diseases.”

Lawrence Goldstein, director of the UC San Diego Stem Cell Program and Sanford Center

Such work is well underway. Last week, doctors at UC San Diego and Veterans Affairs San Diego Healthcare System, in collaboration with the San Diego-based biotechnology firm ViaCyte, Inc., treated the first patient in an unprecedented phase one-two trial of a stem-cell-derived therapy for patients with Type 1 diabetes. The trial involves implanting specially encapsulated embryonic stem-cell-derived cells under the skin where it’s hoped they will mature into pancreatic beta and other cells able to produce a continuous supply of needed insulin and other substances.

Last month, a 26-year-old woman paralyzed in a car accident a year ago successfully underwent the first experimental procedure to test whether neural stem cells injected at the site of a spinal cord injury is safe and could be an effective treatment. It is hoped that the procedure – the first of four in the phase one trial sponsored by the Sanford Center and Maryland-based Neuralstem Inc. – will ultimately lead to a treatment in which transplanted neural stem cells will develop into new neurons that bridge the gap created by an injury, replace severed or lost nerve connections and restore at least some motor and sensory function.

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

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

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

Achieving alpha clinic status should help, he said. One element of the new grant is expanded public outreach to raise awareness and understanding of stem cell science, in part to combat what Goldstein calls “stem cell tourism” and the marketing of unproven, unregulated and potentially dangerous therapies.

“Clinical trials are the fastest and safest way to develop therapies that are truly safe and that actually work. You want to prove that a new therapy will work for more than just a single, random patient. These alpha clinic awards not only provide valuable support that will help accelerate experimental stem cell therapies into clinical trials, they also bring with them a ‘stamp of approval’ that our center meets important standards set by peers for testing of stem cell therapy trials.”

The alpha grant reflects CIRM’s continued support for UC San Diego’s stem cell research and development efforts. Since 2004, CIRM has approved 74 awards totaling more than $147 million to UC San Diego stem cell scientists and programs. The three clinical trials launched are just the first of many to come, said alpha clinic principal investigator Jamieson. Other trials for heart failure, amyotrophic lateral sclerosis (Lou Gehrig’s disease) and blindness are in the planning stages.

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UC research spans the globe

UC’s global reach can be seen from health to agriculture to sustainability and more.

By Alec Rosenberg

From addressing the Ebola outbreak in Africa to exploring aquatic environments in Antarctica, University of California researchers span the globe to serve the public and create new knowledge.

As UC President Janet Napolitano likes to say, “UC teaches for California and researches for the world.”

UC’s global reach can be seen from health to agriculture, sustainability to tech commercialization and bridge-building efforts such as the president-led UC Global Food Initiative and UC-Mexico Initiative.

UC’s global clout is reflected in its strong showing in international rankings. UC placed four campuses in the top 20 and nine in the top 150 in the Academic Ranking of World Universities, and scored similarly in the Times Higher Education World University Rankings and the inaugural U.S. News and World Report Best Global Universities rankings.

On the front lines of global health

One sign of UC’s strength is its 62 Nobel Prizes, the latest of which was announced this month in physics to UC Santa Barbara’s Shuji Nakamura for the invention of efficient blue light-emitting diodes. Another sign can be seen in Sierra Leone, a West African nation at the center of the Ebola crisis.

UCSF’s Dan Kelly became interested in Africa as a student at Albert Einstein College of Medicine. Inspired by a roommate from Sierra Leone, Kelly co-founded Wellbody Alliance in 2006 to provide health care to the poor in that country, which had been ravaged by a decade-long civil war.

From California, Kelly watched as the epidemic progressed rapidly this summer and close friends died.

“It hit me really hard,” Kelly said. “Within 48 hours, I went to Sierra Leone. I was there 3 ½ weeks and trained 1,000 health care workers. It restored my hope.”

Working with colleagues at UCSF and a coalition of partner organizations, Kelly started a crowdfunding campaign to ramp up relief — one of a variety of UC-led efforts to tackle Ebola.

“We’ve got a long way to go,” said Kelly, who has taken a leave as a UCSF infectious disease fellow to dedicate himself full time to the Ebola crisis.

Kelly was a speaker at UCSF’s sold-out global health symposium, held Oct. 2 to celebrate the 10th anniversary of UCSF’s Global Health Sciences program.

International health research at UCSF, which got its start in the late 1980s with a small AIDS program in Uganda, now spans 600 investigators working in 190 countries. Similarly, hundreds of faculty and an increasing number of students across UC’s 10 campuses are engaged in global health, reflected by the 2009 launch of the systemwide UC Global Health Institute, the 2011 establishment of the Global Health Research, Education and Translation Program at UC Irvine and the launch this fall of a global health major at UC San Diego.

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UC receives nearly a quarter of NIH brain research grants

14 projects are led by researchers from six UC campuses.

The National Institutes of Health awarded UC researchers nearly a quarter of the $46 million in grants announced today (Sept. 30) in support of President Barack Obama’s BRAIN Initiative.

UC scientists have long been at the frontline of efforts to understand the brain’s inner workings — a pre-eminence reflected by the grants: Of the 58 NIH awards, 14 are projects led by researchers from UC Berkeley, UC Davis, UC Irvine, UCLA, UC San Diego and UC San Francisco.

Collectively, UC researchers will receive more than $10 million of the $46 million that the NIH is awarding for 2014.

“The human brain is the most complicated biological structure in the known universe. We’ve only just scratched the surface in understanding how it works — or, unfortunately, doesn’t quite work when disorders and disease occur,” said NIH Director Dr. Francis S. Collins in a statement. “There’s a big gap between what we want to do in brain research and the technologies available to make exploration possible.”

The BRAIN Initiative was launched last year by Obama as a large-scale federal effort to help scientists develop new tools and technologies to gain a deeper understanding of how the brain functions and to accelerate the creation of new treatments for neurological disorders.

“These initial awards are part of a 12-year scientific plan focused on developing the tools and technologies needed to make the next leap in understanding the brain,” Collins said. “This is just the beginning of an ambitious journey and we’re excited about the possibilities.”

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UC innovation grants produce healthy returns

Report finds return on investment of more than 5 to 1.

UC San Diego Dr. Greg Maynard leads a five-campus UC project to reduce dangerous blood clots (venous thromboembolism, or VTE), which prevented an estimated 140 VTE occurrences in 2013 for an annual savings of $1.45 million.

By Alec Rosenberg

A University of California center that fosters health care innovation at UC’s five medical centers is proving to be a boon to both patient health and the bottom line.

A report assessing the impact of grants made by the Center for Health Quality and Innovation (CHQI) found that UC’s investment is paying off with improvements such as fewer blood clots and improved post-surgery care at UC hospitals. Based on current cost savings, revenues and additional funds received, the projected net financial gain in 2016 of the center’s grants will be about $40 million from a $7.3 million allocation from UC medical centers — a return on investment of more than 5 to 1.

“The investment has been a good one,” said Dr. John Stobo, UC Health senior vice president and CHQI chairman. “The innovation center has done a lot of good in terms of improving quality and saving costs.”

CHQI was established in 2010 to foster innovations developed at UC medical center campuses and hospitals in order to improve quality, access and value in the delivery of health care. To date, the center has issued a total of 50 grants. In addition to funding from UC’s five medical centers, CHQI also has awarded $7.7 million it received from the UC Office of Risk Services for grants designed to reduce the risk of clinical harm to UC patients.

“We’ve been able to support innovative projects that produce better outcomes for patients, reduce costs and are being expanded across the UC Health system,” said CHQI Executive Director Karyn DiGiorgio. “This report helps quantify our impact.”

Examples include:

  • A five-campus project led by UC San Diego’s Greg Maynard to reduce dangerous blood clots (venous thromboembolism, or VTE) prevented an estimated 140 VTE occurrences in 2013 for an annual savings of $1.45 million.
  • A project at UC Irvine reduced the median length of stay for high-risk abdominal surgery patients by two days, resulting in fewer complications and projected annual savings of $816,000 (Maxime Cannesson).
  • The 2012 UC San Diego colorectal postoperative program reduced length of stay by 4.5 days for high-risk surgical patients and 0.9 days for moderate-risk patients, resulting in projected annual savings of $553,000 (Elisabeth McLemore).
  • A 2012 UCSF palliative care intervention resulted in 45 additional palliative care consults in the intensive care unit, generating $167,000 in annual savings from reduced ICU bed-days (Wendy Anderson).
  • A 2012 UC Davis specialty pharmacy initiative led to contracts that generated $18,000 in revenue at UC Davis and $1.36 million in revenue at UCSF during a CHQI fellowship (John Grubbs).
  • The 2012 UCLA elective surgery discharge program increased net revenues through a discharge pharmacy program for surgical services by $639,000 during a CHQI fellowship (Michael Yeh).

The report projects at least $25 million in grant-generated cost savings and revenues by the end of 2016. Also, seven project teams have received an additional $16 million in external funding based on their CHQI work, including a UCSF-led radiation safety project (Rebecca Smith-Bindman), a UC Davis pediatric telehealth project (James Marcin) and a UCSF-led eConsult project (Nathaniel Gleason).

In addition, 16 papers in national journals have been published based on work funded by CHQI.

The report did not assess the center’s other activities, such as hosting three systemwide colloquiums and convening multicampus collaboratives to develop and implement evidence-based practices.

The report was prepared by the center’s Innovation Evaluation Committee, which includes Michael Ong of UCLA, Patrick Romano of UC Davis, Andrew Auerbach of UCSF, Sheldon Greenfield of UC Irvine, Theodore Ganiats of UC San Diego and Stephen Shortell of UC Berkeley, and Karyn DiGiorgio, executive director of the center. CHQI plans to issue a yearly update, and by 2016 expects to present an in-depth review of the overall impact of the programs funded by the center.

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