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UC medical students celebrate Match Day

More than 650 UC graduating medical students match to residency programs.

UCLA graduating medical students Jiwoon Chang (left) and Abinav Baweja celebrate after learning that they matched together to the internal medicine residency program at NYU.

For graduating medical students, Match Day is the Academy Awards without the red carpet, March Madness without the brackets. It’s a thrilling time when the nation’s future doctors learn which hospital has accepted them for residency to get advanced training in their chosen specialty.

On March 20, more than 650 UC medical students were among the nearly 17,000 seniors at traditional U.S. medical schools who learned where they were matched.

UCLA graduating medical students Abinav Baweja and Jiwoon Chang couldn’t wait to tell each other where they were matched. The friends were overjoyed to find out that they matched together to their first choice – a top East Coast program in internal medicine.

“NYU: We said it at the same time. We burst into tears and laughter. It was a big moment for both of us,” Baweja said. “There is no better feeling than this … we made it!”

UC Davis' Chelsea Ma reacts to her residency match.

Virtually all UC graduating medical students matched, including 105 at UC Davis, 96 at UC Irvine, 161 at UCLA, 115 at UC San Diego and 177 at UC San Francisco. Most will continue their training in California.

“It’s a little hard to put into words,” said Agustin Morales, a fourth-year UC Davis medical student from Salinas who was part of the first San Joaquin Valley PRIME cohort – a collaboration between the UC Davis School of Medicine, UC Merced and UCSF Fresno that trains medical students with a special emphasis on patients in underserved communities.

“It’s been an amazing journey, and I matched to my number-one pick, UCSF Fresno,” added Morales. “It’s a gem of a program in internal medicine and I’m excited about the next three years.”

Newly minted UC Irvine doctor Jacob Blickenstaff and his wife, Jacky, cheer over his letter from the medical institution where he'll begin his career.

Fourth-year UCSF medical student Aaron Smith, was excited to be graduating and begin his residency program in internal medicine at Oregon Health & Science University.

“My dream growing up has always been to become a doctor,” Smith said. “Now when people call me a doc, I’m actually a doc! This is the fulfillment of what I’ve always wanted to do.”

At UC Irvine, Match Day is an emotional, festive event during which the future doctors are called to a podium one at a time to open an envelope and read aloud before hundreds of family members, friends and classmates the name and location of the hospital where they’ll spend the next three to seven years pursuing postgraduate medical training as a resident physician.

UC San Diego graduating medical students celebrate their matches.

A former elementary school teacher, Marcella Torres, 40, used her experience volunteering with the Peace Corps in Panama and helping Burmese refugees in Northern Thailand to enter UC Irvine’s PRIME program for the Latino community, the first medical training program to address the specific needs of America’s largest and fastest-growing community. She matched with a family medicine residency program at Contra Costa Regional Medical Center in Martinez and next month plans to go Cuba with another PRIME student to observe its community-based primary care health system.

Among the UC San Diego participants was Thomas Onyia, an immigrant from central Africa who plans to be an anesthesiologist and participate in surgical outreach missions in Africa and other developing countries.

UC San Francisco medical students Tarann Henderson (left) and Matthew Abad-Santos matched with emergency medicine and surgery programs, respectively.

“I feel great,” said Onyia, after his envelope revealed that he got his wish to do his residency at UC San Diego. “The best thing about it is that I have great mentors here who have supported me throughout the process.”

With a match rate of 93.9 percent, nearly all of the nation’s seniors at traditional medical schools landed a first-year residency.

A computer algorithm from the National Resident Matching Program matches the preferences of applicants with the preferences of residency programs at teaching hospitals throughout the country. The students from traditional medical schools such as UC apply for the available residency positions along with thousands of independent applicants, including osteopathic students and graduates of foreign medical schools. Overall, more than 41,000 individuals applied for more than 30,000 residency slots across the country.

“We are extremely proud of this year’s Match Day group,” said Mark Servis, professor of psychiatry and behavioral sciences and senior associate dean for medical education at the UC Davis School of Medicine. “This is the future of medicine, caring individuals with a passion for health care and a desire to develop their clinical skills to the very best of their abilities. As I told them before they opened their envelopes, ‘It’s not where you match that is most important, it’s what you do in caring for your patients and working with others that is the key to your success and the ultimate accomplishment as a physician.’”

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U.S. News ranks UC grad schools among best in nation

In each discipline, all or nearly all UC graduate schools were highly ranked.

Graduate student Morgan Nunn Martinez performs research at the Stable Isotopes Lab, UC San Diego.

By Alec Rosenberg, UC Newsroom

University of California graduate schools rank among the nation’s top programs in a survey released today (March 10) by U.S. News & World Report.

U.S. News’ 2016 Best Graduate Schools guide evaluates graduate schools for business, education, engineering, law, medicine and nursing, and specialties within each area. In each discipline, all or nearly all UC graduate schools were highly ranked.

The annual Best Graduate Schools rankings are based on two types of data: expert opinions about program excellence and statistical indicators that measure the quality of a school’s faculty, research and students.

Below are UC’s ranked schools in the six main disciplines, which include for the first time expanded rankings for nursing, with master’s programs evaluated based on both statistical and reputational data. For specialty programs within these areas, go to the Best Graduate Schools site.

Business

All six of UC’s business schools were ranked:

7. UC Berkeley Haas School of Business
15. UCLA Anderson School of Management
48. UC Davis Graduate School of Management
53. UC Irvine Paul Merage School of Business
63. UC San Diego Rady School of Management
Ranked: UC Riverside A. Gary Anderson Graduate School of Management

Of note: UC Berkeley’s business school had the No. 1 part-time MBA program, and UCLA’s was No. 5. For executive MBA programs, UCLA ranked No. 8 and UC Berkeley was No. 9.

Education

In education, all eight of UC’s schools were ranked:

13. UCLA Graduate School of Education and Information Studies
17. UC Berkeley Graduate School of Education
31. UC Irvine School of Education
38. UC Davis School of Education
67. UC Santa Barbara Gervitz Graduate School of Education
76. UC Riverside Graduate School of Education
99. UC San Diego Department of Education Studies
110. UC Santa Cruz Education Department

Engineering

All nine of UC’s engineering schools were ranked:

3. UC Berkeley College of Engineering
14. UCLA Henry Samueli School of Engineering and Applied Science
17. UC San Diego Jacobs School of Engineering
23. UC Santa Barbara College of Engineering
33. UC Davis College of Engineering
37. UC Irvine Henry Samueli School of Engineering
71. UC Riverside Bourns College of Engineering
88. UC Santa Cruz Jack Baskin School of Engineering
140. UC Merced School of Engineering

Law

All five of UC’s law schools were ranked, including UC Irvine in its first year of eligibility:

8. UC Berkeley School of Law
16. UCLA School of Law
30. UC Irvine School of Law
31. UC Davis School of Law
59. UC Hastings College of the Law

Medicine: Research

Five UC medical schools were ranked in research:

3. UC San Francisco School of Medicine
13. UCLA David Geffen School of Medicine
17. UC San Diego School of Medicine
43. UC Davis School of Medicine
45. UC Irvine School of Medicine

Medicine: Primary care

Five UC medical schools were ranked in primary care:

3. UC San Francisco School of Medicine
7. UCLA David Geffen School of Medicine
19. UC Davis School of Medicine
19. UC San Diego School of Medicine
62. UC Irvine School of Medicine

Nursing

Three UC nursing schools were ranked, including UC Davis, in the first year it was eligible for inclusion in the survey:

2. UC San Francisco School of Nursing
19. UCLA School of Nursing
43. UC Davis Betty Irene Moore School of Nursing

In other health-related rankings this year, UC Davis was recognized as the nation’s best veterinary school, while in public health UC Berkeley ranked ninth and UCLA was 10th.

The rankings also include previous assessments of a number of other health fields, which U.S. News surveys but not each year. UCLA ranked first in clinical psychology and UCSF ranked first in pharmacy. The surveys do not rank dental or optometry schools.

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UC Global Food Initiative: Healing hunger, nurturing nutrition

UC President Janet Napolitano highlights initiative’s role in Cultures magazine.

UC President Janet Napolitano and UC San Diego Chancellor Pradeep K. Khosla listen as volunteer Karemah Alhark talks about the Ocean View Growing Grounds. (Photo by Erika Johnson, UC San Diego)

By Janet Napolitano

Janet Napolitano is president of the University of California. This piece was published in the March edition of Cultures magazine.

The quest to establish global food security has never been so urgent.

A billion people – most of them in the developing world – suffer from chronic hunger or serious nutritional deficiencies. More than a half billion – primarily in industrialized nations – are obese, and diabetes mellitus is an epidemic. Against this backdrop, climate change and population growth fuel additional uncertainty about how the world will feed itself in the years ahead.

Recognizing that the University of California (UC) is uniquely positioned to play a leading role in addressing food security and the related challenges of nutrition and sustainability, we launched the UC Global Food Initiative in July 2014.

Our goal is audacious and far-reaching. We aim for nothing less than the development and export of solutions for food security, health and sustainability throughout California, the United States and the world. By building on the extensive efforts already underway, and creating new collaborations among our 10 campuses, affiliated national laboratories, and the Division of Agriculture and Natural Resources, UC looks to put the world on a pathway to feed itself in ways that are both nutritious and sustainable.

Why UC?

UC is California’s land-grant university and has played a key part in helping California become the nation’s leading agricultural state. In the late 1800s, UC research showed how to remove salts from the alkali soils in the Central Valley, turning what was once barren land into one of the world’s most productive farming regions.

UC has continued to play a pivotal role in food over the years. Our student farms at UC Davis and UC Santa Cruz have provided innovative learning opportunities since the 1970s. UC San Diego researchers, whose work has linked air pollution with reduced crop yields, are studying ways to achieve global food security and mitigate climate change. Our agricultural division has collaborators in more than 130 countries from Afghanistan to Zimbabwe, working to solve agricultural problems at home and abroad. We have been a pioneer in sustainable agriculture, helping farmers increase water efficiency and developing new plant varieties that feed the world. Our flood-tolerant rice, for example, is now grown by more than 10 million farmers.

It is intrinsic to our role as a public research university that we address pressing societal problems such as global food security. Our campuses, agricultural division and laboratories are equipped to tackle the food challenge across multiple disciplines. UC is deeply engaged in the knowledge export business – rooted in California, but with a global reach – in the fields of agriculture, medicine, nutrition, climate science, public policy, social science, biological science, humanities, arts and law, among others.

Our efforts start at home. UC campuses are living laboratories for sustainable operations, with the Global Food Initiative complementing our ongoing commitments to sustainability. For example, UCLA’s Healthy Campus Initiative draws upon the campus’s research and teaching expertise to find new and innovative ways to promote healthy living at UCLA and share that education and research with other communities. Last year, UC sustainable food procurement practices shifted more than $25 million (20 percent) of our total annual food expenditure toward local, fair, ecologically sound and humane food sources. We have set a systemwide goal of zero waste by 2020 and pledged to become carbon neutral by 2025.

The UC Global Food Initiative is a collaborative endeavor, involving faculty, staff and students, including a class of 54 student fellows. We have launched projects developed by multicampus working groups to identify best practices and develop toolkits to implement them in curriculum, operations, policy, research and service. From increasing local food security to enhancing the availability of healthy eating choices, we are working to improve nutrition and sustainability on our campuses and then share those ideas with schools and communities in California, across the country and around the world.

Extending our reach

Through food, we are making new connections. We have launched the UC Food Observer blog, a daily selection of must-read news on food policy, nutrition, agriculture and more to help inform conversations around food. UC San Francisco launched SugarScience, a research and education initiative designed to highlight the most authoritative scientific findings on sugar and its impact on health. UC Berkeley’s Edible Education course, which this semester includes such food luminaries as Mark Bittman, Marion Nestle and Michael Pollan, is expanding its audience by making the lectures available to the public by live stream.

The UC Global Food Initiative is reaching out to partner with others in government, higher education, school districts, nonprofit organizations and the private sector.

These partnerships can be profound. For example, UC Davis, with more than two dozen centers focused on food and agriculture, has had a longstanding collaboration with Mars Inc. that continues to blossom. UC Davis, Mars and other global partners are part of the African Orphan Crops Consortium, which is sequencing 100 African crop species and training the next generation of plant breeders to increase food security and improve nutrition, especially among Africa’s youth. In January, UC Davis and Mars launched the Innovation Institute for Food and Health, designed to deliver big-impact, Silicon Valley-type breakthroughs in food, agriculture and health.

Lawrence Berkeley National Laboratory engineers have designed a highly efficient cookstove and partnered with a nonprofit organization to address food security issues posed by displaced persons in Darfur. Berkeley Lab scientists also developed a system for removing arsenic from groundwater, which an Indian company has licensed, to help provide safe drinking water for people in India and Bangladesh.

Meanwhile, UC Santa Barbara hosted the California Higher Education Food Summit, which convened students, staff and faculty from UC, California State University and community college campuses, and community and food agency leaders, to discuss food access, security and justice. This Global Food Initiative event was organized by students, an inspiring example of what we can accomplish when we work together toward a common purpose.

Moving forward

As the UC Global Food Initiative advances, we seek to find common ground to help communities in California and around the world find their way to a sustainable food future.

We are enhancing campus gardens, integrating food issues into more courses, reforming vending machine practices to increase the availability of healthy choices, and leveraging food-purchasing power to encourage sustainable farming practices and to serve nutritious fare in campus dining halls. Along with identifying best practices and sharing them, we plan to use the power of UC research and extension to help individuals and communities access safe, affordable and nutritious food while sustaining our natural resources. And we are deploying UC’s research to help shape, impact and drive policy discussions around food issues at the local, statewide, national and international levels.

Finding solutions to the food crisis, one of the most critical problems of our age, is within our reach. We hope that by making global food issues a priority, we will inspire others to join our efforts to put the world on a path to sustainably and nutritiously feed itself.

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Cultures magazine

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Facebook connection leads to lifesaving organ transplant

‘I call James Lebowitz my angel,’ donor recipient says.

By Yadira Galindo and Jackie Carr, UC San Diego

In January 2015, the lives of more than 60 people changed forever when Paul and Susan Lebowitz made the decision to donate their son’s organs and body tissue to recipients across the United States.

That month their beloved son James had suffered a fatal brain aneurysm at his university dormitory at Cal Poly Pomona. Doctors informed the parents that James’ life could not be saved and suggested organ donation.

In shock and grief, Paul posted a message to Facebook announcing the loss of 18-year-old James, “I don’t want to say goodbye, I thought we had a whole lifetime together.”

After discussion with his wife, a second Facebook message offered the possibility of organ donation.

“If you know someone on an organ transplant list, please let me know,” posted the father. “We can potentially direct a donation from James to help them. We have a day.”

Luckily, a man named George Martinez and his longtime friends Tommy and Randy were among Facebook’s 1.3 billion registered users. The men read Paul’s post and immediately replied by tagging and suggesting George as a potential recipient. Minutes later, a connection was made.

Martinez is a 15-year Navy veteran who works as a substance abuse assessor for the San Diego County Office of the Public Defender. He counsels people with substance abuse issues to get the help they need. George’s life was split between work and undergoing continuous medical treatment for kidney failure.

For 3.5 years, Martinez sat through dialysis from 6 p.m. to 3 a.m. three days a week. He would sleep for a few hours and then go to work. George was looking at an additional 2.5 years of dialysis before his turn could come up on the transplant list.

“My family members were not a match for an organ donation,” said Martinez. “My friends that tried were not a match either. I don’t think I could have waited another 2.5 years. I felt my body was really getting weak. It was getting hard to go to work. I’m more surprised than anybody that Facebook came to my aid.”

After hearing Martinez’s story, the Lebowitzs knew that helping George would not only save his life, but it would also help hundreds of other people he counseled on how to overcome addiction and return to a healthy lifestyle.

“It hit me in an instant as we watched over our son, that someone we know, or one step away from us, might be on the transplant list,” said Paul. “For my wife and I, there was no choice to be made. My son could help others. He liked to help people feel good and to fix problems. I have no doubt that James would want to do this.”

The amount of time a patient waits on a transplant list varies by geographic location. In San Diego, the average wait is five to seven years. In 2014, there were more than 20,000 people waiting for a kidney transplant in California — but only 2,000 people received one. More than 100,000 people in the U.S. are waiting for a kidney.

“We are in desperate need for lifesaving organ transplants in the United States,” said Dr. Kristin Mekeel, surgical director of the Kidney and Pancreas Transplantation Program at UC San Diego Health System. “Right now, there are more than 120,000 people listed for organ transplants, but only 24,000 transplants are done per year. The number of patients on the transplant list grows longer every year, but the number of donors remains static. The only way we can make up the difference is having more donations.”

George underwent a successful kidney transplant surgery at UC San Diego Medical Center, the largest kidney transplant program south of Los Angeles.

“Wow — UC San Diego — what a team. For the first three days after the surgery, I thought I was the only patient in the hospital. I don’t think I went five seconds that I pressed a button that a nurse was not there,” said Martinez. “The team kept me informed of everything.”

Martinez’s health has improved each day, allowing him to participate in a paddle out memorial service at La Jolla Shores to honor James and his lifesaving gift. Dozens of people on kayaks, boards and a boat joined the Levowitzs to say thank you and goodbye to a young man who helped more people than he’ll ever know.

“My commitment to the Lebowitz family is to get well, take care of this kidney and continue to help people,” said Martinez. “I want to help continue James’ legacy of caring.”

James saved Martinez and four additional people who were matched through the organ donation waiting list. A 50-year-old California man received James’ second kidney while a 60-year-old Californian was given his liver. A Nebraska man in his 30s was gifted James’ lungs and, fittingly, an 18-year-old Californian received his heart.

“Not only are you helping individuals, but each one of these people that James saved has a family and friends,” said Paul. “We’re really talking about touching a thousand people or more. You should register to be an organ donor.”

Tissue banks have a very limited supply of donated skin, bone, heart valves, tendons and corneas­— making James a hero to many people. Tissues from his corneas have helped two people see again.

“I call James Lebowitz my angel,” said Martinez. “I cannot imagine what they went through to make the decision to help others through their loss. I would encourage people to please be organ donors. An act of kindness and love can go so far.”

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UC leads nation in NIH biomedical research funds

UC system received $1.8B in 2014 contract and grant funding from NIH.

UC San Francisco and UC Newsroom

The University of California system received more than $1.8 billion in 2014 contract and grant funding from the National Institutes of Health (NIH), making it the leading recipient for high-caliber biomedical research that is driving advances in science and breakthroughs in health.

UC placed three campuses in the top 20 funding recipients and five in the top 50, according to annual NIH figures. UC San Francisco was second overall in NIH funding, and for the second year in a row its four schools — dentistry, medicine, nursing and pharmacy — led the nation in federal biomedical research funding in their fields.

These highly competitive NIH funds enable UC scientists to advance understanding of the underlying causes of cancer, cardiovascular disease, diabetes, HIV, Parkinson’s and Alzheimer’s disease, and others, and work to develop improved therapies for them.

“The projects these funds support at UCSF are driving advances in the biomedical sciences, from fundamental, curiosity-driven science to the application of those discoveries to patient care and populations, to training the next generation of scientists and health care professionals to carry those innovations forward,” said UCSF Chancellor Sam Hawgood, M.B.B.S. “NIH funding is the lifeblood of that research and the heart of efforts by our faculty, staff, students and trainees to collectively transform health.”

The UCSF School of Medicine topped the list of NIH funding for medical schools for the third year in a row, at $480.6 million for fiscal year 2014, supporting research, graduate-student training and fellowships for postdoctoral scholars.

The UCSF schools of pharmacy, dentistry and nursing also ranked first in their fields in NIH grants for 2014: Pharmacy for the 35th consecutive year, with $31.8 million in grants; dentistry for the 23rd year, with $15.5 million; and nursing for the 10th time in the last dozen years, with $10.1 million.

All told, UCSF received more than $538.1 million total in grants, with an additional $8.5 million in NIH contracts, for which UCSF scientists compete to perform specific research projects for the national institutes. Johns Hopkins University was the top organization with $618.6 million in overall NIH funding.

NIH funding not only supports powerful scientific advances in research institutions nationwide, it buoys local and regional economies, as the scientists purchase materials and instruments and employ laboratory staff. Other economic engines include patents and scientific advances generated by NIH-funded research and related industries, such as biotechnology, as well as the entrepreneurs who launch companies based on research conducted on campus. These grants also play a tremendous role in helping innovative young scientists launch their research careers.

“In the past year, our graduate students and postdocs played key roles in discoveries in areas like the human microbiome, cancer immunotherapy and genome editing,” said Elizabeth Watkins, Ph.D., dean of the UCSF Graduate Division and vice chancellor of student academic affairs. “These funds are critical in supporting the early careers of those future scientific leaders, and instrumental in supporting the discoveries they make.”

By the numbers

Here is a UC campus/location breakdown of National Institutes of Health funding for 2014:

  • UC Berkeley: $122.5M
  • UC Davis: $189.3M
  • UC Irvine: $105.3M
  • UCLA: $373.1M
  • UC Merced: $4M
  • UC Riverside: $15.4M
  • UC San Diego: $398.7M
  • UCSF: $546.6M
  • UC Santa Barbara: $18M
  • UC Santa Cruz: $30.1M
  • UC Office of the President: $216,000
  • Berkeley Lab: $26M
  • Livermore Lab: $2.6M
  • Los Alamos Lab: $5.2M

UC system total: $1.8B

Related link:
UCSF schools lead nation again in NIH biomedical research funds

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Looking back and ahead, Shiley’s vision remains clear

UC San Diego emerges as regional hub for eye care, research, education, community service.

By Scott LaFee, UC San Diego

Time may blur, but the first quarter-century of the Shiley Eye Center – it celebrates that anniversary this year – remains sharply defined in its accomplishments and focus on the future.

When the $8 million center debuted in 1991, launched by a $1 million leadership gift from the late philanthropist Donald Shiley and his wife, Darlene, it stood alone – quite literally. The neighboring Perlman Ambulatory Care Center (now Perlman Medical Offices) and UC San Diego Thornton Hospital were both two years from completion. More to the point, the new Shiley Eye Center represented the first institution in San Diego entirely dedicated to eye care and science.

“No other major city had been without an eye center,” said Dr. Stuart Brown, then-chair of the Department of Ophthalmology and the center’s founding director at the opening gala in 1991. “And now we will be allowed to achieve our mission and our greatest potential.”

The ambition of the Shiley team was to establish an eye center unrivaled in the region. To a remarkable degree, they have succeeded. It’s a vision that has accelerated under the current Shiley director and ophthalmology chair, Dr. Robert N. Weinreb. “The Shiley has emerged as a hub for clinical care excellence, outstanding vision research and broad-based eye health education. By investing in unsurpassed facilities, equipment and brainpower, we have become a destination for preventing and curing blinding eye diseases for the residents of San Diego and beyond.” said Weinreb.

This week, Shiley expands upon that success, changing its name to the UC San Diego Donald P. and Darlene V. Shiley Eye Institute, which will encompass the Shiley Eye Center, the Anne F. and Abraham Ratner Children’s Eye Center, the Hamilton Glaucoma Center and the Joan and Irwin Jacobs Retina Center. The institute is part of the UC San Diego Health System.

“The new name more accurately captures the fullness of the work being done at Shiley,” said UC San Diego Chancellor Pradeep K. Khosla. “The institute and department of ophthalmology, working hand-in-hand with the School of Medicine and other programs across campus, will leverage every possible tool and expertise, from genetics, bioengineering and pharmacy to pathology, neurosciences and stem cell research, to improve the treatment of eye diseases, find new cures and hasten the day when blindness is entirely preventable.”

The institute will include the new Richard C. Atkinson Laboratory for Regenerative Ophthalmology, created last year with an anonymous $6.5 million gift from a grateful patient. The new lab will investigate cell replacement therapies, tissue engineering and other biomedical advances to reverse vision loss and blindness. Researchers will explore novel stem cell approaches and work closely with the Sanford Clinical Stem Cell Center at UC San Diego Health System, which was established in 2013.

Nearby, a new Vision Research Center is in the early stages of planning along with the creation of a framework to fund the project. The center is envisioned to accelerate the translation of new research into treatments for patient with blinding ophthalmic diseases.

“The center is intended to help bridge the gap between laboratory and clinic by bringing together brilliant minds and diverse talents in a shared facility,” said Weinreb. “This integrated approach will speed the transformation of discoveries into clinical applications that can be tested through clinical trials.”

If past is prologue, the future looks bright. Over the years, Shiley physicians and researchers have made major contributions to preventing and curing eye diseases such as macular degeneration, glaucoma, diabetic retinopathy, corneal disorders and cataracts.

Recently, for example, they have been involved in developing an artificial retina, a smart contact lens that wirelessly monitors intraocular pressure (a key risk factor in glaucoma) and the use of self-renewing stem cells to repair or restore vision lost to diseases like macular degeneration, glaucoma and corneal opacity. They are even helping explore the possibility of whole eye transplants.

Clinical care remains a cornerstone. In 2014, there were 106,470 patient visits and 4,862 surgeries. Patients ranged in age from one day to 105 years. The Shiley Eye Mobile conducted 12,238 vision screenings, 2,011 eye exams, dispensed 1,288 pairs of free glasses and referred 107 children for more serious follow-up care.

“It was always very clear that my late husband had a special place in his heart for the Shiley Eye Center,” said Darlene Shiley. “I will never forget how moved he was by Dr. Brown’s description of the work being done and the work that still needed to be addressed. And now, decades later, Dr. Weinreb is focused on patient-centric care excellence and leading the Shiley into new areas of eye research and treatment. Successful past, bright future – how lucky we all are to have such dedicated physicians, researchers, staff and eager volunteers.”

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A gamechanger for pediatric diabetes

UC Santa Barbara scientists are developing a pediatric artificial pancreas.

UC Santa Barbara chemical engineers Frank Doyle (left) and Eyal Dassau with a model of their artificial pancreas for adults.

By Sonia Fernandez, UC Santa Barbara

Anyone who lives with Type 1 diabetes is all too familiar with the sheer amount of effort — and often round-the-clock attention — required to manage the disease. Food intake is closely monitored, as is physical activity, and the period between meals is carefully tracked in order to calculate appropriate insulin dosages, which have to be delivered at the right time.

All this to keep blood glucose levels within a healthy range.

For parents of children with Type 1 diabetes, the stress is amplified. Children’s unpredictable eating habits and food preferences, spontaneous physical activity and sensitivity to insulin require parents to be extra vigilant. The dreaded overnight hypoglycemia — a condition in which glucose levels drop to dangerously low levels between dinner and breakfast — requires parents to interrupt their own sleep habits so they can check their children’s blood sugar and give the child a snack if needed. Conversely, if the glucose reading is too high, they would need to administer insulin. And those eagerly anticipated birthday parties (complete with cake and ice cream), sleepovers and playdates? Only if the other parents involved can be trusted to monitor the child closely and respond to emergencies.

But with a $1.8-million, three-year grant from the National Institutes of Health, UC Santa Barbara chemical engineers Frank Doyle and Eyal Dassau and Yale University’s Dr. Stuart Weinzimer could make such hands-on care a thing of the past. And it could happen within a decade. The researchers and their teams are embarking on the development of artificial pancreas (AP) for children. The grant is the UC Santa Barbara researchers’ first award for a pediatric closed-loop study.

“I think one of the most important things we can do is alleviate parents’ fears of overnight hypoglycemia,” said Dassau, a research engineer in UC Santa Barbara’s Department of Chemical Engineering and the principal investigator on this study. “As a result, parents can get a full night’s sleep without having to worry what might happen at 4 a.m., or who’s awake to check their child’s glucose. That would be a big success.”

Over the past 12 years, Doyle, director of the Institute for Collaborative Biotechnologies at UC Santa Barbara, and his research group have developed the artificial pancreas, a combination of sensor technology and insulin pump, which, thanks to a control algorithm, reads levels of glucose and injects the appropriate amount of insulin based on the data, and the patient’s individual characteristics.

Thus far, the researchers have made great strides in developing UCSB’s AP for use in adults. In a collaboration with the William Sansum Diabetes Research Center in Santa Barbara, and in local and international clinical trials, the AP’s multinational team of researchers has been refining the device based on input from engineering, clinical and behavioral aspects of diabetes management.

Tailoring the device to manage pediatric diabetes, however, requires the researchers to consider an additional set of factors.

“Children have unpredictable eating habits,” said Dassau. “You can put a certain amount of food in front of them, but you don’t know whether they’re going to eat it all.” Additionally, they may graze throughout the day, and tend to be more spontaneous than adults with their physical activity. Also coming into play are the children’s general lack of awareness about their condition and their limited ability to inform parents and caregivers of any immediate health situations.

The protocols for diabetes management vary by age as well. With adults and teenagers who can predict their meals and mealtimes, insulin can be delivered subcutaneously about 15 minutes before eating to ensure an adequate amount of the hormone has reached the bloodstream by the time they eat. This “pre-meal bolus” is an ideal way to manage meal glucose control, as it allows insulin to be absorbed when the glucose surge arrives with the meal, and mimics as closely as possible the way a healthy individual’s body regulates blood sugar.

However, in younger children with Type 1 diabetes, because of unpredictable eating habits and higher sensitivity to insulin, the hormone must be delivered after the meal, which creates both a delay and the chance of a swing to the hypoglycemic extreme of the blood sugar range, due to the tendency to overcompensate.

According to the researchers, the first phase of research for the pediatric AP involves data collection. With clinical expertise from Weinzimer, a pediatric endocrinologist, professor at Yale School of Medicine and a leading expert on Type 1 diabetes in children, the researchers will tune the AP’s Zone MPC (model predictive control) algorithm to meet the specific challenges of managing pediatric diabetes.

“I would look for the following things in a pediatric version of an AP: safety above all; efficacy; reliability; and ease of use,” said Weinzimer. In addition to protecting against constant wild swings in blood sugar, which would in turn alleviate the high rates of anxiety, depression and burnout in parents, and prevent the additional problem of disrupted psychosocial development in children with Type 1 diabetes, he said. The device itself must perform in a predictable manner and not be overly complicated or burdensome to use.

“One of the things I appreciate most about Drs. Doyle and Dassau is that they are, above all, scientists. They are extremely knowledgeable about control systems for the artificial pancreas, world experts in fact, and they approach this field with scientific rigor and balance,” Weinzimer continued. “We have to be very careful as investigators not to minimize the potential risks and shortcomings in our systems as we test them. We have a moral duty to protect our patients. I firmly believe that these systems will be transformative in diabetes care, but we should not lose our scientific objectivity and skepticism. Frank and Eyal have always struck me as very balanced and circumspect in how they approach this field, and I am looking forward to working with them.”

“We’ve already proved in previous clinical trials that our medically inspired artificial pancreas design can handle unannounced meals and physical activity,” said Dassau, adding that bringing this design to the younger population of Type I diabetes patients would ease the burden on parents who worry about the extra cookie or surprise sugary treat. “We’ve already developed safety algorithms for hypo- and hyperglycemia that can be adjusted for young children.”

Because insulin requirements change as the child gets older, the algorithm will be adjusted and refined according to different age groups, the researchers noted.

The second phase of the project involves developing and in-clinic testing of an advisory system and an alert system for parents that both provides insight on strategies for the management of their children’s conditions in general, and informs them of impending hypo- or hyperglycemia.

At every phase, the researchers will conduct repeated evaluations and refinements to the algorithm as well as to the alert and advisory systems. The goal is to give parents and children the ability to be involved in the management of diabetes to the extent that they can be, while safeguarding against extremes when unexpected circumstances arise. Snacking, unscheduled naps, spur-of-the-moment activities or missed meals will no longer result in increased stress levels for both parents and children.

According to Doyle, who holds the Mellichamp Chair in Process Control at UC Santa Barbara, when his group started work on the artificial pancreas over a decade ago, the researchers found that subjects using the conventional multiple daily injection method of controlling blood sugar were able to keep their glucose level in a safe range for only slightly over 50 percent of the time.

“In our most recent trials, we have demonstrated that our algorithms can keep subjects in a safe range for 80 percent or more of the time,” he said. The UC Santa Barbara AP’s Health Monitoring System sends user alerts in the form of messages and audible signals when problems arise, such as blood sugars that are trending low. Additionally, Doyle’s AP researchers have two other active grants funding research to examine how the device can monitor its own operations and alert users to potential malfunctions.

In future studies, pediatric AP testing will move to an outpatient component, in which subjects are given free rein over what they eat and do, but at locations near the clinic, with supervision from technical staff.

“But the home is where we want to get,” said Doyle, “with the normal routine, with no interference or intrusion. The true end-game is at home.”

Research for the development of this artificial pancreas is supported by the National Institutes of Health, award number DP3DK104057.

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UC plans to require vaccinations for incoming students

The plan is being phased in over three years.

Credit: iStock

By Alec Rosenberg

The University of California will require incoming students to be screened for tuberculosis and vaccinated for measles, mumps, rubella, chicken pox, meningococcus, tetanus and whooping cough, under a plan set to take effect in 2017.

Currently, the UC system only requires students to be vaccinated against hepatitis B, though several campuses have additional requirements.

The plan — designed to help protect the health of students and campus communities — has been in the works for a year. But the need is more pressing than ever, given the current multistate measles outbreak and the re-emergence of other vaccine-preventable diseases among those not completely immunized.

“I’m really excited that there’s support and momentum for this new immunization plan,” said Dr. Gina Fleming, medical director for the UC Student Health Insurance Plan. “We know that these preventive measures are effective.”

Three-year phase-in

The plan is being phased in over three years. The first phase focuses on building awareness among students about the upcoming requirement, with all fall 2015 incoming UC students receiving notification of the recommended vaccines and the process for making them mandatory. The intent of the plan is to set a baseline for all of UC, but does not prevent individual campuses from setting immunization standards for all students, or implementing the plan more rapidly.

It was developed based on recommendations from the California Department of Public Health, and in consultation with UC’s student health center directors, vice chancellors for student affairs and the UC system senior vice president for health sciences and services.

It will require that by 2017 all incoming students show documentation not only for hepatitis B vaccination but also for TB screening and four more vaccines: measles, mumps and rubella; meningococcus; varicella (chicken pox); and tetanus, diphtheria and pertussis (whooping cough).

“The University of California is committed to protecting the health and well-being of our students,” said Mary Knudtson, executive director of the UC Santa Cruz Student Health Center and chair of the UC Immunization Policy Committee. “Therefore, all of the UC campuses are implementing procedures to ensure that students are educated about, and receive, vaccinations to prevent potentially dangerous illnesses and undergo screening to identify those who may have infectious tuberculosis.”

Starting in fall 2016, all incoming UC students will be expected to have their required vaccines and enter the data into the university’s electronic medical record platform. But the plan is not to enforce the requirement until the following year. Starting in fall 2017, UC students who do not meet the vaccination requirement will have a hold put on their registration. The rationale for the phased approach is to ensure that the process runs smoothly before potentially impacting students’ ability to register for classes.

All UC campuses have experienced cases of vaccine-preventable diseases in recent years — something not unique among college campuses, which have varying vaccination requirements. For example, only about half of states have laws requiring all college students to be vaccinated against measles, according to a U.S. Centers for Disease Control and Prevention database.

“Despite the fact that many people receive the recommended vaccines, there are still documented cases of outbreaks of vaccine-preventable diseases in California and on the campuses each year amongst those who were not properly immunized,” Knudtson said. “All students are strongly encouraged to obtain the vaccines recommended by the California Department of Public Health prior to starting classes.”

Breaking down barriers

While getting such vaccines has long been considered a good public health practice, the cost of vaccines and the difficulty for student health staff to obtain and verify the information have been barriers to implementation.

Two developments have broken down those barriers, Fleming said. Now that the Affordable Care Act provides insurance coverage for vaccines, the cost of vaccination is less of a problem. Also, a new electronic medical record platform soon will allow UC students to directly enter their vaccination date. Four campuses will be piloting the module for entering vaccination data this fall, and the remaining campuses anticipate being able to use it by fall 2016.

The issue of immunization has evolved into a hot topic of discussion in California and across the nation in recent weeks after a measles outbreak that started at Disneyland. On Wednesday, state Senators Richard Pan and Ben Allen announced they will introduce legislation that would eliminate the ability for parents of school children to opt out of vaccinating their kids based on a personal belief.

UC’s plan will allow exemptions for medical or religious purposes, Fleming said. In the coming months, officials will discuss how to handle requests for other exemptions and how to validate the vaccination information.

“We need to be mindful of the population we’re serving,” Fleming said.

UC’s plan might be extended to already enrolled students and additional vaccines could be added later, such as meningococcus B, Fleming said. Vaccines recommended for preventive care include vaccines for hepatitis A, HPV, influenza, polio and pneumococcal pneumonia.

Officials are determining whether additional approvals are needed to adopt the plan, Fleming said, even as they move forward with implementation.

Meanwhile, leadership in student affairs and student health centers are working with other campus departments to inform students about the plan.

“That’s really a critical piece,” Fleming said. “We can’t expect students to adhere to a requirement that they haven’t heard about. They need to know what the plan is.”

Related link:
Associated Press: Los Alamos National Lab creates website for measles fight

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Restoring touch to amputees

DARPA taps Livermore Lab to enable naturalistic feeling, movements in prosthetic hands.

Lawrence Livermore National Laboratory engineer Sat Pannu and his Neural Tech Group research team are developing wireless electronic packages for HAPTIX called smart packages. These packages would contain electronics that record and stimulate the peripheral nervous system to control movement and sensation in a patient’s prosthetic hand. (Photo by Julie Russell, Lawrence Livermore National Laboratory)

By Kenneth Ma, Lawrence Livermore National Laboratory

The Defense Advanced Research Projects Agency (DARPA) recently selected Lawrence Livermore National Laboratory (LLNL) to join a collaborative research team that intends to build the world’s first neural system to enable naturalistic feeling and movements in prosthetic hands.

Known as Hand Proprioception and Touch Interfaces (HAPTIX), the program seeks to provide wounded service members with dexterous control over advanced prosthetic devices that substitute for amputated hands. If successful, HAPTIX intends to give patients the psychological benefit of having natural sensation in their prosthetic hands and reduction of “phantom limb” pain, a sensation some amputees can feel despite the removal of a limb.

Lawrence Livermore’s Neural Tech Group and their collaborators (Case Western Reserve University and the Louis Stokes Cleveland Veterans Administration Medical Center) intend to develop neural interface systems that measure and decode motor signals recorded in peripheral nerves and muscles in the forearm by using tiny electrodes.

“The HAPTIX project intends to achieve a phenomenal breakthrough in prosthetics never thought possible,” LLNL’s project leader Sat Pannu said. “Its neural system intends to re-create a range of functions, including a real feeling of touch when holding another person’s hand.”

For these neural interface systems, LLNL intends to further develop the advanced prosthetic limb systems developed under DARPA’s Revolutionizing Prosthetics and Reliable Neural-Interface Technology (RE-NET) programs, which has made major steps forward in providing a direct and powerful link between user intent and prosthesis control.

The HAPTIX program intends to incorporate sensors that provide tactile and proprioceptive feedback to the patient from their hands, delivered through a patterned stimulation of sensory pathways in peripheral nerves.

The Revolutionizing Prosthetics and RE-NET programs, combined with the neural interface systems, intends to allow users to control prosthetic hand movements with their thoughts and have natural sensations. That means the bionic hand would be able to perform movements of a human hand and experience pressure, touch and texture.

One of HAPTIX’s key challenges is identifying stimulation patterning strategies that elicit naturalistic sensations of touch and movement. The ultimate goal is to create a fully implantable device that is safe, reliable, effective and approved for human use.

Pannu and his team of engineers are developing wireless electronic packages for HAPTIX called smart packages. These packages would contain electronics that record and stimulate the peripheral nervous system to control movement and sensation in a patient’s prosthetic hand.

Smart packages intend to be designed to miniaturize electronics normally the size of a third of a cell phone into a package the size of a watch battery. The electronics would be made of ceramics and titanium, biocompatible materials that would seal the package tightly, preventing components from leaking into nerves or human tissue from entering the package.

“The packages have to be really small, so they don’t put any weight or pressure on the nerves,” said Pannu, adding that the smart packages need to bond with the electrodes to function. “We don’t want to damage the nerves.”

The Neural Tech Group also is collaborating with Medtronic and Ardiem Medical. Some collaborators plan to develop the electrode arrays for sensation and muscle control, while others aim to validate and characterize it.

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UCSF Medical Center at Mission Bay opens

Large-scale transport completed with support of city of San Francisco agencies.

More than 130 patients were carefully transported from Parnassus and Mount Zion campuses to the new UCSF Medical Center at Mission Bay on Feb. 1. (Photo by Noah Berger)

>>Related: UCSF Medical Center at Parnassus and Mount Zion to expand care

>>Related: President Bill Clinton tours new UCSF hospitals

By Karin Rush-Monroe, UC San Francisco

With 40 ambulances, approximately 300 UCSF staff and faculty, as well as 100 emergency medical services personnel, UCSF Medical Center on Sunday, Feb. 1,  safely transported 131 patients to the new UCSF Medical Center at Mission Bay from its Parnassus and Mount Zion campuses.

The move day started at 7 a.m. on the UCSF Parnassus campus; later in the day patients also were transported from the UCSF Mount Zion campus. The last patient to be moved arrived at UCSF Medical Center at Mission Bay at 3:33 p.m. The new medical center also greeted the first baby born at the new hospitals, a healthy boy who entered the world at a little more than seven pounds.

The opening of the new hospitals was the culmination of more than 10 years of planning and construction of the complex, which includes UCSF Benioff Children’s Hospital San Francisco, UCSF Betty Irene Moore Women’s Hospital, UCSF Bakar Cancer Hospital and the UCSF Ron Conway Family Gateway Medical Building.

The move day, itself, reflected significant planning. “Patient safety was our top priority during the patient move, along with minimizing disruption to our neighbors. We achieved both goals, thanks to the superb work of our medical center faculty and staff as well as our partners in the City of San Francisco,” said Mark R. Laret, CEO of UCSF Medical Center and UCSF Benioff Children’s Hospitals. “We have been looking forward to this day for some time, and the opportunity to start providing care in our new location at UCSF Mission Bay.”

The majority of patients who made the trip on Sunday were children, as UCSF Benioff Children’s Hospital San Francisco moved from Parnassus to its new home at UCSF Mission Bay.

Strategically located on UCSF’s world renowned UCSF Mission Bay biomedical research campus, the new medical center puts UCSF physicians in close proximity to UCSF researchers and nearby biotechnology and pharmaceutical companies in Mission Bay and beyond who are working to understand and treat diseases ranging from cancer to cardiovascular disease to neurological conditions.

“Placing the hospitals on our Mission Bay campus underscores our commitment to driving discoveries toward patient care, ensuring that our world-class researchers are working in close proximity to our leading clinical researchers and physicians in the hospitals,“ said Sam Hawgood, M.B.B.S., chancellor of UC San Francisco.  “They also will provide invaluable training for our medical students, the next generation of clinicians who will take care of patients at health care facilities across California and nationally.

“Significantly, the move also frees up space on our Parnassus and Mount Zion campuses, which will allow us to enrich our medical programs for adult patients there. With the opening of the hospitals at Mission Bay, we now have integrated clinical care and research programs on all of our campuses, the critical factor that has contributed to UCSF’s local, regional and global impact.”

The UCSF Parnassus campus will be restructured to provide more specialized clinical services, such as transplants, and the UCSF Mount Zion campus will become a world-class hub for outpatient care.

“UCSF Medical Center’s new $1.5 billion, state-of-the-art campus in our city’s Mission Bay neighborhood will help improve the health of children, women and cancer patients,” said San Francisco Mayor Ed Lee. “This is not just a milestone for UCSF; this is a milestone for our city and our city’s health care industry, which is at the heart of our economy providing good jobs for our residents.

“Right before our eyes, we have seen the transformation of this underutilized railyard in Mission Bay into an epicenter where new discoveries and innovation in medicine are saving lives around the world. By working together with our great partner UCSF, and the many generous philanthropists that helped build these new hospitals, we will continue to ensure our residents get the highest quality of health care.”

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UC Food Observer blog launches

Learn more in Q&A with blog curator Rose Hayden-Smith.

Credit: Classic Film / CC BY 2.0

The University of California has launched UC Food Observer, a daily selection of must-read news on food policy, nutrition, agriculture and more.

Developed as part of its Global Food Initiative, the UC Food Observer blog (www.ucfoodobserver.com) and related social media channels capture and highlight important news and further discussions about the world of food.

Find out more in this Q&A with UC Food Observer curator Rose Hayden-Smith, a UC academic, author and historian.

Rose Hayden-Smith

What can readers expect from UC Food Observer?
UC Food Observer offers a daily roundup of interesting news, reports and thought pieces from a broad range of sources that represent diverse perspectives. The intent is not to focus on UC, but instead allow UC to reflect and perhaps add to the very important discussions that are occurring. Pieces will be posted throughout the day on the UC Food Observer website and social media. The goal is to achieve a balance of perspectives and topics in the lineup. If it might help the reader, larger context may be provided, through background information or additional links in a posting. There also will be an original long-form piece a couple of times each month by me and guest commentators. And UC Food Observer will be engaging actively with people across social media. The hope is to add value to the conversation and to provide a service.

What’s the inspiration for the blog?
The idea originated with our colleague, Pete King. With interest in food and agriculture at an all-time high, it seemed like there might be space for something like this: a knowledgeable, curated selection of what’s important and interesting in the dialogue around food. There’s an incredible amount of good information on any number of topics relating to food and agriculture. There are big ideas out there, and great conversations occurring. If UC Food Observer can help share some of that information, highlight key themes and connect people, it will be a good thing. The more we all know, the better.

Why is the blog needed?
To have a neutral voice pulling together the most important and interesting parts of the conversation around food gives both food insiders and the general public another source of information that hopefully will reflect the constantly evolving food landscape. We hope that the blog will add value to the myriad conversations occurring; not only by including and sharing the terrific work that’s being produced by others, but also by providing some unique, original content. We also hope that the blog may engage audiences who have not previously been as engaged in food systems work. Everyone eats. Everyone is a stakeholder in the food system.

How do you decide what to include in the blog?
It’s a process of continually scanning the environment, talking to people and organizing a well-balanced “menu” of content each day. The team has a calendar of key gatherings that one of us either attends or “watches” via social media. The content will reflect diverse interests and follow many threads of discussion. A part of the decision-making lies in thinking about what might inform and inspire others.

Included is breaking news and information that’s less time-sensitive — for example, perhaps the release of a significant report. A daily lineup generally will include news, information about events and some lighter pieces such as book reviews. We’ll share different things on each platform, so the articles shared on Facebook may differ from the articles included in the blog. Content is organized around a couple of dozen categories ranging from local events to issues of global importance. Featuring UC news is not a primary goal; institutional news finds its way into the lineup on its own merit.

The original pieces will vary, but readers can certainly expect some to include a historical perspective and how the lessons of the past might apply to contemporary issues.

You’re an author, historian and garden educator. How will that inform your curation for UC Food Observer?
I have an unusual professional background. I consider myself a “consilient” thinker (i.e., literally the “jumping together of knowledge” from various disciplines, as explained by British polymath William Whewell). I’ve worked as both a technical and more creative writer. I’ve worked in the technology industry, been an educator, a youth development professional in 4-H, a Master Gardener advisor, done some advocacy work as a W.K. Kellogg Foundation Fellow and served as leader for UC Agriculture and Natural Resources’ strategic initiative in sustainable food systems.

My training as a U.S. historian always gives me pause to consider context and to examine how current practices might be influenced by the past. I’ve curated exhibits and online content as a historian. You make decisions about content, and hopefully they are inclusive, representative and honor various perspectives. I am always eager to understand how we got here. I consider my work as a historian a scientific enterprise: I study the rate, nature and character of change over time.

My personal experience as a school and community garden educator has shaped my thinking in profound ways. I think I bridge social and cultural understandings of food systems with more technical aspects and systems thinking. Things are inextricably linked in a food system — it truly is a web — and I like to think about issues from the hands-on, local level to the broadest implications of that work (often global).

As a UC academic and alum, what led to your interest in this position?
This position combines all the things that I am most passionate about in a single enterprise. I love the opportunity to learn about new things in the food system every day, and being able to cover a broad intellectual and cultural landscape is appealing. I’m a communicator by nature: writing, interacting and connecting with others are all fundamental aspects of who I am. I think the topic of food is incredibly interesting, nuanced, varied and rich … and I think understanding food systems is vital to nearly every challenge we face in the world.

I’m thrilled that UC is engaging in this work. UC has influenced my life in amazing ways … and that experience of influence and learning is still unfolding. I participated in the 4-H program as a youth, was in-residence at UC for summer programs during high school, and attended UC as an undergraduate and graduate student (the last one: three times). Over the course of my career, I have worked in campus-based academic departments, campus extension, the Cooperative Extension service and in student affairs. I am amazed each day — anew — by how the UC system influences our day-to-day lives in the most positive of ways locally and in a more global sense. I reflected a little about all of this in a California Agriculture article I wrote on the 150th anniversary of the Morrill Land Grant Act. It’s a wonderful opportunity — and a privilege — to be part of UC’s work in this critical area.

If you could change one thing in the food system, what would it be?
That’s a difficult question. So many changes are needed. In my book, which was published last year, I identify 10 steps that I think people could take to effect change; many relate to gardening, which is a passion of mine. There’s been a great deal of discussion recently about an op-ed written by Mark Bittman, Michael Pollan, Ricardo Salvador and Olivier De Schutter. It appeared in the Washington Post and called for a national food policy. It’s a bold idea … and a necessary one.

I encourage what I term a “fundamental restructuring of agricultural and food policies.” What we have currently is a hodge-podge of regulations and policies that are often in contradiction with one another and that don’t always serve us (people and the environment) well. We need a more coherent national policy that considers all aspects of the food system. Our national policy impacts the global food system.

I remain extremely concerned about childhood nutrition and food access. As a nation, we’ve struggled with this for decades. Childhood nutrition and food access are among the great moral issues of our time – they need to be addressed and resolved.

At the outset of WWII, Vice President Henry Wallace told the nation, “On a foundation of good food we can build anything. Without it we can build nothing.”

I know Wallace has a mixed legacy, but this statement strikes me as both a profound truth and a goal we ought to aspire to.

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Tackling brain injuries head on

UC Davis scientists developing system to better assess on-field concussions.

For much of this fall, as in falls past, a Friday night crowd comes out for the weekly football game and likely witnesses the star running back getting rattled by a hard tackle.

The coach faces a decision: keep the player in the game and risk serious head injury or pull him and face the wrath of the player, the team and the crowd. What the coach needs is a way to accurately assess the player’s status – right now.

This scenario is being played out at sports fields around the world. How do we make objective decisions about a player’s health in the heat of competition?

The problem intrigues UC Davis physician Khizer Khaderi. A neuro-ophthalmologist, Khaderi is applying his expertise in the eye-brain connection to investigate traumatic brain injury (TBI). Whether the result of a car accident, explosion, skiing or a tackle, TBI can affect vision, memory and even mental health.

Imperfect solutions

Khaderi and colleagues are developing a system that will take the guesswork out of assessing an on-field concussion, an early form of TBI.

It would replace a system of neurocognitive tests that many teams use now. In these tests, a player is asked a number of questions, of which answers are compared to baseline results recorded earlier. However, with players’ strong incentive to stay in the game, some have learned to circumvent the system.

“One of the problems with the neurocognitive approach is that it’s very subjective,” says Khaderi, an assistant professor of clinical ophthalmology and head of the Sports Vision Lab. “Players will intentionally do poorly on the baseline test, so if they do get injured, it won’t look as severe.”

Khaderi’s solution focuses on the eyes. A third of the brain is devoted to the visual system, making the eyes an ideal window on brain health. Several biometric tests exist but Khaderi’s team has found that relying on three established biometric tests greatly increases the chances of accurately assessing TBI risk on the field in real time.

UC Davis neuro-ophthalmologist Khizer Khaderi tests a system he and his team developed to facilitate a quick assessment of an on-field concussion, an early form of traumatic brain injury. Helping with the test is medical resident Rachel Simpson.

Eyes, pupils and brain waves

Using eye movements to assess TBI has advantages. For example, researchers have measured how long the eye takes to move from a central to peripheral focus. This would be the motion a driver would make when shifting attention from the road to a child crossing it. This motion takes less than seven-tenths of a second for a healthy person, but much longer for those who’ve experienced a brain injury.

The opposite motion is also informative. In the same scenario, the driver could make the decision to look away from the child stepping into the road.

“The natural reaction is to look at the child,” says Khaderi, “but instead you look away. This involves cognition, so it’s a good measure of executive function.”

Pupil function can also measure an injury’s severity. A coach could use a flashlight to assess dilation, but background light can skew results. To combat this, Khaderi has adopted a psychological method called the International Affective Picture System, which uses pictures to make the pupil respond.

The third metric measures brain waves. When they’re awake, people generally have a higher ratio of fast alpha waves to slow theta waves. However, that ratio is reversed after a brain injury. High theta waves indicate a dreamy state of mind.

Moving forward

Khaderi plans to bring these tools to playing fields everywhere. Fortunately, much of this technology is being used for other purposes and can be repurposed for TBI detection.

“Our goal is to create a platform that integrates commercially available eye tracking hardware and EEG (brain wave) systems,” says Khaderi.

The group has found a development partner and is working with the UC Davis athletic department to set up clinical trials. The ultimate goal is to create a system that could be accessed through a tablet computer or other device.

“These injuries don’t just strike kids who are playing sports, but anyone who leads an active life,” says Khaderi. “Our brains are precious and we need to do all we can to protect them.”

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Related link:
UC Davis Medicine magazine

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