UC San Diego chancellor visits Tijuana to learn about industry, health care and education.

Health Frontiers in Tijuana Clinic

From touring the production floor of one of Mexico’s best places to work to witnessing a student-run free health clinic in action, UC San Diego Chancellor Pradeep K. Khosla’s visit to Tijuana, Mexico, Friday offered him an introduction to the bustling metropolis just across the border from San Diego. The one-day tour included visits to Hospital Angeles Tijuana, the Health Frontiers in Tijuana Clinic, the Business Innovation and Technology Center, El Florido Parque Industrial, and the Culinary Art School.

“I’m pleased to have the opportunity to meet with our community partners in Tijuana and learn more about this region and cross-border issues,” said Khosla. “My goal is to strengthen the existing partnerships between UC San Diego and our neighboring country, and pursue other opportunities for collaboration. Our teamwork is vital for the economic and social growth and prosperity of our regions, and we look forward to the ongoing exchange of ideas.”

Accompanying Khosla in Tijuana were Mary Walshok, associate vice chancellor for Public Programs at UC San Diego; Juan Lasheras, interim dean of the Jacobs School of Engineering; Alberto Díaz-Cayeros, director of the university’s Center for U.S.-Mexican Studies; and James Clark, director general of the Mexico Business Center at the San Diego Regional Chamber of Commerce, who helped arrange the trip.

The day began with a visit to Hospital Angeles Tijuana, Mexico’s largest private hospital network and a top-tier facility for medical care. In a series of brief presentations, Khosla was introduced to the hospital’s breadth of services, novel technology and leading-edge research. Representatives from UC San Diego and Hospital Tijuana discussed where there may be opportunities for future collaboration, from research and clinical trials to training students.

Next on the tour was a visit to a different side of healthcare in Tijuana: a student-run free clinic in one of the city’s poorest districts. About a dozen patients, many homeless, gathered in the alley in front of the Health Frontiers in Tijuana (HFiT) Clinic, waiting to be seen.

The HFiT Clinic is a collaborative project of UC San Diego and the Universidad Autónomo de Baja California. Students from both sides of the border are mentored by faculty at the clinic to provide free care for underserved populations in Tijuana. Faculty and students also collaborate on a number of research projects focusing on HIV and STD prevention, substance abuse, policing practices and sex trafficking.

“There is an intense need for health services here,” said Steffanie Strathdee, associate dean of global health sciences at UC San Diego, as she gave an overview of the project. “We align research, training and service. And we, the professors, learn as much from the students as they learn from us.”

Before leaving the site, Khosla thanked the graduating medical students for their work. “What you’re doing here is truly amazing,” he said. “I had heard about some of this work, but it is not the same as being here today and seeing the impact.”

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UCLA working group helps Guatemalans.

High above a village of shanties in Guatemala, plastic and reconstructive surgeon Dr. Reza Jarrahy of UCLA hauls concrete bricks to make stoves to replace wood-burning ones that spread soot in people's homes.

UCLA plastic and reconstructive surgeon Reza Jarrahy realized that he was missing something when his young Guatemalan patient developed a mysterious infection after undergoing surgery. That puzzled the surgeon, who travels Guatemala twice a year to do pro bono surgery on people from indigenous communities.

“I knew these people were destitute, uneducated and medically unsophisticated, but I didn’t appreciate the deeper social context in which they were living and how that influenced surgical outcomes,” said Jarrahy.

The realization that caring for indigenous people in parts of the world like Latin America requires more than just medical knowledge and skills has brought physicians and public health experts together with anthropologists and others from across the campus to learn from each other under the auspices of the UCLA Latin American Institute.

Funded by a Title VI grant from the U.S. Department of Education, this UCLA working group, led by Jarrahy, a board-certified plastic surgeon specializing in pediatric plastic surgery and craniofacial surgery, and Bonnie Taub, a medical anthropologist who teaches anthropology as well as public health, met recently for the first of a series of three symposia hosted by the institute to discuss how Westernized health care can intersect with traditional healing practices and beliefs.

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UC San Diego’s Raul Coimbra part of World Health Organization initiative.

Raul Coimbra, UC San Diego

Raul Coimbra, M.D., Ph.D., FACS, is the only trauma surgeon in the western United States recently invited to be part of the Global Alliance for the Care of the Injured (GACI) – a World Health Organization initiative to improve trauma care in low and middle income countries.

“One of the goals of the GACI is to teach standards in trauma care, data collection, injury surveillance and quality improvement,” said Coimbra, chief of the Division of Trauma, Surgical Critical Care and Burns at UC San Diego Health System. “It is crucial that we share our experiences in the United States around the world. Trauma is a major public health problem, and extending high quality of care to patients worldwide will also improve the way Americans traveling receive health care.”

As president of the first World Trauma Congress held in Rio de Janeiro last year and president of the World Coalition for Trauma Care, a collaborative of multiple professional organizations to advance trauma care, education, prevention and systems development, Coimbra is deeply devoted to international outreach.

“Trauma is a disease that exhibits a pattern with causes that can be defined. It is preventable. If we treat trauma as a disease, with efforts toward prevention, we’ll save lives and make people and communities safer,” said Coimbra.

UC San Diego Health System established the region’s first Level I trauma center, and the highly trained personnel and special facilities are part of the collaborative San Diego Trauma System. Coimbra is recognized internationally as a trauma care expert and pioneer. The San Diego Trauma System has become a model for trauma centers around the world and for the upcoming 2014 World Soccer Cup and 2016 Olympic Games in Brazil.

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May 1 symposium to be Blum Center’s inaugural event.

UCLA has formed the UCLA Blum Center on Poverty and Health in Latin America, where faculty and students from multiple disciplines will work with other institutions to conduct research, develop training programs and promote innovative policy solutions aimed at addressing key social and health-related issues in the region.

“As a public university, UCLA has a duty to address the world’s challenges, and our cross-disciplinary strengths in medicine, public health, humanities, social sciences, research and public policy position us to make a difference,” said UCLA Executive Vice Chancellor and Provost Scott Waugh. “We have strong ties to Latin America and welcome the opportunity to strengthen our collaborations with other academic institutions, nonprofit groups and nongovernmental organizations in the region. The UCLA Blum Center is a team effort that draws faculty and students from across campus who are committed to redressing issues of poverty and health in Latin America.”

Dr. Michael Rodriguez, professor and vice chair of research in the department of family medicine at the David Geffen School of Medicine at UCLA, will serve as the center’s director.

“The programs of this new center reflect our mission to work collaboratively with a wide range of UCLA disciplines, as well as Latin American partnering institutions, to identify and promote solutions in health policy and practice,” Rodriguez said. “We expect to build the center into a preeminent authority in our three focus areas — research, policy and training on the social determinants contributing to health inequalities in Latin American populations.”

UC San Diego researcher spreads word about potential short-term win vs. climate change.

Veerabhadran Ramanathan, UC San Diego

A push to curb air pollution as a means of slowing the pace of climate change is gaining momentum as a UC San Diego Scripps Institution of Oceanography researcher takes his message to new audiences.

Veerabhadran Ramanathan, a distinguished professor of climate and atmospheric sciences at Scripps, published new findings April 14 that control of certain pollutants can significantly attenuate sea-level rise. Prior to that, Ramanathan framed the issue as a matter of climate justice during an event at UC San Diego on April 10 with former Irish president and human rights advocate Mary Robinson. Next week, Ramanathan will take the message to Congress, when he takes part in a hearing on the benefits of controlling emissions of methane, a key greenhouse gas.

Ramanathan’s research over the past two decades has led him to conclude that if emissions of soot, methane, and refrigerants and the formation of ozone can be controlled, the speed at which global average temperatures are rising could be cut nearly in half. In combination with efforts to control emissions of carbon dioxide, the most ubiquitous greenhouse gas produced by everyday activities, mitigation of such pollutants could help society avoid many of the dangerous consequences of climate change, according to Ramanathan.

The veteran researcher, who joined UC San Diego’s Scripps Institution of Oceanography in 1990, has sought to inform a wide range of legislative and even spiritual leaders about this solution, operating outside of common science channels to engage diplomats and religious leaders. Ramanathan made pollution control the centerpiece of his remarks during the April 2012 visit of the 14^th Dalai Lama to UC San Diego. Ramanathan had previously witnessed the creation of a multilateral initiative to curb pollution launched by then-U.S. Secretary of State Hillary Clinton. The Climate and Clean Air Coalition to Reduce Short-Lived Climate Pollutants began in February 2012 with six countries and the United Nations Environment Programme as members. It has grown to 25 members in the past 14 months.

“I’ve been encouraged at the reception this concept has received,” said Ramanathan. “I think policymakers are impressed when they understand that they can achieve relatively fast results using technologies that are already available. This kind of action needn’t be delayed by the need to achieve global political consensus that has prevented action on climate before. Countries can do this now and reap the benefits themselves.”

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Computer scientist aims to integrate health data and make it globally available by phone.

Ramesh Jain, UC Irvine

Ramesh Jain is wired for health. The courtly UC Irvine computer science professor has a black NikeFuel wristband that flashes blue numbers, an oblong black amulet dubbed Fitbit around his neck, and a special app on his iPhone. All let him know – waking or sleeping, walking to class or waving his arms – exactly the amount of energy he’s burning and other key health indicators. As someone who has conquered cancer, that’s important to him.

Soon, thanks to work he and his team are doing, his doctors and many others should be able to download data from multiple sources and have it processed into a complete picture of a patient’s health. They could then recommend behavioral changes, customized treatments and other lifesaving measures.

Jain wants everyone in the world, rich or poor, to have access to such mobile health aids, via an innovative process he and his students call “social life networks.” Three to four billion people globally have no access to computers but do possess so-called “feature phones” which have wireless Internet access and limited images. Jain thinks mobile networks could be a godsend in rapidly growing economies where food, water, health care, transportation and education are still often substandard.

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UC Berkeley discovery leads to production of partially synthetic version of arteminisin.

Twelve years after a breakthrough discovery in his UC Berkeley laboratory, professor of chemical engineering Jay Keasling is seeing his dream come true.

Today (April 11), the pharmaceutical company Sanofi will launch the large-scale production of a partially synthetic version of artemisinin, a chemical critical to making today’s front-line antimalaria drug, based on Keasling’s discovery.

Jay Keasling with children in a village outside Nairobi, Kenya

The drug is the first triumph of the nascent field of synthetic biology and will be, Keasling hopes, a lifesaver for the hundreds of millions of people in developing countries who each year contract malaria and more than 650,000, most of them children, who die of the disease. Synthetic biology involves inserting a dozen or more genes into microbes to make them produce drugs, chemicals or biofuels that they normally would not.

Keasling and colleagues at Amyris, a company he co-founded in 2003 to bring the lab-bench discovery to the marketplace, will publish in the April 25 issue of Nature the sequence of genes they introduced into yeast that allowed Sanofi to make the chemical precursor of artemisinin. The paper became available online April 10.

“It is incredible,” says Keasling, who also serves as associate director for biosciences at Lawrence Berkeley National Laboratory and as CEO of the Joint BioEnergy Institute in Emeryville. “The time scale hasn’t been that long, it just seems like a long time. There were many places along the way where it could have failed.”

The yeast strain developed by Amyris based on Keasling’s initial research and now used by Sanofi produces a chemical precursor of artemisinin, a compound that until now has been extracted from the sweet wormwood plant, Artemsia annua. Artemisinin from either sweet wormwood or the engineered yeast is then turned into the active antimalarial drug artesunate, and typically mixed with another antimalarial drug in what is called arteminsinin combination therapy, or ACT.

Global demand for artemisinin has increased since 2005, when the World Health Organization identified ACTs as the most effective malaria treatment available. Sanofi said that it is committed to producing semisynthetic artemisinin at its new production line in Gerassio, Italy, using a no-profit, no-loss production model, which will help to maintain a low price for developing countries. Though the price of ACTs will vary from product to product, the new source for its key ingredient, in addition to the plant-derived supply, should lead to a stable cost and steady supply, Keasling said.

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View live webcast April 9.

By Carolyn McMillan

There are now more than 7 billion people on Earth, a number that is expected to soar over the next dozen years to 8 billion.

How will we feed so many people? Already, more than a billion people go hungry every day. With population growth accelerating, the challenge of finding sustainable ways to feed the world is compounded by global climate change, shifting geo-politics, rising energy demands and limits on natural resources.

“It’s one of the big questions of our time: How do we sustainably feed 8 billion people?” said Barbara Allen-Diaz, vice president of the University of California’s Division of Agriculture and Natural Resources. “UC is uniquely positioned to bring people together across a wide range of disciplines in search of common ground and science-based solutions.”

On April 9, ANR will convene some of the world’s leading experts — farmers, researchers, policymakers, economists, environmentalists and geopolitical experts — at a daylong forum focused on addressing how to sustainably feed 8 billion people by 2025.

Keynote speakers at the Global Food Systems Forum include Mary Robinson, former president of Ireland and a leader on climate justice for the world’s poor, and Wes Jackson, founder and president of the Land Institute.

The event will be webcast, and is open to everyone via online registration. People have registered from around the world — including Australia, Kenya, Thailand and Venezuela, to name just a few places. In fact, Antarctica is the only contintent not represented among webcast attendees.

“Our goal is to start a national and international conversation,” Allen-Diaz said. “There are so many interconnected issues and none of them will be addressed overnight. It’s going to take collaboration and dialogue to get where we need to go. We see an important role for UC in furthering that conversation.”

ANR already has launched a website and blog featuring commentary and insight from forum participants on topics as divergent as whether women are disproportionately affected by food insecurity to the debate about whether organic foods are better than genetically modified ones.

Michael Specter, who writes about global issues for the New Yorker, will moderate a panel focusing on the political, ethical, economic, environmental and technical challenges facing food systems from a global perspective.

In a 2010 TED talk, he framed the environmental challenge succinctly:

“We’ve used our imagination to thoroughly trash the globe. Potable water, arable land, rainforests, oil, gas — they are all going away. And they’re going away soon. And unless we can innovate our way out of this mess, we’re going away, too. The question is, can we do that? And I think we can.”

UC is especially suited to the search for solutions: Its discoveries in crop management, pest control and agricultural machinery have helped farmers around the world boost productivity. UC researchers also discovered how to leach salts from Central Valley soils, a development that transformed California into the most productive farming region in the world.

Journalist Mark Arax, who has written extensively about California, will moderate a panel focusing on the state’s role as an innovator in addressing the looming food challenge. A range of UC and non-UC people will participate.

“For almost 100 years, ANR has used the power of scientific research to improve agricultural production and protect our natural resources,” Allen-Diaz said. “This forum will help us continue in that leadership role and prepare for the uncertainties that lie ahead.”

To learn more about the UC Global Food Systems Forum and to sign up to view the webcast, visit http://food2025.ucanr.edu. You may also join the ongoing conversation on Twitter by following #Food2025.

Global Food Systems Forum webcast

WHAT: Live webcast of UC ANR Global Food Systems Forum

WHO: World-renowned leaders in food systems dialogue. View participant list.

WHEN: 9 a.m.–5 p.m. April 9, 2013

WHERE: Register for the webcast.

Study examines relationship between birth control use and cultural preference for sons.

Anita Raj, UC San Diego

While poverty and under-education continue to dampen contraception use in Nepal, exacerbating the country’s efforts to reduce maternal and child mortality rates, researchers say another, more surprising factor may be more intractable: Deeply held cultural preferences for sons over daughters.

Writing in the March 7 online International Journal of Gynecology and Obstetrics, scientists from the UC San Diego School of Medicine found that geography (urban versus rural), age and levels of education, wealth and social status all predictably influenced whether Nepalese women used birth control.

Young wives in Nepal were among those least likely to use contraceptives, 24 percent of wives ages 20-24 and just 14 percent of wives ages 15 to 19 years old. These low percentages, said first author Anita Raj, Ph.D., professor of medicine in the UC San Diego School of Medicine, were particularly notable among young wives who did not have any sons.

“Daughter aversion” reflects a profound, historical cultural bias in Nepal and in other central and south Asian countries, said Raj, an international authority on gender issues in the region. Part of the reason is financial, she said. Males traditionally enjoy greater economic opportunity.

“But tradition also says sons take care of parents,” Raj said. “Daughters are supposed to leave the family and become the daughter of the in-laws, no longer the daughter of the parents. Practices like that are going to affect investment in your daughters.”

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UCLA researchers’ models reveal potential super-flu danger zones.

Potential influenza reassortment areas in Egypt

This year’s unusually long and rocky flu season would be nothing compared to the pandemic that could occur if bird flu became highly contagious among humans, which is why UCLA researchers and their colleagues are creating new ways to predict where an outbreak could emerge.

“Using surveillance of influenza cases in humans and birds, we’ve come up with a technique to predict sites where these viruses could mix and generate a future pandemic,” said lead author Trevon Fuller, a UCLA postdoctoral research fellow at the Institute of the Environment and Sustainability’s Center for Tropical Research.

The researchers’ models revealed that coastal and central China and Egypt’s Nile Delta are danger zones where bird flu could combine with human flu to create a virulent kind of super-flu. Governments can prioritize these zones — and use the researchers’ models to identify other hotspots — for increased monitoring of flu in humans, livestock, poultry and wild birds. That could help detect a novel flu virus before it spreads worldwide, the researchers said.

The research paper, “Predicting Hotspots for Influenza Virus Reassortment,” was published today (March 13) in the peer-reviewed public health journal Emerging Infectious Diseases.

Previous pandemics, such as the 1957 and 1968 influenzas that each killed more than a million people or the 2009 H1N1 swine flu outbreak that killed 280,000 worldwide, developed when viruses from humans and animals exchanged genes to create a new virus in a process called reassortment. Recent research using mice confirms that genes from bird flu and human flu can combine to create dangerous new flu strains. Swine, which are susceptible to both bird and human flu, could serve as a mixing vessel for reassortment between the two viruses.

“The mixing of genetic material between the seasonal human flu virus and bird flu can create novel virus strains that are more lethal than either of the original viruses,” said senior author Thomas Smith, director of the Center for Tropical Research and a professor at UCLA’s Institute of the Environment and Sustainability and the UCLA Department of Ecology and Evolutionary Biology.

“These findings predicting potential outbreak sites can help decision-makers prioritize the most important areas where people, poultry and livestock should be vaccinated and animals should be monitored for novel viruses, which could help predict and prevent the next pandemic,” he said.

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UC Irvine study finds phenomenon more marked in developing countries.

Sarah Pressman, UC Irvine

Positive emotions are known to play a role in physical well-being, and stress is strongly linked to poor health, but is this strictly a “First World” phenomenon? In developing nations, is the fulfillment of basic needs more critical to health than how one feels? A UC Irvine researcher has found that emotions do affect health around the world and may, in fact, be more important to wellness in low-income countries.

The study, which appears online in Psychological Science, is the first to examine the emotion-health connection in a representative sample of 150,000 people in 142 countries. Previous research on the topic has been limited to industrialized nations.

“We wondered whether the fact that emotions make a difference in our health is simply because we have the luxury of letting them,” said Sarah Pressman, assistant professor of psychology & social behavior and the study’s lead author. “We wanted to assess the impact of emotions on health in places where people face famine, homelessness and serious safety concerns that might be more critical correlates of wellness.”

Against expectations, researchers found that the link between positive emotions (enjoyment, love, happiness) and health is stronger in countries with a weaker gross domestic product. In fact, the association increased as GDP decreased, according to Pressman.

People in Malawi, which has a per capita GDP of $900, show a more robust connection between positive emotions and health than residents of the U.S., which has a per capita GDP of $49,800.

“A hostile American with hypertension can take blood pressure-lowering medication. A Malawian cannot,” Pressman said. “Medical interventions might lower the impact of emotions on health.”

Using data from the Gallup World Poll, researchers noted whether participants had reported experiencing enjoyment, love, happiness, worry, sadness, stress, boredom, depression or anger during the previous day. They also measured physical health and the degree to which subjects’ basic needs were met. Security was assessed by asking if participants felt safe walking alone at night or whether they had been robbed, assaulted or mugged.

“We hope that by showing that this phenomenon is prevalent and stronger than some factors considered critical to wellness, more attention will be drawn to the importance of studying both positive and negative emotions,” Pressman said.

She co-authored the study with Shane Lopez of the Gallup Organization and Matthew Gallagher of Boston University.

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