TAG: "Innovation"

Genomics initiative launch draws enthusiastic industry, academic partners


UC Berkeley-UCSF partnership will apply new gene-editing techniques to improve health.

By Robert Sanders, UC Berkeley

Several hundred guests crowded the lobby of the Li Ka Shing Center for Biomedical and Health Sciences Wednesday night (Feb. 4) as the campus celebrated the launch of the Innovative Genomics Initiative (IGI), a partnership between UC Berkeley and UC San Francisco researchers and the biopharmaceutical industry to perfect new gene-editing techniques and apply them to drug development and global health in general.

Among the attendees were a representative from the Li Ka Shing Foundation, which was an early lead supporter of IGI, as well as representatives from two pharmaceutical companies – AstraZeneca and Agilent – that have signed agreements to partner with IGI to use the CRISPR/Cas9 technology to better understand diseases and speed the development of new drugs to treat them.

“The science is cool, but the kind of collaborative structure we have is cool as well,” said Lorenz Mayr, vice president for reagents and assay development at AstraZeneca.

IGI, located in the Li Ka Shing Center for Genomic Engineering, was formed after Berkeley biochemist Jennifer Doudna and her colleagues discovered precision “DNA scissors,” a complex of RNA and protein called CRISPR/Cas9, that can snip DNA at very specific targets in a the genome, allowing scientists to cut out or edit defective genes, or add new genes. Doudna, a professor of molecular and cellular biology and a Howard Hughes Medical Institute investigator, hopes that IGI will make the Bay Area, with its wealth of scientific and clinical research and its business, technology and investment innovation, a global hub for development and application of the groundbreaking technology.

“The Bay Area offers a unique combination of world-leading academic research facilities and clinical institutions with a vibrant and innovative biotech sector,” said Doudna, who cofounded IGI with Jonathan Weissman, a UCSF professor of cellular and molecular pharmacology and HHMI investigator. “There is no better place in the world to spark innovation and discovery in the field of genomics.”

The technology is already being explored by IGI collaborator Jennifer Puck, medical director of the UCSF Clinical and Translational Science Institute’s Pediatric Clinical Research Center, as a possible way to treat severe combined immunodeficiency (SCID), often called the “Bubble Boy” disease. Puck’s work has focused on the genetic cause of SCID and the development of gene-targeted therapies for SCID.

Other scientists around the globe are applying CRISPR/Cas9 to understand and explore new treatments for diabetes, HIV/AIDS, blood cancers and rare genetic diseases like Huntington’s.

“Professor Jennifer Doudna’s groundbreaking scientific work and her launch of the Innovative Genomics Initiative are emblematic of all that we strive for in our research endeavors at Berkeley,” UC Berkeley Chancellor Nicholas Dirks said in a statement. “With its enormous potential to dramatically improve the health and well-being of people around the world, the IGI is another wonderful example of how this university’s research enterprise contributes to the greater good.”

AstraZeneca, IGI’s first partner, plans to use CRISPR/Cas9 to identify and validate gene targets relevant to cancer; cardiovascular, metabolic, respiratory, autoimmune and inflammatory diseases; and regenerative medicine to understand their precise roles in these conditions.

“We are excited to pair the IGI’s premier expertise in CRISPR/Cas9 gene editing and regulation with AstraZeneca’s deep experience in therapeutics,” said Jacob Corn, IGI’s scientific director. “I’m confident that, in working side-by-side with scientists at AstraZeneca, our collaboration will positively impact drug discovery and development to hasten treatments to patients.”

For more on IGI’s new partnerships, link to IGI’s website and AstraZeneca’s press release.

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1,000th solar suitcase is beacon in developing world


This innovation out of UC Berkeley has saved lives in places where light, power unreliable.

In 2008, an idea for bringing solar-powered light and electricity to energy-starved sub-Saharan Africa was burning brightly in Laura Stachel’s mind.

Stachel, an obstetrician turned public health graduate student at UC Berkeley, was appalled at conditions she saw at a maternity ward in a hospital in northern Nigeria. Frequent power outages meant emergency patient care was delayed, disrupted, or just impossible.

Stachel and her husband, solar energy educator Hal Aronson, devised the solar suitcase — delivering power and light from a most reliable source, the sun. The Blum Center for Developing Economies, at UC Berkeley, helped bring We Care Solar to life. Now, the nonprofit has shipped its 1,000th solar suitcase to provide electricity to health clinics trying to recover from the Ebola outbreak in Sierra Leone.

Read more on the Blum Center’s site

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Eat.Think.Design: A public health course for the startup generation


UC Berkeley course feeds need for rethinking problems of food and nutrition.

By Tamara Straus, UC Berkeley

For the creators of the UC Berkeley course Eat.Think.Design, two things are certain.

First, the United States is facing a food and nutrition crisis, with rocketing rates of diabetes, hunger and health disparity.

Second, graduate students today — from fields as different as public health, business, information technology and engineering — want their education to be more hands-on, more interdisciplinary and more “impactful” to society at large.

In the case of the Eat.Think.Design course, they want to spend class time not just learning about food and nutrition problems, they want to devise actual food and nutrition solutions.

This may sound grand, but for the course’s three instructors — Jaspal Sandhu, a UC Berkeley lecturer in design and innovation; Nap Hosang, a longtime Kaiser Permanente medical doctor and UC Berkeley School of Public Health instructor; and Kristine Madsen, an associate professor in the Joint Medical Program and Public Health Nutrition at Cal’s School of Public Health — there is nothing grand or inappropriate about letting students attempt societal solutions while in graduate school.

“The reason we emphasize experiential learning is because it has proved to be more effective,” says Sandhu, who is also a partner at the Gobee Group, a consulting firm he runs with two other multilingual Fulbright scholars with UC Berkeley roots. Sandhu speaks Punjabi, Spanish, Mongolian and English, and prior to Gobee worked with the Mongolian Ministry of Health designing mobile health information systems.

Sandhu emphasizes that his students’ backgrounds demand more than lecturing. Among the 25 people enrolled in Eat.Think.Design this spring, many have relevant work experience. At least three have started their own companies, several have worked for big companies like IBM, Deloitte and Eli Lilly, and most have about five years under their belts working for government agencies or large nonprofits. “To keep the attention of such students,” says Sandhu, “we need to give them actual problems to focus on.”

Working in interdisciplinary teams of three under an instructor, Eat.Think.Design students spend the bulk of the semester on one project, conducting ethnographic and market research, investigating models and constantly devising and then revising potential solutions. Members of last year’s class, for example, streamlined SNAP federal nutrition benefits payments at San Francisco’s Heart of the City Farmer’s Market, worked with the Kossoye Development Program in Ethiopia on strategies to make home gardening more accessible and built a pilot program with Partners In Health: Navajo Nation to test a pop-up grocery store in areas that are one hour’s drive from fresh food. Although the project in the Navajo Nation helped COPE to receive a three-year, $3 million REACH grant from the Centers for Disease Control & Prevention to pursue healthy eating programs in the vast American Indian territory — Hosang argues that the course is not designed to incubate social innovations per se.

“Our goal is to incubate innovative people — people who can be influencers in the public health sector,” he says.

Hosang, who has served as head of the interdisciplinary online MPH degree program for the past 15 years and executive director of the Interdisciplinary MPH degree program since 2010, is not subtle in his criticism of public health teaching.

“Most academics are in a silo,” he said, “and their silo has driven them more and more into their specialist thinking.”

Yet this specialist thinking, Hosang argues, is running counter to the view that public health is enmeshed in almost every field — from architecture and transportation, to product design and education.

“We need to change the way public health professionals approach problems,” said Hosang, “and we need them to be in touch with people from other disciplines to inform their problem-solving processes.”

Hosang and Sandhu started working on their public health course in October 2010, after Hosang read Sandhu’s dissertation on public health design research in rural Mongolia and was impressed by the combination of grassroots and trial-and-error learning. In the spring of 2011, they launched their course, with financial support from the Blum Center for Developing Economies, which seeds interdisciplinary, social impact courses on campus. Madsen joined the course in 2014 when the focus narrowed from designing innovative public health solutions to designing innovative food solutions. In a forthcoming article in the American Journal of Public Health titled “Solutions That Stick: Activating Cross-Disciplinary Collaboration in a Graduate-Level Public Health Innovations Course at the University of California,” the three instructors describe how their approach is part of a much-needed pedagogical shift. They write:

A Lancet Commission, convened to discuss the education of health professionals in the 21st century, argued that educational transformation is critical to meet the public health problems we face in this century. Specifically, the commission called for a higher level of learning, moving beyond informative learning, which transmits knowledge to create experts, to transformative learning, which transmits leadership attributes to create agents who can successfully implement change.”

Sandhu explained that when he and Hosang came up with the idea for the course, not only was this “change agent” approach novel but no one was applying design thinking or human-centered design approaches at the School of Public Health at UC Berkeley. (He describes those approaches as ones that enable teams to systematically develop novel, effective solutions to complex problems.) Yet Sandhu says it is clear there’s a demand for this kind of problem solving.

Sandhu’s proof is the continual over-enrollment in and rave reviews of his course. This year, 60 students applied for 25 spots. And for the past four years, 40 percent of students indicated it was the “best course” they took at UC Berkeley, with the other 40 percent stating it was in the “top 10 percent” and the rest saying it was in the “top 25 percent.”

Christine Hamann, an M.B.A./M.P.H. candidate who took Eat.Think.Design in 2014, confirmed that “the teaching team is phenomenal — both in terms of the academic leadership and the mentoring of graduate students.”

She also confirmed that she and her fellow students want “practical challenges in graduate school,” adding, “we are tired of theory.”

Hamann is one of the many students who has brought past work into the classroom. Before grad school, she worked for seven years at Partners In Health, most recently on the nonprofit’s COPE Project in the Navajo Nation. She said the course forced her to look at Navajo Nation residents’ consumer needs around food and nutrition — and to see food less as a supply issue and more of a demand issue.

“Traditional public health approaches focus on supply, but that is why you see programs that don’t meet the needs of the community,” she said.

Hamann and the three other graduate students opted not to focus on the best truck routes to bring fresh produce into the 27,000 square mile territory — and instead focused on seeing what citizens there want to consume and what can last in what is a food (and actual) desert. During the summer of 2014, with funding from the Blum Center, Hamann created pop-up grocery stores in Navajo, to determine which food items were most in demand and could help reduce chronic diseases like diabetes, which affects 20 percent of residents. This exploration helped lead to the aforementioned $3 million CDC grant for COPE.

As to why so many Cal students are so focused on food and nutrition, Hamann has this to say: “From a public health perspective, I think we’re seeing the ramifications of the American diet play out in really scary chronic disease indicators.” She also noted that there is a general heightened awareness of food systems — “of where food is coming from, the corporations that own it, and the detrimental effects those relationships can have on both health outcomes and business models.” Third, Hamann said a growing number of students want to see tech innovation applied to less wealthy and less urban populations—“the people,” she said, “who need it.”

Then, there are the galling statistics: Americans throw out an estimated 40 percent of food grown per year. An estimated 50 million Americans do not have access to enough food. As of 2012, about half of all adults — 117 million people — have one or more chronic health conditions, such as heart disease, stroke, cancer, diabetes, obesity and arthritis. And childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years.

Sandhu is aware that a course on food innovation is well timed at UC Berkeley. In 2013, UC Berkeley’s College of Natural Resources, the Goldman School of Public Policy, the Graduate School of Journalism, Berkeley Law and the School of Public Health joined forces to create the Berkeley Food Institute to improve food systems locally and globally. A year later, UC President Janet Napolitano launched the UC Global Food Initiative — to prompt all 10 campuses, UC’s Division of Agricultural and Natural Resources, Lawrence Berkeley National Lab, and a consortium of faculty, researchers and students to address food security, nutrition and sustainability issues. Even BigIdeas@Berkeley, the annual student innovation prize, has a contest category on food systems innovation.

“Our timing is either well forecasted or extremely lucky,” said Sandhu.

Eat.Think.Design may be a popular course — and may inspire copycats — but both students and instructors are quick to point out that the course cannot serve as a model for every graduate-level class.

“It is difficult to take more than one experiential class per semester,” said Hamann. “The time commitment with fellow students and with our client is just too big.”

Amy Regan, who took the course in 2013 and now works with the San Francisco Unified School District’s Future Dining Experience program, agrees that “compromising and agreeing on the best approach among a group takes time.”

For instructors, professor Madsen estimates the course requires one and a half to two times more time than an average School of Public Health offering, because she, Sandhu and Hosang each mentor three student groups during and after class time. The three instructors also spend time cultivating their connections to bring in student projects from nonprofits and government agencies. During the class on Feb. 4, 16 pitches were made by representatives of various organizations, including California Farm to Fork, San Quentin State Prison and Project Open Hand.

“Much more work goes into creating the class because of all the connections to be made,” said Madsen.

And very little is scripted. This gives the course the feeling of a kind of pedagogical startup, exciting but uncertain. Madsen said this atmosphere comes with a distinct disadvantage for professors.

“You have to admit you don’t know as much,” she said. “If your identity is wrapped up in being an academic expert, this won’t work; you’ll always default to the more narrow but comfortable path.”

For Sandhu and Hosang, who are adjuncts, there is less face to lose.

“I think over the last seven years, since the start of the Great Recession, there’s been a transformative energy happening in higher education,” said Hosang. “It’s coming from the younger generation who see the world has changed and who no longer see college as a ticket to success. That’s where this move toward an interdisciplinary, hands-on approach is coming from.”

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Wearable electronics device makes it easier to image infants


Flexible, lightweight and wearable electronics strategy has led to plans for clinical trials.

New wearable electronics will allow an infant to be swaddled in a blanket laced with a network of nearly weightless, printed “coils” for more comfortable, less expensive MRI scanning.

By Wallace Ravven

An infant born three months prematurely fails to flush pink at birth and has an alarmingly low blood pressure. Ultrasound identifies a heart abnormality and doctors rush the newborn to an MRI suite to confirm the diagnosis. But the scanning itself can cause physical agitation that interferes with clear imaging. In some cases, it can make it harder for the baby to breathe.

When scans require high sensitivity on a small area of the body, a hard, heavy vest of metal coils must press down on the baby. The bulky burden weighs more than the newborn. Infants squirm under the pressure, but anesthesia to calm them down adds an unwanted risk. Lightening the load by securing the weighty apparatus off the baby leads to degraded resolution, prompting a need for longer MRI exposures.

The hardware is part of the radio frequency (RF) coil assembly that receives the MRI’s electromagnetic signals. Besides being awkward and heavy, the coils are expensive to manufacture and must be reused for years. Sanitizing the bulky assembly is difficult.

Cut to a faculty lunch in 2011. UC Berkeley MRI expert Miki Lustig hears his colleague Ana Claudia Arias describe her lab’s progress adapting a technique similar to conventional ink jet printing to fabricate electronic devices.

It was a technology, Lustig says, that was “well beyond my comfort zone.” But he wondered if Arias’ printable electronics techniques could fabricate ultra-lightweight, “two-dimensional” RF coils to ease the trauma to tiny tots and improve image quality.

Lustig and Arias, both faculty members in the electrical engineering and computer sciences department, walked back to their offices together.

“I asked her if she thought RF coils could be printed. It just seemed like a good idea. She said ‘let me think about it.’ A few days later — almost immediately — she said we should give it a try. She started ordering materials to test different substrates and putting a team together.”

Printing electronic circuits and devices based on metals and semiconductors from solution is a very young field that Arias first entered in 2003 at the near-legendary Xerox PARC in Palo Alto. She came to PARC from Plastic Logic Limited, where she worked after finishing her Ph.D. in physics at the Cavendish Laboratory at Cambridge University, U.K.

While at Xerox, Arias began to explore fabrication of wearable sensors. Her group developed several components of a flexible sensor that targeted the prevention of brain injuries by monitoring pressure, acoustic and light levels in the battlefield.

When she joined the Berkeley EECS faculty in 2011, she began to expand her collaborations to developed wearable medical devices that could track vital signs and give doctors feedback on their patients health.

“Printed electronics is an ideal technology for fabrication and integration of devices with different functionality, such as sensors, light sources and simple circuits. It is ideal for deposition of unique and customized designs. And when one adds flexible substrates to the equation you could start thinking about truly wearable — and comfortable — electronics”

To make “wearable electronics” for infant MRI patients, her team first tried to print directly onto cloth fabric.

“We wanted to make our coil feel like a swaddle blankie that fits snugly and softly around the babies,” she says.

But the cloth’s texture interfered with the ability to print high-quality capacitors, so the team turned to printing the “electronic inks” layer by layer onto plastic thin film, like what is used in photo transparencies. The lab succeeded in fabricating and demonstrating functioning RF coils with performance properties comparable to conventional RF coils.

Arias is supported by a Bakar Fellowship at Berkeley, support intended to help commercially promising research make the leap from the lab to the real world. She and Lustig plan to start a company to advance the technology into clinical use.

“We, researchers, don’t usually have experience and training with steps such as securing IP protection and developing a business plan to attract investment and ensure success. Mentors we met through the Bakar Program have been very helpful,” she says.

Their proof-in-principle of the flexible, lightweight and wearable electronics strategy has led to plans for clinical trials early next year. She and Lustig are collaborating with pediatrician Shreyas Vasanawala at Lucile Packard Children’s hospital to test the wearable RF coils on babies needing MRI scans. Vasanawala has been a key clinical consultant to the project from the beginning.

Arias sees the technology’s potential for adult MRI scanning as well — helping to make the MRI experience more comfortable and less scary to everyone, while getting better images of parts of the body that the bulky conventional RF coil assemblies don’t fit very well.

Meanwhile, she still has her eyes on developing that electronic blankie. “When you see kids in the hospital, it’s scary for them. When they’re in a blanket, it’s a much more comforting experience. We want to swaddle them.”

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Health Data Exploration project announces Agile Research Project awards


Recipients selected for capacity to advance use of personal health data for research.

By Tiffany Fox, UC San Diego

The Health Data Exploration project – based at the California Institute for Telecommunications and Information Technology (Calit2) and supported by the Robert Wood Johnson Foundation (RWJF) – has announced five recipients in its $200,000 Agile Research Project competition. The recipients, selected for their capacity to advance the use of aggregated and anonymous personal health data for research, are:

  • Rumi Chunara, New York University, “Keeping Pace: Dynamic Assessment of Environment and Exercise Using Personal Health Data,” $50,000
  • Julie Kientz, University of Washington, “When Am I At My Best? Passive Sensing of Circadian Rhythms for Individualized Models of Cognitive Performance,” $36,772
  • Emil Chiauzzi, PatientsLikeMe (company), “From Self-Monitoring to Self-Experimentation: Behavior Change in Patients with MS,” $37,700
  • Michelle De Mooy, Center for Democracy and Technology (non-profit), “Towards Privacy-Aware Research and Development in Wearable Health,” $50,000
  • Eric B. Hekler, Arizona State University, “Exploring Strategies to Improve Acceptability and Usability of a Just In Time Adaptive Intervention via Incorporation of Proximity Sensors and a Smartwatch,” $25,528

The Agile Research Project grants were created to encourage collaboration among members of the Health Data Exploration (HDE) Network, and to generate new training and learning opportunities for the field. Established in June 2014 with a $1.9 million grant from RWJF, the Network brings together companies, researchers and other partners to strategize, coordinate and experiment with ways to use personal health data for the public good.

“We were delighted at the response to our call for proposals, and very pleased to see these projects emerge as the ones selected,” said Dr. Kevin Patrick, principal investigator of the HDE project. “These hold great promise to move the field of personal health data research forward. Taken together these projects are exploring how to leverage anonymous and aggregated data from companies like Fitbit, Jawbone and RunKeeper in ways that improve our understanding of health.”

Chunara’s project, for example, will develop a platform for users of RunKeeper devices to provide their data, which will then be used to better understand the relationship between the built environment and how types and amounts of exercise vary over time.

De Mooy will work with Fitbit to explore how companies can integrate responsible privacy practices into their internal research to protect users’ privacy while improving products and fitness results for customers. As the market leader in connected health and fitness, Fitbit has always been committed to protecting consumer privacy and keeping data safe, and only reviews anonymous, aggregated data for research purposes.

Hekler’s project will explore how new and emerging technologies, particularly the smartwatch and home-based sensors, can be used to provide highly personalized and context-appropriate support for being physically active, including marking times when a person will not want to be disturbed.

The HDE leadership adopted an “agile development approach” for the competition, encouraging participants to conduct applied research projects on personal health data within a short time frame (two to six months). The participants are expected to use a timely and efficient methodology (in terms of program scoping, solicitation, peer review, contractual negotiations) that matches the pace of industry. The winning projects also leverage collaborations with one or more other members of the growing HDE Network of researchers and companies in the personal health data arena.

”We see a tremendous opportunity for personal health data to improve our understanding of the connections between community environments, individual behavior and health,” said Lori Melichar from RWJF. “We expect that the Agile Research Projects from this first round of funding will help us better understand how to use data in a practical and meaningful way in our efforts to build a national Culture of Health.”

The HDE project, and its associated Network, is supported by Calit2, which is based at both UC San Diego (where it is known as the Qualcomm Institute) and UC Irvine. Last year, HDE issued a report titled Personal Data for the Public Good, which found that many people who track health-related data are interested in sharing that data with researchers in medical and public health — provided adequate privacy controls exist.

The HDE Network brings together companies that collect and store personal health data, captured through the use of wearable devices, smartphone apps and social media, with researchers who mine the data for patterns and trends and other strategic partners. Through a set of research projects using personal health data, the Network will identify policies and best practices for using these new forms of data to produce transformative knowledge about health.

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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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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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Quest to create real-world tricorder


XPRIZE teams will test Star Trek-inspired medical devices at UC San Diego.

Mark 1 tricorder from the Star Trek TV series.

By Scott LaFee, UC San Diego

Seeking to boldly go where medical science has not gone before, the Clinical and Translational Research Institute (CTRI) at UC San Diego has been named the official testing site for the $10 million Qualcomm Tricorder XPRIZE, a global competition sponsored by the Qualcomm Foundation to develop a consumer-friendly, mobile device capable of diagnosing and interpreting 15 physiological conditions and capturing vital health metrics.

The XPRIZE competition is inspired by the tricorder medical device that debuted in the original 1966 “Star Trek” TV show and was frequently featured in subsequent series and movies.

“Of course, the tricorder in ‘Star Trek’ was originally fantasy, a wonderful bit of science fiction,” said Gary S. Firestein, M.D., CTRI director, dean and associate vice chancellor of translational medicine at UC San Diego. “But the idea – and this XPRIZE competition – symbolizes a very real vision of how we can shape a healthier future with creative use of cutting edge discoveries. It’s emblematic of our focus on ‘disruptive innovation’ to improve human health. We are looking forward to working with XPRIZE in the quest to seek out new technologies.”

CTRI will serve as the physical location of the test program, with doctors, technicians and staff providing logistical and personnel management. CTRI will be responsible for recruiting up to 480 volunteers to serve as consumer-testers, gaining their consent and instructing them in the use of the devices, overseeing device testing and conducting follow-up surveys.

Late last year, 10 teams were selected as finalists for the Qualcomm Tricorder XPRIZE. The teams come from the United States, Canada, India, Taiwan, Slovenia and the United Kingdom, representing both academic and private enterprises.

Beginning in early summer and for several months, these teams will have their entries evaluated at UC San Diego on specific measures of health assessment and consumer experience. For example, the devices must accurately diagnose a set of health conditions, such as diabetes, atrial fibrillation, stroke, tuberculosis, chronic obstructive pulmonary disease, pneumonia and hepatitis A. They must also capture real-time health metrics, such as blood pressure, respiratory rate and temperature.

“A tricorder could empower patients to capture reliable diagnostic data that will help them self-evaluate symptoms they are having and better prepare them for discussing their symptoms with their health care team,” said Gene “Rusty” Kallenberg, M.D., professor and vice-chair, Department of Family Medicine and Public Health in the UC San Diego School of Medicine.

Final results will be announced in 2016 – the 50th anniversary of the original Star Trek series. First prize is $7 million, with $2 million for second place and $1million for third.

The CTRI testing site team will include physician-monitors, clinical coordinators, a database programmer and technical advisors. Kallenberg and a physician oversight team will direct preparatory tasks prior to testing, then medically monitor emergencies, field medical questions and handle issues requiring medical opinion or interventions during testing.

Coordinators trained in managing clinical trials will oversee the XPRIZE testing experiences of consumer-testers. The database programmer will program and produce reports to identify potential consumer-testers by location and/or department or by disease condition.

The team will also include staff from the Qualcomm Institute at UC San Diego to provide technical support. The Qualcomm Institute’s role will be to capture relevant data from the multiple participants in the test scenario (the tricorder, the consumer tester, the XPRIZE on-site technician and the on-site test monitoring tools), transfer that data to a central repository and perform review, analyses and scoring based upon captured metrics.

Testing will occur at CTRI’s Center for Clinical Research on the UC San Diego campus, UC San Diego Medical Center – Hillcrest, and at primary care clinics and some specialty clinics in the UC San Diego Health System.

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Inaugural Byers Family Distinguished Professorship goes to QB3 leader


UCSF professorship supporting entrepreneurship and innovation awarded to Regis Kelly.

Celebrating the creation of the Byers Family Distinguished Professorship are (from left) Shawn Byers, Regis Kelly, Brook Byers and UCSF Chancellor Sam Hawgood.

By Lisa Cisneros, UC San Franicsco

UC San Francisco announced today (Feb. 3) that the inaugural Byers Family Distinguished Professorship will be awarded to Regis Kelly, Ph.D., in recognition of his visionary leadership at QB3, a thriving center of early-stage entrepreneurship and innovation that has capitalized on the premier health sciences research coming out of UCSF.

The professorship is named in honor of Brook Byers and his family, who are longtime champions of innovation at UCSF. A member of UCSF Foundation and co-chair of the Campaign for UCSF, Byers has supported all spectrums of UCSF’s research from basic to translational science that made Byers Hall on UCSF’s Mission Bay campus the home of QB3. He also helped create one of the most visionary venture funds in academia, known as the Mission Bay Capital Fund. To recognize his many contributions, the university awarded Byers the UCSF Medal, its most prestigious honor, in 2007.

As executive director at QB3, Kelly has led the way in bridging academia with industry partners, entrepreneurs and venture capitalists. Under his leadership, QB3 is launching startup biotech companies, patenting their discoveries and converting them into therapies, tools and devices that improve health and boost the economy.

A joint venture of UCSF, UC Berkeley and UC Santa Cruz, QB3 was the first of its kind among the California Institutes for Science and Innovation established in 2000 by then-Gov. Grey Davis to stimulate science, create new companies and drive the economy.

The investment proved timely, as the subsequent recession and the rising cost of health care made it clear that the state needed to build academic-industry partnerships to convert life sciences research into solutions for better health, a sustainable environment and a dynamic economy.

Kelly and Douglas Crawford, QB3’s associate director, created the first startup incubator at the University of California, the “QB3 Garage,” which has expanded into a network of five incubators serving more than 40 companies. Under Kelly’s direction, QB3 partnered with industry, which is essential for early-stage science to move forward. Its partners include Pfizer, Johnson & Johnson and GE Healthcare, to name a few. He also created a fund to support translational research and provide startups with the potential for commercialization to get the resources and advice they need.

To expand this model throughout the UC system, UC President Janet Napolitano appointed Kelly as special advisor on innovation and entrepreneurship in December 2014. In addition to his ongoing role at QB3, Kelly will work closely with leaders at the university’s 10 campuses, five medical centers and three national laboratories. He will also develop external partnerships that drive long-term revenue for the university and maximize the public benefit of UC innovations.

To support this effort, the University has established UC Ventures, a $250 million fund – without using state or tuition funds – to invest in technologies emerging from the 10 campuses.

“We’re delighted that Reg Kelly has been named the first Byers Family Distinguished Professor given his role at the forefront of entrepreneurship at UCSF and given his new role as special advisor on innovation and entrepreneurship at the UC Office of the President,” said UCSF Chancellor Sam Hawgood, MBBS. “Establishing this professorship at UCSF will help fortify the great work that Reg and Brook have been doing together over the last decade through QB3 and will ensure that UCSF will remain at the vanguard of translating fundamental basic research that happens in our labs to find applications to benefit society.”

UCSF marks two Byers anniversaries

The distinguished professorship announcement comes at a time when UCSF is marking the 20th anniversary of the Byers Lecture for Basic Science and the 10-year anniversary from when QB3’s headquarters, Byers Hall, opened at UCSF Mission Bay. Byers’ 20-year sponsorship of the Byers Award in Basic Science has shined a light on curiosity-driven research by providing support for mid-career researchers undertaking high-risk, high-reward research.

“Brook understands that great advances in health often begin with the most fundamental discoveries found in our research labs, and his support to our basic science community has been extraordinary,” Chancellor Hawgood said. “Brook is always looking to enhance the innovation ecosystem here at UCSF and I’m delighted that he and his wife Shawn recently decided to build on the powerful investments he has already made to UCSF.”

Byers is a member of UC President Napolitano’s UC Innovation Council, which advises UC on how to tap potential entrepreneurs and innovation from UC’s 10 campuses. To support this effort, Napolitano in late June 2014 rescinded a 25-year-old policy that prohibited campuses from directly investing in companies and services that it incubated or helped build through research.

“We are truly grateful to Brook and Shawn Byers and their family for establishing this distinguished professorship to help QB3 sustain its public service mission in the years to come,” said Kelly. “We hope that the creation of this distinguished professorship might inspire other campuses to appoint one of its established investigators to a similar role to support innovation and entrepreneurship for public benefit.”

As federal and state funding to support public universities continues to wane, securing more endowed professorships for the faculty is a top priority for UCSF Chancellor Hawgood and John Ford, vice chancellor of University Development and Alumni Relations.

“It is crucial for allowing us to compete with our private peers for top recruits, ensure our faculty have a stable source of support to pursue their most bold and innovative ideas and enables us to see that as much grant money as possible goes to support research,” Ford said.

A neuroscientist, Kelly grew up in a working class family graduated with a bachelor’s degree in physics in 1961 from the University of Edinburgh in Scotland after receiving a scholarship. He earned a Ph.D. degree in biophysics at the California Institute of Technology in 1967. Kelly joined the UCSF faculty in the Department of Biochemistry in 1971. He served as UCSF’s executive vice chancellor and provost overseeing the development of the UCSF Mission Bay campus before becoming director of QB3 in 2004. In recognition of his many contributions to science and innovation, Kelly was awarded the OBE – the Most Excellent Order of the British Empire – by Queen Elizabeth II.

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‘Frontiers of Innovation’ program seeds seven projects at UC San Diego


Large-scale, multidisciplinary efforts address global challenges of the future.

Photo by Erik Jepsen, UC San Diego

By Paul Mueller, UC San Diego

As a key part of the strategic plan developed by faculty, administrators, postdoctoral scholars, graduate and undergraduate students, staff, alumni and other members of the UC San Diego community, Chancellor Pradeep K. Khosla and Vice Chancellor for Research Sandra A. Brown are committed to significant investments in scholarship and science that will keep the university at the forefront of socially beneficial research.

Some of these investments are taking place already; other programs will be announced in the months ahead. What they all have in common is a thoughtful cultivation of promising people and innovative projects that will strengthen the university’s record of problem-solving research.

One such initiative, led by the UC San Diego Office of Research Affairs, will help launch seven major projects on campus, all focused on advancing the university’s strategic research goals.

The “Frontiers of Innovation” program is a campus-wide effort to support the primary research initiatives of the UC San Diego Strategic Plan.

One component provides fellowships for undergraduate and graduate students as well as postdoctoral scholars. The other component provides funding to support teams of UC San Diego scholars from across campus in their efforts to launch large-scale, multidisciplinary research-center applications.

“Our support for these new centers reflects our strong commitment to the research goals articulated in the campus strategic plan,” Khosla saida. “The forward-looking Frontiers of Innovation program will help ensure our continued leadership in research well into the future. Vice Chancellor for Research Sandra Brown and the Academic Senate are to be commended for driving these investments in our faculty, our students, and their vital work.”

UC San Diego’s research enterprise, said Brown, is focused on four strategic avenues of inquiry: understanding and protecting the planet; enriching human life and society; exploring the basis of human knowledge, learning, and creativity; and understanding cultures and addressing disparities in society.

“We want to engage all campus members in research to answer basic questions and address the needs of our global society,” Brown said. “We were challenged by the large number of applications for this seed funding. However, the faculty review committee identified seven exciting efforts we can foster now.”

This year, the Frontiers of Innovation Center Development funds will go to the following centers:

“These creative and ambitious faculty efforts,” Brown said, “will help us take a bold step toward meeting the grand challenges facing the world today.”


Center for Biological Timing in the 21st Century

Led by Michael Gorman
Research area: Understanding and protecting the planet


Sustainable Power and Energy Center

Led by Shirley Meng, Oleg Shpyrko
Research Area: Understanding and protecting the planet

Ying Shirley Meng, associate professor of nanoengineering: “The Sustainable Power and Energy Center is a multidisciplinary initiative dedicated to advancing the frontiers of energy technologies, focusing primarily on forward-looking renewable energy conversion, storage and power integration.  Our specific goals are to make UC San Diego a global leader in renewable energy research and integration; promote interdisciplinary energy research, education and training programs; and expedite lab-to-market transitions and support local and California clean-tech industries.”


UC San Diego Center for Translational Computer-Aided Drug Discovery & Project Management

Led by Rommie Amaro, James McKerrow
Research area: Enriching human life and society


UC San Diego Center for Compound Resources

Led by William Gerwick, Dionicio Siegel
Research area: Enriching human life and society

William Gerwick, distinguished professor of oceanography and pharmaceutical sciences: “The newly formed UC San Diego Center for Compound Resources (UCCR) will provide the campus with a unified, well-curated and easily accessible resource of diverse natural products and other small molecules for testing in biological assays. Synergistic connection between these areas of campus expertise is a clear opportunity to discover and develop new molecules of significance to human health and the planet.”


Institute for Integrative Science of the Developing Mind and Brain

Led by Jeff Elman, Susan Taper
Research area: Exploring the basis of human knowledge, learning and creativity

Jeff Elman, distinguished professor of cognitive science: “The Institute for Integrative Science of the Developing Mind and Brain will bring together researchers from across different disciplines, departments and divisions of the campus for large-scale longitudinal studies of children and adolescents, with the goal of identifying the social, cultural and educational factors that contribute to their growth and well-being. The institute will also facilitate collaborative research that aims to better explain the observations made in children by studying basic cellular and molecular mechanisms that may play a role.”


Center for Research on Gender in STEMM

Led by Mary Blair-Loy, Wendy Campana, Pamela Cosman
Research area: Understanding cultures and addressing disparities in society

Mary Blair-Loy, associate professor sociology and associate vice chancellor for faculty diversity and equity: “The new Center for Research on Gender in Science, Technology, Engineering, Mathematics and Medicine (STEMM) brings together faculty and graduate students who use basic social science to study cultural and interactional factors that create gender inequality in STEMM fields. Subtle yet persistent barriers to women’s full participation in STEMM fields persist, despite official commitments to meritocracy, objectivity and excellence in diversity. Our center begins with two empirical studies on the obstacles to recruiting women at a top research university. We also convene a Faculty Learning Community, an interdisciplinary group of faculty and graduate-student instructors who engage in teaching about gender.”


The UC San Diego Community Stations

Led by Angela Booker, Fonna Forman, Teddy Cruz
Research area: Understanding cultures and addressing disparities in society

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UCLA Medical Group, Cigna introduce Collaborative Care program


Affiliation will improve health care and lower costs.

By Roxanne Moster, UCLA

UCLA Medical Group and Cigna have launched a collaborative care initiative to improve patients’ access to health care, enhance care coordination and achieve the goals of improved health, affordability and patient experience.

“This new affiliation provides us with an important framework in our mission to provide accountable, better coordinated patient care,” said Dr. Samuel A. Skootsky, chief medical officer of the UCLA Faculty Practice and UCLA Medical Group. “UCLA Health System has developed an innovative model of primary care to improve care coordination and provide needed services for our patients, in addition to providing exemplary specialty care. This partnership allows us to take this enhanced approach to health care for Cigna’s PPO patient population — focusing on high-value, high-quality care that is truly patient-centered and puts patients first.”

The UCLA Medical Group comprises more than 1,200 physicians who are clinical faculty members at the David Geffen School of Medicine at UCLA. They provide primary and specialty medical care at over 100 ambulatory locations as well as at the Ronald Reagan UCLA Medical Center, Mattel Children’s Hospital UCLA, UCLA Medical Center–Santa Monica and the Resnick Neuropsychiatric Hospital at UCLA.

Under the program, UCLA physicians will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to see their current physician and automatically receive the benefits of the program. Individuals who are enrolled in a Cigna health plan and later choose to seek care from a UCLA doctor also will have access to the benefits of the program. There are no changes in any plan requirements regarding referrals to specialists. Patients most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes, heart disease and obesity.

Cigna Collaborative Care is the company’s approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program, which began Jan. 1, will benefit more than 5,900 people covered by a Cigna health plan who receive care from more than 1,600 UCLA primary care doctors and specialists. Cigna now has seven collaborative care arrangements in California and 114 of them nationwide.

In places where it has been introduced, Cigna Collaborative Care is helping to improve the health of Cigna customers while effectively managing medical costs. The programs are helping to close gaps in care, such as missed health screenings or prescription refills, reinforcing the appropriate use of hospital emergency rooms, increasing the number of preventive health visits and improving follow-up care for people transitioning from the hospital to the home.

“Together our goal is to change the health care system from one that pays for the number or volume of services to one that places more emphasis on the quality and results of that care,” said Gene Rapisardi, president and general manager for Cigna in Southern California. “We believe this change will lead to better health, lower costs and increased satisfaction for both our customers and their doctors.”

Critical to the program’s benefits is a UCLA care coordination system based on in-office care coordinators and registered nurse clinical advisors, employed by UCLA, who will help patients navigate the health care delivery system. The care coordinators and clinical advisors are aligned with a team of Cigna case managers to ensure a high degree of collaboration between UCLA physicians and Cigna, which will ultimately provide a better experience for the individual.

The UCLA care coordinator team will enhance care by using patient-specific data from Cigna to help identify patients being discharged from the hospital who might be at risk for readmission, as well as patients who may be overdue for important health screenings or who may have skipped a prescription refill. The care coordinators are part of the physician-led care team that will help patients get the follow-up care or screenings they need.

Care coordinators can also help people schedule appointments, provide health education and refer patients to Cigna’s clinical support programs that may be available as part of their health plan, such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs for quitting smoking or managing weight.

Cigna will compensate UCLA physicians for the medical and care coordination services they provide. Additionally, physicians may be rewarded through a “pay for value” structure for meeting targets for improving quality of care and lowering medical costs.

Cigna has been at the forefront of the accountable care organization movement since 2008 and now has 114 Cigna Collaborative Care arrangements with large physician groups that span 28 states, reach more than 1.2 million commercial customers and encompass more than 48,000 doctors, including more than 23,000 primary care physicians and more than 25,000 specialists.

Cigna Collaborative Care is one component of the company’s approach to physician engagement for health improvement, which also includes the innovative Cigna–HealthSpring care model for Medicare customers. Today, more than 1.5 million Cigna and Cigna–HealthSpring customers benefit from nearly 280 engaged physician relationships across 31 states, with more than 79,000 doctors participating, including more than 33,000 primary care physicians and more than 46,000 specialists.

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Temporary tattoo offers needle-free way to monitor glucose


‘Proof-of-concept’ tattoo could pave way for UC San Diego to explore others uses of device.

Nanoengineers at UC San Diego have tested a temporary tattoo that both extracts and measures the level of glucose in the fluid in between skin cells.

By Ioana Patringenaru

Nanoengineers at UC San Diego have tested a temporary tattoo that both extracts and measures the level of glucose in the fluid in between skin cells. This first-ever example of the flexible, easy-to-wear device could be a promising step forward in noninvasive glucose testing for patients with diabetes.

The sensor was developed and tested by graduate student Amay Bandodkar and colleagues in professor Joseph Wang’s laboratory at the NanoEngineering Department and the Center for Wearable Sensors at the Jacobs School of Engineering at UC San Diego. Bandodkar said this “proof-of-concept” tattoo could pave the way for the center to explore other uses of the device, such as detecting other important metabolites in the body or delivering medicines through the skin.

At the moment, the tattoo doesn’t provide the kind of numerical readout that a patient would need to monitor his or her own glucose. But this type of readout is being developed by electrical and computer engineering researchers in the Center for Wearable Sensors. “The readout instrument will also eventually have Bluetooth capabilities to send this information directly to the patient’s doctor in real-time or store data in the cloud,” said Bandodkar.

The research team is also working on ways to make the tattoo last longer while keeping its overall cost down, he noted. “Presently the tattoo sensor can easily survive for a day. These are extremely inexpensive — a few cents — and hence can be replaced without much financial burden on the patient.”

The center “envisions using these glucose tattoo sensors to continuously monitor glucose levels of large populations as a function of their dietary habits,” Bandodkar said. Data from this wider population could help researchers learn more about the causes and potential prevention of diabetes, which affects hundreds of millions of people and is one of the leading causes of death and disability worldwide.

People with diabetes often must test their glucose levels multiple times per day, using devices that use a tiny needle to extract a small blood sample from a fingertip. Patients who avoid this testing because they find it unpleasant or difficult to perform are at a higher risk for poor health, so researchers have been searching for less invasive ways to monitor glucose.

In their report in the journal Analytical Chemistry, Wang and his co-workers describe their flexible device, which consists of carefully patterned electrodes printed on temporary tattoo paper. A very mild electrical current applied to the skin for 10 minutes forces sodium ions in the fluid between skin cells to migrate toward the tattoo’s electrodes. These ions carry glucose molecules that are also found in the fluid. A sensor built into the tattoo then measures the strength of the electrical charge produced by the glucose to determine a person’s overall glucose levels.

“The concentration of glucose extracted by the non-invasive tattoo device is almost hundred times lower than the corresponding level in the human blood,” Bandodkar explained. “Thus we had to develop a highly sensitive glucose sensor that could detect such low levels of glucose with high selectivity.”

A similar device called GlucoWatch from Cygnus Inc. was marketed in 2002, but the device was discontinued because it caused skin irritation, the UC San Diego researchers note. Their proof-of-concept tattoo sensor avoids this irritation by using a lower electrical current to extract the glucose.

Wang and colleagues applied the tattoo to seven men and women between the ages of 20 and 40 with no history of diabetes. None of the volunteers reported feeling discomfort during the tattoo test, and only a few people reported feeling a mild tingling in the first 10 seconds of the test.

To test how well the tattoo picked up the spike in glucose levels after a meal, the volunteers ate a carb-rich meal of a sandwich and soda in the lab. The device performed just as well at detecting this glucose spike as a traditional finger-stick monitor.

The researchers say the device could be used to measure other important chemicals such as lactate, a metabolite analyzed in athletes to monitor their fitness. The tattoo might also someday be used to test how well a medication is working by monitoring certain protein products in the intercellular fluid, or to detect alcohol or illegal drug consumption.

Bandodkar was joined on the study by UC San Diego nanoengineers Wenzhao Jia, Ceren Yardımcı, Xuan Wang, Julian Ramirez and Wang, director of the Center for Wearable Sensors and SAIC Endowed Chair and distinguished professor in the NanoEngineering Department.

The publication is “Tattoo-Based Noninvasive Glucose Monitoring: A Proof-of-Concept Study,” published Dec. 12 in the journal Analytical Chemistry.

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