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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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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Chemists find a way to unboil eggs


Ability to quickly restore molecular proteins could slash biotechnology costs.

Chemistry major Stephan Kudlacek and professor Greg Weiss have developed a way of unboiling a hen egg. (Photo by Steve Zylius, UC Irvine)

By Janet Wilson, UC Irvine

UC Irvine and Australian chemists have figured out how to unboil egg whites – an innovation that could dramatically reduce costs for cancer treatments, food production and other segments of the $160 billion global biotechnology industry, according to findings published today (Jan. 23) in the journal ChemBioChem.

“Yes, we have invented a way to unboil a hen egg,” said Gregory Weiss, UCI professor of chemistry and molecular biology & biochemistry. “In our paper, we describe a device for pulling apart tangled proteins and allowing them to refold. We start with egg whites boiled for 20 minutes at 90 degrees Celsius and return a key protein in the egg to working order.”

Like many researchers, he has struggled to efficiently produce or recycle valuable molecular proteins that have a wide range of applications but which frequently “misfold” into structurally incorrect shapes when they are formed, rendering them useless.

“It’s not so much that we’re interested in processing the eggs; that’s just demonstrating how powerful this process is,” Weiss said. “The real problem is there are lots of cases of gummy proteins that you spend way too much time scraping off your test tubes, and you want some means of recovering that material.”

But older methods are expensive and time-consuming: The equivalent of dialysis at the molecular level must be done for about four days. “The new process takes minutes,” Weiss noted. “It speeds things up by a factor of thousands.”

To re-create a clear protein known as lysozyme once an egg has been boiled, he and his colleagues add a urea substance that chews away at the whites, liquefying the solid material. That’s half the process; at the molecular level, protein bits are still balled up into unusable masses. The scientists then employ a vortex fluid device, a high-powered machine designed by Professor Colin Raston’s laboratory at South Australia’s Flinders University. Shear stress within thin, microfluidic films is applied to those tiny pieces, forcing them back into untangled, proper form.

“This method … could transform industrial and research production of proteins,” the researchers write in ChemBioChem.

For example, pharmaceutical companies currently create cancer antibodies in expensive hamster ovary cells that do not often misfold proteins. The ability to quickly and cheaply re-form common proteins from yeast or E. coli bacteria could potentially streamline protein manufacturing and make cancer treatments more affordable. Industrial cheese makers, farmers and others who use recombinant proteins could also achieve more bang for their buck.

UCI has filed for a patent on the work, and its Office of Technology Alliances is working with interested commercial partners.

Besides Weiss and Raston, the paper’s authors are Tom Yuan, Joshua Smith, Stephan Kudlacek, Mariam Iftikhar, Tivoli Olsen, William Brown, Kaitlin Pugliese and Sameeran Kunche of UCI, as well as Callum Ormonde of the University of Western Australia. The research was supported by the National Institute of General Medical Sciences (grant R01 GM100700-01) and the Australian Research Council (grants DP1092810 and DP130100066).

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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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Iron overload disease causes rapid growth of potentially deadly bacteria


Deficiency of the hormone hepcidin makes people vulnerable to Vibrio vulnificus.

By Amy Albin, UCLA

Every summer, the news reports on a bacterium called Vibrio vulnificusfound in warm saltwater that causes people to get sick, or die, after they eat raw tainted shellfish or when an open wound comes in contact with seawater.

People with a weakened immune system, chronic liver disease or iron overload disease are most at risk for severe illness. Vibrio vulnificus infections in high-risk individuals are fatal 50 percent of the time.

Now, researchers at UCLA have figured out why those with iron overload disease are so vulnerable. People with the common genetic iron overload disease called hereditary hemochromatosis have a deficiency of the iron-regulating hormone hepcidin and thus develop excess iron in their blood and tissue, providing prime growth conditions for Vibrio vulnificus.

The study also found that minihepcidin, a medicinal form of the hormone hepcidin that lowers iron levels in blood, could cure the infection by restricting bacterial growth.

The early findings were reported online today (Jan. 14) in the journal Cell Host and Microbe.

“This is the first time that the association of hepcidin deficiency and susceptibility to Vibrio vulnificus infection was tested,” said senior author Dr. Yonca Bulut, a clinical professor of pediatrics at Mattel Children’s Hospital at UCLA and a researcher with the UCLA Children’s Discovery and Innovation Institute. “The dramatic effectiveness of the new treatment, even after the infection was established, was impressive.”

To conduct the study, researchers compared the fatality of Vibrio vulnificus infection in healthy mice with mice that lacked hepcidin, modeling human hereditary hemochromatosis. The results showed that the infection was much more lethal in hepcidin-deficient mice because they could not decrease iron levels in the blood in response to infection, a process mediated by hepcidin in healthy mice.

Giving minihepcidin to susceptible hepcidin-deficient mice to lower the amount of iron in the blood prevented infection if the hormone was given before the Vibrio vulnificus was introduced. Additionally, mice given minihepcidin three hours after the bacterium was introduced were cured of any infection.

Hereditary hemochromatosis is a genetic disease that causes the body to absorb and store too much iron. It affects as many as 1 in every 200 people in the United States. Since it can take decades for the body to store damaging levels of iron, many people may not be aware that they have the disease until signs of the condition begin to appear later in life.

The co-directors of the UCLA Center for Iron Disorders, Dr. Tomas Ganz, a professor of medicine and pathology at the David Geffen School of Medicine at UCLA, and Elizabeta Nemeth, a professor of medicine at UCLA, led the invention of minihepcidins at UCLA. Minihepcidins are being developed for treatment of iron-overload disorders, such as hereditary hemochromatosis and Cooley’s anemia. The use of minihepcidin to treat potentially lethal infections is a possible new application.

“We found that hepcidin is required for resistance to a Vibrio vulnificus infection,” said the study’s lead author Joao Arezes, a visiting graduate student from the University of Porto in Portugal. “The development of the treatment tested in mouse models could reduce the high mortality rate of this disease.”

The next stage of research is to understand why Vibrio vulnificus bacteria become so lethal when iron levels are high, and to learn which other microbes respond similarly to excess iron.

The research was conducted at the UCLA Center for Iron Disorders.

Other study authors were Grace Jung, Victoria Gabayan, Erika Valore, Piotr Ruchala, Ganz and Nemeth, all of UCLA, and Paul Gulig of the University of Florida.

The study was funded by the UCLA Today’s and Tomorrow’s Children Fund, the UCLA Stein/Oppenheimer Endowment Award, the UCLA Children’s Discovery and Innovation Institute and the National Institutes of Health (grant R01 DK090554).

The Regents of the University of California is the owner of patents and patent applications directed at minihepcidins and methods of use thereof, which are managed by UCLA’s Office of Intellectual Property and Industry Sponsored Research. This intellectual property is licensed to Merganser Biotech, for which authors Ruchala, Ganz and Nemeth are scientific advisors and equity holders. Other disclosures are available in the manuscript.

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‘NanoVelcro,’ temperature control used to extract tumor cells from blood


System could allow doctors to detect, analyze cancer to tailor treatment for individuals.

The device, developed at UCLA, enables scientists to control the blood’s temperature — the way coffeehouses would with an espresso machine — to capture and release the cancer cells in optimal conditions. (Credit: Tseng Lab, UCLA)

By Shaun Mason, UCLA

An international group led by scientists at UCLA’s California NanoSystems Institute has developed a new method for effectively extracting and analyzing cancer cells circulating in patients’ blood.

Circulating tumor cells are cancer cells that break away from tumors and travel in the blood, looking for places in the body to start growing new tumors called metastases. Capturing these rare cells would allow doctors to detect and analyze the cancer so they could tailor treatment for individual patients.

In his laboratory at the UCLA California NanoSystems Institute, Hsian-Rong Tseng, a professor of molecular and medical pharmacology, used a device he invented to capture circulating tumor cells from blood samples.

The device, called the NanoVelcro Chip, is a postage-stamp–sized chip with nanowires that are 1,000 times thinner than a human hair and are coated with antibodies that recognize circulating tumor cells. When 2 milliliters of blood are run through the chip, the tumor cells stick to the nanowires like Velcro.

Capturing the tumor cells was just part of the battle, though. To analyze them, Tseng’s team needed to be able to separate the cells from the chip without damaging them.

In earlier experiments with NanoVelcro, the scientists used a technique called laser capture microdissection that was effective in removing individual cells from the chip without damaging them, but the method was time-consuming and labor intensive, and it required highly specialized equipment.

Now Tseng and his colleagues have developed a thermoresponsive NanoVelcro purification system, which enables them to raise and lower the temperature of the blood sample to capture (at 37 degrees Celsius) and release (at 4 degrees Celsius) circulating tumor cells at their optimal purity. Polymer brushes on the NanoVelcro’s nanowires respond to the temperature changes by altering their physical properties, allowing them to capture or release the cells.

Because it could make extracting the cancer cells much more efficient and cost-effective at a time in a patient’s life when information is needed as quickly as possible, Tseng said it is conceivable that the new system will replace laser capture microdissection as the standard protocol.

“With our new system, we can control the blood’s temperature — the way coffeehouses would with an espresso machine — to capture and then release the cancer cells in great purity, ” said Tseng, who is also a member of UCLA’s Jonsson Comprehensive Cancer Center. “We combined the thermoresponsive system with downstream mutational analysis to successfully monitor the disease evolution of a lung cancer patient. This shows the translational value of our device in managing non–small-cell lung cancer with underlying mutations.”

The study, which was published online by the journal ACS Nano, brought together an interdisciplinary team from the U.S., China, Taiwan and Japan. The research was supported by the National Institutes of Health, RIKEN (Japan), Academia Sinica (Taiwan), Sun Yat-sen University (China) and the National Natural Science Foundation of China.

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Project launched to promote innovations in emergency medical services


UC San Diego, Mount Sinai seek to foster better, more efficient delivery of care.

By Scott LaFee, UC San Diego

UC San Diego Health System, in collaboration with Mount Sinai Health System in New York City, announced today (Jan. 7) the launch of a new project entitled “Promoting Innovations in Emergency Medical Services.”

Supported by the National Highway Traffic Safety Administration, Office of Health Affairs, the Department of Homeland Security and the Department of Health & Human Services, the project will address how to better disseminate and implement innovative Emergency Medical Services (EMS) delivery models, while overcoming persistent regulatory, financial and technological barriers.

The effort, which will culminate with development of a national framework tool to provide guidance and foster better, more efficient delivery of health care within EMS across the country, is funded by a two-year, $225,000 federal grant.

Co-project directors are James Dunford Jr., M.D., professor emeritus at UC San Diego School of Medicine and EMS medical director for the city of San Diego, and Kevin Munjal, M.D., assistant professor of emergency medicine at the Icahn School of Medicine at Mount Sinai.

“Our hope is to engage with a diverse group of stakeholders to create a pathway for the widespread implementation of best practices and delivery system reforms in emergency medical services across the U.S.,” said Munjal.

Experts have long recognized that EMS could serve as a vital link in a coordinated health care system focused on population health management by helping identify and modify risk, assess and facilitate treatment of chronic conditions and improve coordination of care for acute complaints.

“This is a fantastic opportunity for EMS to merge imagination, sound medicine and health information technology to improve care and lower cost,” said Dunford. “Tomorrow’s innovations will likely improve domestic preparedness, increase patient access to care, decrease health care costs and improve community resilience.”

Dunford added that novel urban and rural EMS programs have begun filling gaps in systems of care. Terms such as “community paramedicine” and “mobile integrated health care” are being used to describe how the full clinical, operational and financial capacity of EMS could be harnessed.

As EMS agencies strive to innovate within the current infrastructure, noted Munjal, they face challenges from existing laws, regulations, even fixed mind-sets. He said the project team is aware of the delicate balance between enabling innovation while still protecting public health and safety through regulatory oversight and maintaining a statewide systems approach to the provision of emergency medical care. “State offices of EMS play a vital role in fostering innovation and will be vital stakeholders in this project,” said Munjal, “which seeks to develop model legal, regulatory and financial frameworks to assist and encourage state and local health systems to test new EMS delivery models.”

Key aspects of the project include:

  • Collection of input from EMS and community health care stakeholders from around the country.
  • Regional stakeholder meetings will be held in San Diego and New York in May 2015, with a focus on incorporating national input into overcoming local barriers to EMS innovation.
  • A national steering committee will be convened in Washington, D.C., in September 2015.
  • An iterative approach to drafting materials and soliciting feedback through in-person, telephonic and online encounters with stakeholder groups.
  • Creation of a National Framework Document that will be broadly representative and thoroughly vetted and will be used as a tool to provide a useful pathway to harness the full potential of EMS.

For more information, visit www.emsinnovations.org.

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UCSF neuroscientist wins Russ Prize, bioengineering’s highest honor


Michael Merzenich lauded for contributions to cochlear implants for the deaf.

Michael Merzenich, UC San Francisco

By Pete Farley, UC San Francisco

Ohio University and the National Academy of Engineering (NAE) announced today (Jan. 7) that UC San Francisco neuroscientist Michael M. Merzenich, Ph.D., is a winner of the 2015 Fritz J. and Dolores H. Russ Prize, the bioengineering profession’s highest honor. Merzenich shares the prize with four other scientists for their fundamental contributions to the development of cochlear implants, electrical devices that enable the deaf to hear.

The cochlear implant is the most-used neural prosthesis developed to date; more than 320,000 hearing-impaired people have received implants in one or both ears.

“This year’s Russ Prize recipients personify how engineering transforms the health and happiness of people across the globe,” said NAE President C.D. Mote Jr. “The creators of the cochlear implant have improved remarkably the lives of people everywhere who are hearing impaired.”

Cochlear implants are electronic devices that allow people with severe to profound sensorineural hearing loss to hear sounds. In such implants, an externally worn audio processor detects sounds and encodes them into electrical signals that are transmitted to small, surgically implanted components that directly simulate the auditory nerve. The auditory nerve sends the signals to the brain, where they are interpreted as sounds.

Merzenich, professor emeritus of otolaryngology at UCSF, established some of the neurophysiological underpinnings of present cochlear implant designs beginning in the early 1970s. In collaboration with two UCSF colleagues, the late Robin P. Michelson, M.D., and Robert A. Schindler, M.D., professor emeritus of otolaryngology, Merzenich later conducted one of the first clinical trials of multichannel cochlear implants. These trials paved the way for the eventual commercialization of UCSF-designed devices in the late 1980s by Advanced Bionics, still one of the world’s leading manufacturers of cochlear implants.

Merzenich shares the Russ Prize with Blake S. Wilson, adjunct professor of biomedical engineering, electrical and computer engineering, and surgery at Duke University and co-director of the Duke Hearing Center; Graeme M. Clark, Ph.D., Foundation Professor of Otolaryngology at the University of Melbourne, Australia; Erwin Hochmair, DTech, professor emeritus in the Institute for Ion Physics and Applied Physics at the University of Innsbruck, Austria; and Ingeborg Hochmair-Desoyer, Ph.D., professor of biomedical engineering at the Technical University of Vienna, Austria.

“I am very, very pleased that the cochlear implant has been recognized as a significant advancement that contributes positively to the quality of life of those with hearing impairment,” said Dennis Irwin, Ph.D., dean of Ohio University’s Russ College of Engineering and Technology. “I have had the privilege of knowing and working with several individuals with profound hearing loss throughout my early life and later career, and I witnessed the difficulty several of them faced in athletic pursuits, education and their careers.”

Created by Ohio University alumnus Fritz Russ, a 1942 electrical engineering graduate, and his wife, Dolores, the Russ Prize, which carries a $500,000 award, recognizes a bioengineering achievement that has significantly improved the human condition. Awarded biennially by the NAE, the prize recognizes bioengineering achievements worldwide that are in widespread use and have improved the human condition. Previous recipients include the inventors of the implantable heart pacemaker, kidney dialysis, the automated DNA sequencer and the technology enabling LASIK and PRK eye surgeries.

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