TAG: "Translational medicine"

UC autism summit offers hope for help


First step toward collaborating systemwide to address need for treatments.

Leonard Abbeduto, director of the UC Davis MIND Institute, speaks at the UC summit on autism in Sacramento. (Photo by UC Davis)

By Alec Rosenberg

Researchers from across the University of California convened Thursday (Aug. 14) for a first-ever summit on autism — an initial step toward collaborating systemwide to address the urgent need for treatments.

Epidemiologists and geneticists joined neuroscientists and psychiatrists as more than 50 researchers from five UC campuses participated in the daylong summit at the UC Davis MIND Institute in Sacramento. They shared what they are doing in autism research and discussed ways to increase coordination and have a greater impact in improving the lives of children with autism and their families.

Autism spectrum disorder is one of health’s toughest challenges — a lifelong developmental condition with varying symptoms and severity that can affect social interactions, behavior and the ability to think, learn and problem solve. It has no single known cause and no known cure, though early behavioral-based treatments can help. And its prevalence is rising rapidly: Estimates are that autism affects more than 3 million individuals in the U.S., increasing the need for breakthroughs.

“How can we provide high-quality care for kids when the numbers are increasing dramatically and the resources are not?” said Leonard Abbeduto, Tsakopoulos-Vismara Endowed Chair and director of the UC Davis MIND Institute. “We’re all here because we want to impact the lives of kids and families.”

The autism summit, sponsored by the UC Office of the President, is the first step in an 18-month process aimed at accelerating progress toward treatments and strategies for prevention. The effort will include drafting a strategic plan for a coordinated approach to UC autism research, identifying research opportunities, increasing the number of multicampus grants and launching a series of public statewide autism forums to discuss ways of translating research into improved services.

“These are ambitious goals, but this is the group to make it happen,” Abbeduto said.

Harnessing UC’s expertise

The campuses participating in the summit — Davis, Irvine, UCLA, San Diego and San Francisco — are those with interdisciplinary autism research programs, integrated health care systems and programs that train pediatric health care professionals. Other UC campuses will participate in follow-up meetings.

The summit arose from discussions within the systemwide UC BRAID (Biomedical Research Acceleration, Integration and Development), which identified autism as an area of expertise that was ripe for increased coordination.

“This is really the beginning,” said Dan Cooper, chair of the Department of Pediatrics and director of the Institute for Clinical and Translational Science at UC Irvine. “The summit is designed to harness the unique basic science and translational research talent across the UC system in a way that will profoundly benefit children and adults with autism and related disorders.”

As one of the world’s largest and most prestigious research institutions, UC is uniquely positioned to address the mysteries surrounding autism.

“If we combine and band together, the promise is tremendous,” said Elysa Marco, a cognitive and behavioral child neurologist at UC San Francisco. “I think this represents a wonderful opportunity for us to do something greater.”

A timely collaboration

Thomas Insel, director of the National Institute of Mental Health, who delivered a summit presentation by videoconference, encouraged UC’s efforts, which he said could be a model at the statewide level.

“If you can get a group of people across the state sharing things, that’s a great way to accelerate our understanding and development of treatments,” said neurologist Jeffrey Neul of UC San Diego.

Autism is considered a public health crisis, with an incidence that has increased by more than 600 percent during the past two decades. The U.S. Centers for Disease Control and Prevention estimates that autism now affects 1 in 68 children. More than 350,000 Californians live with autism today.

Los Angeles Unified School District alone has 10,000 students with autism, said James McCracken, the Joseph Campbell Professor of Child Psychiatry and director of the Division of Child and Adolescent Psychiatry at UCLA. He’s optimistic that the UC autism summit will lead to positive outcomes.

“It’s an exciting first step,” McCracken said.

Making an impact

At the summit, researchers split into six working groups aimed at tackling different aspects of autism: genetic risk factors; environmental risk factors; neurobiology; diagnosis, symptoms and developmental trajectories; treatment, pharmacology and services; and research infrastructure.

They identified opportunities for collaboration such as multicampus research projects, hosting workshops to share data and provide training, and developing a systemwide autism patient registry and research repository. They encouraged using the UC ReX (Research eXchange) Data Explorer, a UC BRAID effort that enables UC investigators to identify potential research study cohorts at the five UC medical centers. Several mentioned that offering incentives would spur broader collaborations.

Ultimately, UC summit participants want to help prevent autism and speed treatments and cures. They’re working on many fronts, from behavior to medications to stem cells.

UC Davis MIND Institute researcher Sally Rogers helped develop the Early Start Denver Model, an intensive early intervention therapy for children with autism that fuses play- and relationship-based approaches with teaching practices of applied behavior analysis (a model developed at UCLA).

The Early Start Denver Model is being used around the world. Last week, Rogers trained a group that included participants from Brazil, Canada, Mexico, Spain and Turkey. She wants to have an even bigger impact and sees potential in a universitywide autism collaboration.

“It’s about trying to enhance the quality of life,” Rogers said.

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UC hosting statewide autism summit


UC researchers collaborate across system to address urgent need for treatments.

Bringing together the research prowess of the University of California to address the increase in autism incidence, its public health impacts, and the need to speed the development of treatments for affected individuals and their families, internationally respected scientists from UC campuses at Irvine, Los Angeles, San Diego, San Francisco and Davis will converge at the UC Davis MIND Institute for a daylong summit on innovative translational neurodevelopmental research.

An initiative of the UC Office of the President, the University of California Summit on Translational Research in Autism Spectrum Disorders will be held Thursday (Aug. 14) from 8 a.m. to 5 p.m. at the UC Davis MIND Institute, 2825 50th St., Sacramento. The summit will include a presentation via video conference on “Pressing Issues for a Translational Science of Autism Spectrum Disorder” by Thomas Insel, director of the National Institute of Mental Health (NIMH). Participation in the summit is by invitation only.

“The increase in autism spectrum disorder cases has exceeded the capacity of public and private organizations to provide effective health care, education and treatment to affected families,” said Leonard Abbeduto, Vismara-Tsakopoulos Endowed Chair and director of the MIND Institute.

“We must develop new, more effective strategies for treatment and prevention that are informed by a deeper understanding of the etiology, mechanisms and manifestations of the disorder.”

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UCLA awarded $7M to unravel mystery genetic diseases


One of six institutions chosen by NIH to help tackle the most difficult-to-solve medical cases.

The David Geffen School of Medicine at UCLA is one of six institutions nationwide chosen by the National Institutes of Health to join the agency’s efforts to tackle the most difficult-to-solve medical cases and develop ways to diagnose rare genetic disorders.

Part of a $120 million initiative called the Undiagnosed Diseases Network, the $7.2 million grant to UCLA will support comprehensive “bedside-to-bench” clinical research to aid physicians in their efforts to give long-sought answers to patients living with mystery diseases.

“Undiagnosed diseases take a huge toll on patients, their families and the health care system,” said Katrina Dipple, a co-principal investigator on the UCLA grant with Stanley Nelson, Christina Palmer and Eric Vilain. “This funding will accelerate and expand our clinical genomics program, enabling us to quickly give patients a firm diagnosis and clarify the best way to treat them.”

Despite extensive clinical testing by skilled physicians, some diseases remain unrecognized because they are extremely rare, underreported or atypical forms of more common diseases. An interdisciplinary team of geneticists at each Undiagnosed Diseases Network site will examine and study patients with prolonged undiagnosed diseases.

“A vast number of children and adults suffer from severe, often fatal, undiagnosed disorders,” Vilain said. “This program will enable us to discover new genes causing ultra-rare medical conditions and to identify environmental factors that lead to disease or that interact with genes to cause disease.”

Patients will undergo an intensive weeklong clinical assessment that includes a clinical evaluation, consultations with specialists, and medical tests, including genome sequencing to identify genetic mutations. The team will also evaluate the impact on patients and families of genetic counseling and genomic test results to develop best practices for conveying this information.

The Undiagnosed Diseases Network capitalizes on the strengths of UCLA’s genetic medicine program, particularly its Clinical Genomics Center, which utilizes powerful sequencing technology to diagnose rare genetic disorders. Using a simple blood sample from a patient and both parents, the center can perform a test that simultaneously searches 37 million base pairs in 20,000 genes to pinpoint the single DNA change responsible for causing a patient’s disease. To date, a specific genetic explanation has been identified in a quarter of the cases evaluated with this test, as have a number of novel disease-causing genes.

UCLA is the only facility in the western U.S. and one of only three nationwide with a laboratory that can perform genomic sequence directly usable for patient care, and the university’s Medical Genetics Clinic cares for more than 750 new patients a year and offers comprehensive pre- and post-test genetic counseling.

All patient studies will take place at UCLA’s Westwood campus, at the Clinical and Translational Research Center of the Clinical and Translational Science Institute. Network investigators will share genomic and clinical data gleaned from patients with their research colleagues nationwide to enhance the understanding of rare and unknown diseases.

Patients interested in participating in the Undiagnosed Diseases Network may learn more at www.rarediseases.info.nih.gov/undiagnosed. Applications will be accepted beginning in the fall.

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MedImmune collaboration boosts UCSF’s Catalyst Awards


Partnership will support projects that translate research into treatments.

Roxanne Duan (left), MedImmune, and June Lee, UC San Francisco

The Clinical and Translational Science Institute (CTSI) at UC San Francisco has entered into a three-year collaboration with MedImmune, the global biologics research and development arm of AstraZeneca. The collaboration will focus on CTSI’s Catalyst Awards program, which solicits applications from university scientists who wish to move their translational research beyond the bench and into product development.

This marks the first industrial partnership for CTSI’s Catalyst Awards program’s therapeutic track, which focuses specifically on discovery and development of patient treatment options. The collaboration will benefit both MedImmune’s biologics and AstraZeneca’s small molecule portfolios and will call for proposals in therapeutic areas of interest to MedImmune and AstraZeneca, including cardiovascular and metabolic disease; oncology; respiratory, inflammation and autoimmunity; neuroscience; and infectious disease.

MedImmune and UCSF will collaborate to move forward the most promising research projects over the next three years with the option to extend the partnership. The collaboration will foster scientific exchange and expertise between UCSF and MedImmune scientists, and support projects that translate research into treatments that improve patient outcomes.

“UCSF’s innovative translational research capabilities combined with MedImmune’s industry experience in this area will help identify and nurture promising early science that can benefit MedImmune, UCSF researchers and ultimately patients,” said Dr. Bing Yao, senior vice president and head of MedImmune’s Respiratory, Inflammation and Autoimmunity Innovative Medicines Unit.  “We look forward to partnering with leading scientists at UCSF and growing our collective expertise within the Bay Area, one of the top global bioscience hubs.”

June Lee, M.D., F.A.C.C.P., director of CTSI’s Early Translational Research program, which manages the Catalyst Awards, echoed that sentiment. “This collaboration marks an important first step in cultivating critical industry-academic partnerships in our therapeutics track. Beyond that, it also supports the broader mandate of UCSF and the NIH Clinical and Translational Science Awards to accelerate research to improve health, for which industry and companies like MedImmune are very important partners.”

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University of Texas taps UCSF neurologist to lead new medical school


Clay Johnston to become inaugural dean of medical school at University of Texas at Austin.

Clay Johnston

Clay Johnston

Clay Johnston, M.D., Ph.D., a physician-scientist who expanded UC San Francisco’s patient-centered research through his leadership of the Clinical Translational Science Institute (CTSI) and the new Center for Healthcare Value, is leaving at the end of February to become the inaugural dean of the Dell School of Medicine at The University of Texas at Austin.

A neurologist and epidemiologist, as well as associate vice chancellor for research, Johnston has been at UCSF since his residency 20 years ago. He has published widely in his field – the prevention and treatment of stroke and transient ischemic attack – and treats patients with cerebral aneurysms, vascular malformations and stroke, in addition to directing the hospital stroke service.

Johnston is the principal investigator of a $112 million Clinical and Translational Science Award from the National Institutes of Health aimed at helping scientists bring experimental research into the clinic.

“Clay has played a singular role in UCSF’s drive to accelerate translational research to improve human health,” said Jeffrey Bluestone, Ph.D., executive vice chancellor/provost at UCSF. “He’s a steady and unflappable leader, and this, along with his research acumen, has enabled UCSF to forge critical partnerships in the biotech industry and with foundations and private funders.”

Deborah Grady

Deborah Grady

Johnston, who received his medical degree from Harvard and did his internship at Massachusetts General Hospital, said UCSF was a great training ground for him, and it will continue to be a place where those he mentored and supervised can develop.

“I’m proud of what the people of CTSI have done in the last few years,” he said. “I hate to leave such a strong team and so many great teachers and friends but know that in a place like UCSF their work will only accelerate.  ”

In his new job, he will be building a medical school and hospital, literally from the ground up. The first class of students will enter in the fall of 2016.

CTSI’s co-director, Deborah Grady, M.D., M.P.H., will become interim director of the CTSI. Grady is a professor of medicine, as well as epidemiology and biostatistics. She directs the UCSF/Mount Zion Women’s Health Clinical Research Center and the UCSF Women’s Health Faculty Development Program.

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UCSF, Quest Diagnostics launch collaboration to advance precision medicine


Areas of focus will include autism, oncology, neurology and women’s health.

June Lee, UC San Francisco

June Lee, UC San Francisco

UC San Francisco and Quest Diagnostics, the world’s leading provider of diagnostic information services, have formed a collaboration to accelerate the translation of biomedical research into advanced diagnostics in the field of precision medicine, for improved patient care, treatment and outcomes.

Initial clinical areas of focus include autism, oncology, neurology and women’s health.

The collaboration, which combines the research discoveries and capabilities of UCSF with the national testing database and technical and clinical development capability of Quest Diagnostics, has an overarching aim of enabling holistic and integrated diagnostic solutions that close gaps in care or enable new clinical value.

Under the terms of the agreement, scientists will jointly research, develop and validate diagnostic innovations to solve specific clinical problems and provide actionable information to improve patient care. The organizations will focus on diagnostics to advance precision medicine, an emerging field of medical science that aims to integrate the most informative data from molecular, clinical, population and other research to create predictive, preventive and precise medical solutions for patients. Quest Diagnostics would independently develop and validate any lab-developed tests for clinical use that emerge from the collaboration’s research.

Researchers will utilize laboratory-based diagnostics, imaging procedures and population analysis based on Quest’s national Health Trends database, the largest private clinical database in the U.S., based on more than 1.5 billion patient encounters, to advance precision medicine.

The alliance is the first master agreement that UCSF’s Office of Innovation, Technology and Alliances has signed with a clinical laboratory testing company and augments the university’s efforts to translate laboratory research into new therapies. The broad agreement lays the groundwork for multiple projects between the two organizations.

“Advances in technology and science have identified many promising opportunities to improve outcomes through insights revealed by novel diagnostic solutions, yet fulfilling the full potential of these opportunities often hinges on translational clinical studies which validate their value,” said Jay Wohlgemuth, M.D., senior vice president, science and innovation, Quest Diagnostics. “This unique collaboration between UCSF and Quest brings together the finest researchers and clinicians in the country to accelerate the development of a ‘product pipeline’ of scientific discoveries as clinically valuable diagnostic solutions that enable precision medicine for improved outcomes.”

The collaboration is launching with two specific projects already under way. One project involves Quest’s national database of molecular testing data to facilitate participation in research and development efforts related to genetic variations of autism, based on Quest’s CGH microarray ClariSure technology, which can help identify genetic mutations associated with autism and other developmental disorders. While there currently is no treatment for autism, a test that aids its diagnosis could help identify individuals who might be appropriate candidates for research studies that could lead to future therapies.

The second project aims to identify biomarkers to determine which children with glioma brain tumors may benefit from a drug that is currently available to treat the disease. That project will integrate molecular biomarker testing with advanced MRI imaging technologies. This project is the first phase of larger collaborative studies to develop and validate integrated care pathways, which would include laboratory diagnostics, imaging data and other clinical information to be used in the management of patients with brain cancer and neurological diseases.

UCSF has been at the forefront of the movement toward precision medicine, for which UCSF Chancellor Susan Desmond-Hellmann, M.D., M.P.H., co-authored the initial National Academy of Sciences paper that defined the new field. That paper set the vision of harnessing the vast amounts of genetic, environmental and health data worldwide to make health care more predictive, precise and targeted.

“There are many diagnostics projects underway at UCSF for which Quest could partner and contribute a great deal of value in turning an isolated research project into a diagnostic service or other technology that directly benefits patients,” said June Lee, M.D., F.A.C.C.P., director of early translational research at the UCSF Clinical and Translational Science Institute, which initiated the collaboration with Quest after several scientists from both organizations had formed isolated, but successful, research collaborations. “This agreement will give UCSF researchers access to Quest expertise in developing diagnostics, as well as in understanding the market conditions for projects on campus.”

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New grants to advance career opportunities for young scientists


UC Davis, UCSF two of 10 academic institutions nationwide to receive NIH BEST awards.

Fred Meyers, UC Davis

Fred Meyers, UC Davis

As part of a national effort to broaden scientific training opportunities for young scientists and engineers and better prepare them for a wide variety of careers, the National Institutes of Health has awarded UC Davis a five-year, $1.7 million grant to support the Frontiers of University Training to Unlock the Research Enterprise (FUTURE) program   ̶ a campuswide effort that will expand academic offerings, internships and other experiential learning in the biomedical sciences for graduate students and postdoctoral scholars. UC San Francisco also received one of the NIH Director’s Broadening Experience in Scientific Training (BEST) awards.

UC Davis and UCSF are two of only 10 academic institutions nationwide to receive this first-of-its-kind funding.

“Traditionally, training and career development have been narrowly focused on academic research,” said Fred Meyers, executive associate dean at the UC Davis School of Medicine and one of three principal investigators of the FUTURE program. “But graduate students and postdoctoral scientists need opportunities to develop new skills to enjoy successful careers in today’s diverse employment market. The FUTURE program will provide more opportunities to gain these important skills, increase satisfaction among scholars in training and develop scientists who are well-prepared for the workforce and can make the world a better place to live.”

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UC BRAID holds annual retreat


UC translational medicine leaders celebrate achievements with eye toward future.

UC BRAID program leaders (from left) Clay Johnston, UC San Francisco; Dan Cooper, UC Irvine; Gary Firestein, UC San Diego; Lars Berglund, UC Davis; and Steven Dubinett, UCLA, with Steven Beckwith, vice president for research and graduate studies at the UC Office of the President. (Photo by Christina McCabe, UC San Diego)

UC BRAID program leaders (from left) Clay Johnston, UC San Francisco; Dan Cooper, UC Irvine; Gary Firestein, UC San Diego; Lars Berglund, UC Davis; and Steven Dubinett, UCLA, with Steven Beckwith, vice president for research and graduate studies at the UC Office of the President.

By Patti Wieser

The path forward is clear: To continue and enhance the development of a robust coordinating center that combines the individual University of California health campuses into a model virtual biomedical research institution.

That’s the conclusion reached by representatives of the University of California Biomedical Research Acceleration, Integration, and Development (UC BRAID) program during an annual retreat held at UC San Diego on Oct. 15. About 70 translational medicine researchers, administrative leaders, staff and faculty representing seven UC campuses met to discuss next steps along the path, identify potential research intersections and share the achievements for UC BRAID.

“The largest role for BRAID is enabling partnerships, and that will help us reach our goal of reducing barriers to biomedical research,” said Gary S. Firestein, M.D., UC BRAID chair, director of UC San Diego’s Clinical and Translational Research Institute, and dean and associate vice chancellor of translational medicine at UC San Diego.

Established in 2010, UC BRAID, in collaboration with the University of California Office of the President, is a joint effort of the five UC biomedical campuses to catalyze, accelerate and reduce the barriers for biomedical, clinical and translational research across the UC system. The UC BRAID consortium — UC Davis, UC Irvine, UCLA, UC San Diego and UC San Francisco — pools data, resources and expertise to reach this goal. UC Riverside and Santa Cruz also participated in this year’s UC BRAID meeting.

Major successes of UC BRAID highlighted at the 2013 retreat were:

UC-Research eXchange consortium (UC-ReX): UC BRAID launched the consortium’s first tool from UC ReX, namely the Data Explorer, building the first cross-campus clinical query system capable of exchanging patient-level data, as well as aggregates (counts and descriptive statistics). The UC ReX Data Explorer enables search of 12 million de-identified patient records from the five UC medical centers with one query.

U54 Center for Accelerated Innovation (CAI): NIH’s National Heart, Lung and Blood Institute awarded $12 million to UC to create a Center for Accelerated Innovation (CAI). UC BRAID oversees this new center aimed at translating innovations into improved health.

“An important part of UC BRAID’s mission is to improve UC collaborative research opportunities. UC ReX is a great example of how UC BRAID accomplishes this,” said Firestein, who went on to laud the CAI as a UC BRAID accomplishment. “The new U54 CAI is a remarkable example of inter-institutional collaboration.” Michael Palazzolo, M.D., a professor of medicine at UCLA, is the principal investigator for CAI.

Firestein and UC BRAID Director Rachael Sak, R.N., M.P.H., gave presentations about how UC BRAID takes research from silos to collaboration and how to leverage the program. Firestein cited examples of silos in academic medicine as multiple cores performing the same service, different IT systems in clinical research and resistance to central institutional review boards.

He emphasized the urgency of change, building a guiding team and getting the vision right. “We must empower change, remove obstacles and reward progress,” the UC BRAID chair said.

Clay Johnston, M.D., a member of the UC BRAID Executive Committee, added that UC BRAID realizes its vision by identifying areas of collaboration, aligning across multicampus initiatives, and evaluating priorities and making funding recommendations. “We were established to identify and address, on a systemwide level, the shared challenges of academic translational science,” Johnston said.

Other key topics at the retreat included biorepositories, contracting, regulatory, and drug and device discovery and development. Participants also discussed the new BRAID Child Health Initiative to expand research for the pediatric population. The presentations and agenda are available at: www.ucbraid.org/events.html.

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LaunchPad focuses on catalyzing early-stage research


UCSF project highlights translational research.

UC San Francisco's Ruben Rathnasingham leads the team responsible for LaunchPad.

UC San Francisco's Ruben Rathnasingham leads the team responsible for LaunchPad.

It takes an average of 17 years for new scientific discoveries to make their way into day-to-day clinical practice.

UC San Francisco is working to accelerate this process of translating findings from the bench to the bedside and developing tools and services to make that happen. One of those resources is LaunchPad, a new online resource designed to highlight the experiences and accomplishments of UCSF’s translational researchers, and to support them in their efforts to develop beneficial medical products. The site features videos of investigators sharing their experiences working through five keys to successful translational research – unmet needs, target product profile, collaboration, development plan and organizational support.

Find out more about LaunchPad:

-Visit LaunchPad website
-Read Q&A with LaunchPad’s Ruben Rathnasingham
-Team develops targeted therapies for pain and inflammation
-New drug-delivery system will improve lives of patients with chronic eye diseases
-Researchers develop stem cell therapies for acute lung injury
-UCSF researchers develop novel methods to observe disease processes

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UC consortium designated as Center for Accelerated Innovation


$12M grant to translate discoveries into products that help heart, lung health.

UCLA researcherA consortium of the five University of California medical campuses at Davis, Irvine, Los Angeles, San Diego and San Francisco has been awarded a $12 million grant and designated as one of three Centers for Accelerated Innovations by the National Heart, Lung and Blood Institute (NHLBI). The designation, among the first of its kind from NHLBI, recognizes the University of California’s potential to translate its leading-edge discoveries into innovative products that benefit patients.

The University of California Center for Accelerated Innovation (UC CAI) will leverage the expertise and resources of the system’s five medical center campuses and use industrial product-development practices to incubate technologies with high commercial potential. The five campuses accounted for 7 percent of NHLBI’s fiscal year 2012 grant funding, providing a rich research base to support a diverse pipeline of diagnostics, devices, therapeutics and tools for heart, lung and blood diseases.

The UC CAI, whose administration will be based at UCLA, has four goals:
• Engage University of California heart, lung and blood disease innovators in entrepreneurism through a comprehensive education, training and mentorship program.
• Solicit and select technologies with high commercial potential that align with NHLBI’s mission and address unmet medical needs or significant scientific opportunity.
• Incubate our most promising technologies in accordance with industry requirements to facilitate their transition to commercial products that improve patient care and enhance health.
• Create a high-performing sustainable infrastructure that will serve as a model to academic research centers.

The UC Biomedical Research Acceleration, Integration and Development (UC BRAID), which links the five medical campuses to facilitate contracting, data sharing, regulatory oversight and other activities, will oversee UC CAI.

“The launch of this program is a remarkable example of inter-institutional collaboration,” said Dr. Gary Firestein, director of UC San Diego’s Clinical and Translational Research Institute and chair of UC BRAID. “The leaders of engineering, business and medical schools across the five campuses developed a shared vision and worked with UC BRAID to create an extraordinary proposal. The new resources will dramatically accelerate the development of novel diagnostics, therapies and devices discovered at the University of California.”

The new center will be closely integrated with the translational research institutes and centers on each campus funded by Clinical and Translational Science Awards (CTSA). The CTSA-funded centers and institutes will provide full access to research resources on each campus, including clinical research facilities and labs, access to research cores, biostatistical support, bioinformatics, pilot funding, regulatory consultations and research education and training.

UCLA and several community partners in June 2011 received a five-year CTSA award of $81.3 million to establish the Clinical and Translational Science Institute on the Westwood campus.

The UC CAI also will have access to local biomedical industry organizations, healthcare agencies, clinical networks, public health departments, nonprofit research institutes, venture capitalists, investors and manufacturers of medical devices, diagnostic equipment and pharmaceuticals, which have developed close interactions with CTSA-funded institutes and centers.

“This is an excellent example of what we can accomplish through our CTSAs by collaborating across University of California campuses and disciplines for effective translation of our discoveries to products that will help our patients,” said Dr. Steven Dubinett, director of the UCLA Clinical and Translational Science Institute.

In addition to the considerable support from the CTSAs, each campus will bring its own unique expertise and resources.

Innovators can access resources across all five campuses, including UCLA’s tissue array and translational pathology cores, San Diego’s biomarker and cardiovascular physiology core, San Francisco’s small molecule discovery center and airway clinical research center, Irvine’s mechanical testing, microscopy and cell and tissue cores specifically for cardiovascular technology and Davis’ animal research center.

A skills development program will provide training and education in entrepreneurism and coordinated access to expert mentors. This educational training will help bridge the gap for scientists who lack an understanding of the commercialization potential of their discoveries.

“By aligning our efforts, researchers will have broad access to an even broader array of research cores and education programs,” said Dr. Lars Berglund, director of the UC Davis Clinical and Translational Science Center. “This collaboration will offer robust internship programs, expanded partnerships with outside private and public organizations and new curricular offerings to enrich and complement our already innovative approaches, while not detracting from or prolonging the existing training time.”

Faculty with experience in heart, lung and blood diseases will be available to innovators for consultations. Project managers with experience in industry and academia will ensure technologies developed by the center meet timelines and benchmarks.

“We have worked strategically with our collaborators to ensure a nimble, efficient, and transparent project management effort,” said Dr. Dan Cooper, director of the UC Irvine Institute for Clinical and Translational Science. “We have embedded mechanisms to ensure that specific goals for each project are established and timelines clear. We will work across BRAID to identify delays and obstacles and deal with them as rapidly as possible.”

“Each of the UCs is a powerhouse, but together they are unstoppable,” said Dr. Clay Johnston, director of the Clinical and Translational Science Institute at UCSF. “There is so much more we can do in collaboration and UC BRAID is helping us realize that.”

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Medicaid use surging in California’s emergency rooms


UCSF study findings could be bellwether of national health care reform.

Renee Hsia, UC San Francisco

Renee Hsia, UC San Francisco

More adults in California are flocking to emergency rooms, especially those on Medicaid who are using ERs at a faster rate than the uninsured or privately insured, according to new UC San Francisco research.

The researchers say the findings could reflect a nationwide trend under the Affordable Care Act. Many uninsured people are expected to transition to Medicaid, and as a result, overall emergency department use may increase because Medicaid patients have higher rates of ER use, as the study found. At the same time, some states are proposing cuts to Medicaid or refusing to expand it, which could exacerbate waiting time in the ER.

The analysis will be published as a “Research Letter” on Sept. 18 in the Journal of the American Medical Association (JAMA).

The study investigated trends in the association between insurance coverage and usage of emergency departments among adults ages 18 to 64.

In California, the number of visits to emergency rooms increased 13.2 percent between 2005 and 2010, from 5.4 million to 6.1 million per year, the researchers reported.

“We undertook the study with an eye toward identifying important coming concerns,” said lead author Renee Y. Hsia, M.D., an associate professor of emergency medicine at UCSF. She is also an attending physician in the emergency department at the UCSF-affilated San Francisco General Hospital & Trauma Center and a faculty member of the UCSF Institute for Health Policy Studies.

“All the findings suggest that emergency department use may actually increase with health care reform, instead of decline, if most of the uninsured patients become eligible and enroll in Medicaid,” Hsia said. “These results should not discourage policymakers from pursuing health care reform. Rather we hope our study will shed some light on issues that need to be addressed as we continue to expand insurance coverage to millions of uninsured patients.”

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Team streamlines application process for UCSF chart review research


Approval time reduced from nearly a month to about six days.

Application formRetrospective chart review research, which analyzes existing patient data, is an important way to get early-stage research off the ground, but the application process can be daunting for investigators.

“Chart review studies provide an essential way for residents and junior investigators, who generally have limited time and budgets for research, to get their foot in the door doing research,” said Amy Gelfand, M.D., an assistant professor at UCSF and a pediatric neurologist at the UCSF Benioff Children’s Hospital. “However, junior researchers may avoid conducting chart review research because of a challenging application process.”

Although chart-review studies qualify for expedited Committee on Human Research (CHR) review, Gelfand notes that the process of completing a 20-page form and waiting a median time of 32 days for approval can be burdensome. The CHR is UCSF’s Institutional Review Board (IRB), a committee that reviews research involving human subjects to ensure ethical and equitable treatment of those subjects.

With the goal of streamlining this process, and supported by a pilot award from UCSF’s Clinical and Translational Science Institute (CTSI), Gelfand convened a multidisciplinary team to conduct a rigorous evaluation of the CHR application and approval pathway.

Aided by collaborators that included John Heldens, director of UCSF’s Human Research Protection Program (HRPP), the research team has significantly improved and shortened the application process, saving applicants valuable time.

“A revised application form helped to reduce time to approval from nearly a month to about six days, a major difference that could significantly change how much a resident could accomplish in a one month research elective,” said Gelfand.

The team also halved the number of back-and-forth rounds necessary between the researcher and the CHR staff before approval could be granted. “Not only does this reduce frustration for researchers, but it frees up the CHR staff so that they can focus on, and potentially expedite, other types of study applications at UCSF,” she said.

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