IN THIS ISSUE
Are Gene Patents Psychiatric Pharmacy News Briefs » PAGE 3 Good for Health Care? UCSF practitioner talks about Journal Club » PAGE 5 The experts weigh in at UCSF managing mental illness. Puzzles » PAGE 7 » PAGE 6 » PAGE 3
Synapse The UCSF Student Newspaper
Thursday, November 14, 2013
Precision Medicine Lecture Series Debuts in Pharmacy School
Student-led initiative receives wide support By Priya Jayachandran Staff Writer
ver a decade ago, a new health care model was conceived to transform the approach to patient care from “one-size-fits-all” to “personalized.” Today, this model incorporates advances in genomics and medical technology to create precise techniques for identifying risk factors and preventing disease. Furthermore, it allows health care providers to precisely manage and treat disease states through patient-specific, personalized therapies. The advancement of new technologies has led to the rebirth of this personalized approach under the heading of “precision medicine.” At UCSF, this hot topic has not escaped the attention of its student leaders. This summer, the School of Pharmacy actively supported the creation of two student-led initiatives relating to precision medicine. The first initiative, led by second-year
PRECISION MEDICINE » PAGE 4
Volume 58, Number 10
Nursing Alumnae Pay it Forward With Helpful Reference Website By Hannah Patzke Staff Writer
fter spending years studying and preparing to become a nurse practitioner (NP), you’ve finally reached your goal. You’ve taken your boards and passed and you are officially a practitioner. What do you do now? Well, the obvious answer includes some job searching and maybe some well-earned relaxation, but three new NPs decided to spend their energy helping others. Sarah Oppenheim, Emily Rodda and Shawna Mitchell Sisler got together the summer after graduation and put together a website filled with all of the links, references and knowledge they had gleaned from their UCSF training experience, and npstudent.com came into being. “I couldn’t think of a better way to ‘pay it forward,’” said Oppenheim. “The site gave me something productive to occupy my free time with as well as an outlet for cataloging resources and references that I'd saved throughout my time as a student at UCSF.” Sisler, who had approached Oppenheim about starting the site, said she wanted a catalog of all the best resources they had come across in their graduate school education.
UCSF Hosts Pre-Health Conference
Photo courtesy of Julia Seaman/PSPG (Left to right) Sarah Oppenheim, Shawna Mitchell Sisler and Emily Rodda have launched npstudent. com, a resource website for nursing students.
“Every professor, preceptor and colleague had something great to add to the list,” said Sisler. “Once I found a compatible platform for the site, it built itself. The three of us were able to take a basic structure and make it our very best study guide we’ve ever made.”
Dia de Los Muertos Conference Showcases Careers in Health
UCSF post-baccalaureate Adriana Martinez practices her suturing technique under the watchful eye of second-year medical student Mariya Samoylova.
NP STUDENT » PAGE 4
By Yi Lu Editor
Photos by Yi Lu/MS2
The site is a well-designed resource for pediatric nurse practitioners. The navigation bar at the top links you to Well-Child Check, Study by System, Meds, SOAP Notes and more. There is a fantastic list
driana Martinez threaded her first simple interrupted suture with the dexterity of an old pro. But since this was the first time that she had ever held a needle driver, the UCSF post-baccalaureate could be forgiven for then dropping her needle and having to look across the lab table for instruction on what to do next with her pig’s foot. “I didn’t know if it would be similar to sewing, but I’m realizing that it’s not,” Martinez said, laughing. “It’s totally different.” Martinez and over 150 other undergraduate and post-baccalaureate students from across Northern California and beyond converged onto the UCSF campus November 2 for the 21st Annu-
al Dia de los Muertos Pre-Health Conference. Organized by the Chicanos/Latinos in Health Education (CHE) chapter at UC Berkeley, with significant support from the CHE chapter at UCSF, this year’s conference provided students the opportunity to learn more about health careers from the perspective of the University of California’s only graduate school in the health sciences. “I think UCSF is unique, in that we can really provide a connection to a variety of health professions,” said Maria Quezada, a second-year medical student who was helping to organize the conference. “I think that all the schools did a great job harnessing all the resources available at UCSF and presenting them to the UC Berkeley CHE organization.” For the UCSF students, the responsibility of helping to organize the Dia de Los Muertos
DIA DE LOS MUERTOS » PAGE 6
2 | November 14, 2013 | synapse.ucsf.edu
EVENTS MISSION BAY EVENTS
PANEL DISCUSSION: TRANSITIONING TO UCSF AND THE UNITED STATES Thursday, Nov. 14, noon-1:30 p.m., Helen Diller, 160, Mission Bay As part of the International Education Month Series, come listen to a panel of UCSF international students and postdocs discuss their transition to UCSF and the United States. You will hear about their experiences, gain helpful tips and receive insights about adjusting to your new community. Additional resources will also be provided. Pizza will be provided with RSVP to https://ucsf.co1.qualtrics.com/ SE/?SID=SV_24yz9Tnhc4QIog5
Friday, Nov. 15, noon-1 p.m., Graduate Division, CC-310, Mission Bay Synapse is looking for Mission Bay and Parnassus writers, bloggers, photographers and designers. Come to the lunch meeting, share your story ideas and enjoy a free lunch. RSVP to email@example.com.
MUSLIM FRIDAY PRAYER SERVICES
Friday, Nov. 15, 1-2 p.m., Helen Diller, 160, Mission Bay The Muslim Community at UCSF holds regular Friday prayer services (Jum’a) for the UCSF Muslim community every week. Join your fellow brothers and sisters for prayer, lunch and socializing. All are welcome.
MISSION BAY RIPS
Friday, Nov. 15, 4-5 p.m., Genentech Hall Auditorium, Mission Bay RIPS is a seminar series in which one student and one postdoc present their current research. Talks are 15 minutes in length and are preceded by a 20-minute social. Snacks and beverages are provided.
NON-ACADEMIC CAREERS: JOB HUNTING IN THE BIOTECH INDUSTRY, PART 1
Monday, Nov. 18, noon-1:30 p.m., Genentech Hall Auditorium, Mission Bay Learn to prepare resumes and cover letters as well as job search strategies necessary for success on the biotech/pharma job market. This seminar will prepare you for a comprehensive job search in the biotech industry. Open to graduate students and postdocs. Sponsor: Office of Career and Professional Development.
MISSION BAY FARMERS’ MARKET
Wednesday, Nov. 20, 10 a.m.-2 p.m., Gene Friend Way Plaza, Mission Bay Shop healthy, shop fresh, shop Californiagrown at the UCSF Farmers’ Market every Wednesday (rain or shine). Sponsor: Pacific Coast Farmers’ Market Association.
PARNASSUS EVENTS SCRIPT YOUR FUTURE INFORMATION SESSION
Friday, Nov. 15, noon-1 p.m., Nursing Building, 225, Parnassus Last year, Script Your Future (SYF) at UCSF participated for the first time in the nationwide Script Your Future Medication Adherence Challenge and was able to place as honorable mention among the 80 university participants. Come to our info session to learn more about how to join the team and contribute as an advocate.
SPANISH SEMINAR SERIES
Friday, Nov. 15, noon-1 p.m., Nursing Building, 217, Parnassus CIENCIA is excited to welcome Dr. Eliseo Pérez-Stable, MD, and Chief of the Division of General Internal Medicine at UCSF Medical Center. Anyone who is curious to hear a scientific/clinical talk in Spanish or interested in improving their proficiency with higher-level Spanish language speaking skills is welcome. Please RSVP to cienciaucsf@ gmail.com. Lunch will be provided with RSVP.
ISPOR INFORMATION SESSION
Monday, Nov. 18, noon-1 p.m., Health Sciences West, 300, Parnassus The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) is holding an information session for interested students regarding our newly created student chapter. When you become a member of ISPOR, you join a community of professionals dedicated to promoting our mission to increase the efficiency, effectiveness and fairness of health care to improve health. As a result of our mission objectives, and by being strategically aligned, ISPOR has been instrumental in translating outcomes research to health care decisions globally.
IAPC NOVEMBER MEETING
Monday, Nov. 18, 5:30-7 p.m., Library, 211, Parnassus Interprofessional Aging and Palliative Care will meet with invited expert guests to discuss designated articles related to the care of older adults and delirium. Please contact Anna Strewler (firstname.lastname@example.org) to view the articles.
ASIAN HEALTH CAUCUS IRON CHEF COMPETITION
Monday, Nov. 18, 6-8 p.m., Faculty Alumni House, Parnassus Please join the Asian Health Caucus in its annual cooking competition, modeled after the popular TV show “Iron Chef.” The contest judges will be UCSF faculty members and your fellow peers. Approximately four to five teams from different schools will be competing, each incorporating the secret ingredient. This event will feature an Asian ingredient and Asian dishes that many people may or may not have tried before. Food will be provided, and raffle prizes too!
Tuesday, Nov. 19, noon-1 p.m., Library, 222, Parnassus Student Health and Counseling Services (SHCS) presents a workshop to find out what makes relationships work. Join SHCS providers and life partners, Dr. Susan Rosen and Dr. Lance Raynor, in a discussion about well-researched tenets of lasting relationships. Free lunch for students who RSVP to healthyrelationships-2013.eventbrite.com.
GENENTECH CRDP BREAKOUT SESSION
Tuesday, Nov. 19, 7-9 p.m., Medical Sciences, 180, Parnassus Are you interested in learning more about Genentech postgraduate opportunities and summer internships? Please join us for the Genentech Commercial Rotation Development Program (CRDP) and Managed Care Medical Communications (MCMC) Internship Breakout Session. Dr. DeAnna Kovach, a CRDP program participant, and Dr. Iris Tam, Director of MCMC, will discuss
opportunities for pharmacists in industry and answer your questions.
Wednesday, Nov. 20, noon-1 p.m., Millberry Union 123W, Parnassus Synapse is looking for Mission Bay and Parnassus writers, bloggers, photographers and designers. Come to the lunch meeting, share your story ideas and enjoy a free lunch. Email for more information and to RSVP: email@example.com.
PARNASSUS FARMERS’ MARKET
Wednesday, Nov. 20, 10 a.m.-3 p.m., ACC, 400 Parnassus Ave. Shop the Farmers’ Markets on Wednesdays to pick up locally grown produce and more. Sponsor: Pacific Coast Farmers' Market Association.
TRANSGENDER DAY OF REMEMBRANCE
Wednesday, Nov. 20, noon-1 p.m., Millberry Union, City Lights Room, Parnassus Transgender Day of Remembrance will include a panel discussion, as well as a reading of names memorializing lives we have lost as a result of tranaphobia. We invite friends, family, and allies of transgender people who have experienced loss and/or violence.
NON-ACADEMIC CAREERS: JOB HUNTING IN THE BIOTECH INDUSTRY PART 1
Wednesday, Nov. 20, 12:30-2 p.m., Health Sciences West, 301, Parnassus Learn to prepare resumes and cover letters as well as job search strategies necessary for success on the biotech/pharma job market. This seminar will prepare you for a comprehensive job search in the biotech industry. Open to graduate students and postdocs. Sponsor: Office of Career and Professional Development.
SIMMER COOKING CLASS
Wednesday, Nov. 20, 5-7 p.m., RSVP for location details, Parnassus Join Student Health’s dietitian, Alison Boden, in an interactive cooking class with easy and healthy recipes. Students prepare (and eat!) the dishes during class. RSVP required, as seats are limited. firstname.lastname@example.org.
SUCCESS WORKSHOP SERIES
Wednesday, Nov. 20, 5-6 p.m., Nursing Building, 217, Parnassus Get organized and develop your professional self! The Success Series offers monthly workshops aimed at enhancing your professional experiences and academic wellbeing at UCSF. Topics include improving focus, managing stress and test anxiety, conflict resolution and respecting differences. Every third Wednesday of the month at Parnassus. Free meal with RSVP to felicia. email@example.com
VOCAL CHORDS A CAPPELLA CALL FOR MALE VOICES
Wednesday, Nov. 20, 6:30-8:30 p.m., Health Sciences West, 300, Parnassus Do you enjoy singing? Vocal Chords A Cappella is seeking tenors, baritones and basses to join. Rehearsals every Wednesdays 6:30-8:30 p.m. Contact Jamie Wong if interested at Jamie.Wong@ucsf.edu. facebook.com/VocalChordsUCSF
OFF-CAMPUS CALIFORNIA ACADEMY OF SCIENCES: METAMORPHOSIS NIGHTLIFE
Thursday, Nov. 14, 6-10 p.m., Cal Academy, Golden Gate Park Explore over a dozen industrial, interaction,
illustration, fashion, furniture and graphic designers from California College of the Arts, as they showcase a transformative array of work, highlighting new technologies and innovative ideas that explore the concept of metamorphosis. From giant interactive puzzles and short performance pieces documenting bizarre animal behaviors, to movement-based music and large-scale projections. http://bit.ly/NightLifeTickets. http://bit.ly/CLSDiscounts.
OFF THE GRID: UPPER HAIGHT
Thursday, Nov. 14, 5-9 p.m., Stanyan and Waller Streets, SF Off the Grid is a roaming mobile food extravaganza that travels to different locations daily to serve delicious food, with a free side of amazing music, craft and soul.
ANNOUNCEMENTS WHERE DO I FIT IN? BEING FIRST GENERATION AT UCSF: RSVP BY NOV. 15
Wednesday, Nov. 20, noon-1 p.m., RSVP for location, Parnassus Are you of the first generation in your family to graduate from college? Is it difficult for your family to understand what you do here? Do you sometimes feel like an outsider at UCSF? If you answered “yes” to the above, please join the First Generation Support Services for lunch, share your experiences with fellow first-gen college students, and learn to survive and thrive while you’re here. RSVP: http://bit.ly/TQcR79
UC BERKELEY-UCSF MASTER OF TRANSLATIONAL MEDICINE PROGRAM: APPLY FOR FALL 2014
The Master of Translational Medicine (MTM) program is a professional master's program run jointly by the College of Engineering at UC Berkeley and the Schools of Medicine and Pharmacy at UCSF. More information at bioeng.berkeley.edu/mtm. Interested applicants may contact Executive Director, Kyle Kurpinski, PhD, kkurpins@berkeley. edu. Applications are due Feb. 3, 2014.
UCSF DENTAL CLASS OF 2015 T-SHIRT FUND-RAISER
Due to popular demand, the D3 class is having a school-wide T-shirt fund-raiser and will be accepting orders until Monday, Nov. 18. The design, known as the “Light of the City” T-shirt, was created by the Department of Dentistry’s very own EJ Abasolo (D3) and highlights the city’s iconic Golden Gate Bridge and skyline. The shirts will be arriving just in time for the holiday season and make a great gift for friends and loved ones. Orders here: ejabasolo.wix.com/sod2015shirt
CLASSIFIEDS RETAIL STORES FOR RENT
Sunset SF retail stores for rent: $2,800/ month each, 2132 and 2134 Taraval St., easy transportation, 1 bedroom, kitchen, full bath in the back of store. (415) 665-4567.
SEEKING VOLUNTEER RESEARCH ASSISTANT
UCSF’s Department of Social and Behavioral Science, Institute for Health and Aging, is looking for a volunteer research assistant to work with its research team, focusing on lifestyle behaviors to improve health and prevent disease among diverse ethnic communities (Filipino, Asian Americans, Hispanics). Flexible 8 hours/week . Commitment of at least nine months. Bachelors degree required. Please send a cover letter stating your academic goals, strengths and interests, along with your curriculum vitae, to: melinda.bender@ucsf. edu.
synapse.ucsf.edu | November 14, 2013 | 3
Experts Weigh In On Gene Patents By Benjamin Cohn Staff Writer
ast summer, the United States’ Supreme Court decided that patents held by Myriad Genetics over the BRCA1 and BRCA2 genes — variants of which predispose certain individuals to breast cancer — were not valid, closing at least one chapter on years of litigation involving the company. To discuss the legal, ethical and economic implications of gene patents, Bay Area’s chapter of the Oxbridge Biotech Roundtable (OBR) recently invited a panel of experts to the University of California, San Francisco to try to answer the question: Are gene patents good for innovation and health care? The panel consisted of Jacob Sherkow, Fellow at the Stanford Law School Center for Law and the Biosciences; John West, CEO of the genome diagnostics company Personalis; Bart Wise, Attorney at Wise IP Law; and William Gunn, head of Academic Outreach for the software company Mendeley. Intellectual Property is Complex: A Disclaimer The event was structured as a debate, and the four guests were split up into two teams and asked to deliver arguments either for or against the patentability of human genes. For the purposes of the exercise, each speaker took only one position. However, the arguments surrounding patenting and intellectual property in the health sciences are nuanced and complex. Therefore, while their remarks are summarized below, specific attribution of who said what has been intentionally omitted to prevent confusion between the speakers’ statements in the debate and their real-life beliefs. A pre-event poll indicated that a majority of attendees thought that genes should not be patented, indicating a perhaps surprising uniformity of opinion around the issue. Voting at OBR’s event on the same topic at the San Diego chapter resulted in a similar outcome. If there was one lesson to be learned that evening, however, it was that the issue is
complicated, and there is probably no “onesize-fits-all” solution to intellectual property. Patent laws must be written carefully with foresight for the direction of the field and a sophisticated understanding of the biological systems at play. The Patent System Is an Economic Policy Tool The patent system was specifically built into the United States Constitution as an economic policy tool to encourage investment in innovation. Since the National Institutes of Health and other government sources cannot meet all financial need in therapeutic research and development, private investment becomes an essential driver in bringing new drugs and diagnostics to market. Because this process takes many years to advance through development, clinical trials and regulatory approval, proponents of gene patenting argue that investors need very good assurance that they’ll make a return on their investment. Additionally, investors want to know that the intellectual property (IP) they’re investing in can be protected in the long run. Some argue that patent law may actually encourage innovation by requiring companies
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and researchers to invent workarounds. The personal genomics company 23andMe, for example, offers testing for three BRCA variants as part of a larger panel of tests for genetic polymorphisms. However, it may be difficult to work around very broadly defined patents, such as those covering naturally occurring genomic sequences, and the 23andMe tests would have likely infringed on Myriad’s patents anyway, though Myriad never pursued legal action against them. While allowing financial rewards for investment seems fair and necessary, exactly how to do this without blocking innovation by others remains unclear. Aside from patent protection, there are other ways to incentivize investment, such as Food and Drug Administration regulatory exclusivities (i.e. the FDA won’t approve another version of the same drug during the exclusivity period), tax credits, streamlined or more predictable approval processes during FDA review, and other tailored solutions. For example, the GAIN (Generating Antibiotic Incentives Now) Act, signed into law in 2012, aimed to accelerate development of new antibiotics, by offering manufacturers five years of guaranteed market exclusivity and priority FDA review for molecules that target qualifying pathogens. Who Owns Our Genes? One of the most impassioned arguments against the patentability of genes typically stems from the notion that facts and products of nature aren’t patentable, and that a private company shouldn’t own or control information about ourselves. Indeed, when the U.S. Supreme Court heard AMP vs. Myriad Genetics last summer, several attempts were made to delineate where natural processes end and human ingenuity begins. While a tree is clearly a non-patentable product of nature, does carving a baseball bat from that tree render the bat patentable merely by its isolation from the wood? Myriad had claimed that BRCA1 and BRCA2, when isolated from the rest of the genome, were chemically distinct molecules, having had the covalent bonds separating them from their genetic context severed. This treatment of genes as mere DNA molecules ignores that the real value of a gene, isolated or otherwise, derives from its informational content. Antiquated patent rules based solely on physical properties become problematic when applied to other molecules, such as DNA, antibodies or proteins. Regardless, the debate may already be evolving. Twenty years ago, when researchers at the University of Utah made their initial discoveries that several mutations in the BRCA1 and BRCA2 genes correlated with el-
GENE PATENTS » PAGE 4
NEWS BRIEFS UCSF Announces Establishment of Health Workforce Research Center UCSF has been awarded one of three Cooperative Agreements from the U.S. Bureau of the Health Professions to establish the UCSF Health Workforce Research Center. According to director Joanne Spetz, PhD, the task of the center will be to examine the supply, demand, distribution and capacity of the health care workforce to meet the needs of older adults and persons with disabilities, many of whom are likely to prefer receiving long-term care at home or in communitybased settings. “The aging of the U.S. and global populations — the so-called ‘Silver Tsunami’ — means that an increasing number of us will require long-term care when we can no longer care for ourselves,” said Spetz, a Professor of Economics at the UCSF Philip R. Lee Institute for Health Policy Studies in the Department of Family and Community Medicine and Associate Director of Research Strategy at the UCSF Center for the Health Professions.
Nobel Prize-Winning Biologist to Deliver Gladstone Lecture David Baltimore, PhD, will present the 2013 Gladstone Distinguished Lecture on Wednesday, November 20. The lecture, titled, “The Role of MicroRNAs in Immune Functions,” will begin at 4 p.m. in the Gladstone Institutes’ Robert Mahley Auditorium. The lecture is free and open to the public. Professor Baltimore is President Emeritus and the Robert Andrews Milikan Professor of Biology at the California Institute of Technology (Caltech). An accomplished researcher and educator, Baltimore is one of the world’s most influential biologists. Baltimore was awarded the Nobel Prize in Physiology or Medicine in 1975 for his research into viral replication, which provided the key to understanding the life cycle of retroviruses. A long-time public advocate for science, he has also profoundly influenced national science policy on such issues as recombinant DNA research and the worldwide AIDS epidemic.
City/UCSF Welfare-to-Work Partnership Honors Graduates Newly minted UCSF interns from EXCEL, the model welfare-to-work program run jointly by UCSF and the City and County of San Francisco, graduated on October 25. EXCEL (Excellence through Community Engagement and Learning) is a job-training program that UCSF established in 1998 to extend opportunities to the economically distressed neighborhoods near its campus and the surrounding biotech hub at Mission Bay. With support from the City and County of San Francisco and the Salesforce.com Foundation, EXCEL is cited by city leaders as an example of what can be done when employers who need entry-level workers carefully manage training programs. Over a 15-year period, EXCEL has graduated more than 180 San Francisco residents, including many who ultimately obtained career employment throughout UCSF. This year, the program was expanded with the financial support of the Salesforce.com Foundation, and UCSF now enrolls about 40 interns per year. Jewish Vocational Services (JVS) runs the 10-week course, which includes training in computers, administration, customer service and medical terminology. Participants are then placed in paid, four-month clerical/administrative internships at UCSF.
4 | November 14, 2013 | synapse.ucsf.edu
Gene Patents » FROM HOME PAGE
evated risk of breast cancer, isolating a gene was non-trivial. Now that the human genome has been sequenced, however, in a sense there are no more genes to be “discovered.” In the future, discussion will likely move to whether individual gene variants may be patented. However, with multiplexing technologies, it could become impractical and expensive to patent and defend hundreds of polymorphisms uncovered in a given screen. The key will be to develop far-sighted patent rules that balance a commitment to private industry and protection of investment with rational ideas of what should and should not be protected. How do Gene Patents Affect Patients? With much discussion revolving around the economic implications of gene patenting, it becomes easy to lose sight of the real goal of drug development: to treat patients and meet unmet medical needs in a safe and accessible way. Indeed, one of the greatest benefits of patent law is that it requires immediate disclosure of patented discoveries to the public, which could guide doctors when treating patients. Without patent protection, companies would be likely to keep the results of research and clinical studies secret for as long as possible to maintain a competitive edge in the market. On the other hand, proprietary ownership of genetic information may make it difficult for patients to seek a second opinion before undergoing expensive or invasive treatments. With the newly passed Affordable Care Act (i.e. “ObamaCare”), many more people will be insured and may seek preventative care. One company’s monopoly on a particular preventive diagnostic test would likely result in a higher cost for that test. Indeed, while health insurance providers typically foot most of the $3,000 Myriad charges for its BRACAnalysis test, the high price tag could put a strain on the system when applied on a larger scale. Competition could make diagnostic health care more affordable, especially as personalized and preventative medicine become the new standards of treatment. Others argue, however, that paying a premium for new treatments now ensures the availability of cheaper alternatives in the future, while protecting the innovative process that led to their development.
Benjamin L Cohn is a fourth-year BMS student and a correspondent for the OBR-Bay Chapter.
Science Festival Brings Thousands to Ballpark Staff Report
he Bay Area Science Festival capped its third annual run with a huge turnout for Discovery Day at AT&T Park. About 30,000 people flooded the ballpark on November 2 to check out more than 150 interactive science exhibits, including a virtual reality experience, a tour of human organs in the Giants dugout and an opportunity to build your own Legoscope, a working microscope made from toy building block pieces. David Chiu, President of the San Francisco Board of Supervisors, welcomed the crowd at 11 a.m., with an official ribbon-cutting by a member of the Robot Zoo. The robots, on display in Willie Mays Plaza, were later pitted against each other for a Frisbee-throwing challenge.
SCIENCE FESTIVAL » PAGE 5
Precision Medicine » FROM HOME PAGE
Photo by Dr. Esteban Burchard Pharmacy School students plan the Precision Medicine Lecture Series. (Left to right): Linda Chen, Megan Li, Pin Xiang, Dr. Alan Wu, Henock Walde, Gha-Hyun Kim, Dor Keyvani, Derek Phan, Collin Yu, Som Young, Julia Choi, Nancy Ta.
pharmacy student Dor Keyvani, is a series of lunchtime discussions that aim to familiarize students with the most current and cuttingedge research, tools, and practices in the field of precision medicine. Keyvani developed his interest in this field even before arriving at UCSF. His vision for the series emerged after he learned more about pharmacogenetics in a course taught by Dr. Esteban Burchard of the Department of Bioengineering and Therapeutic Sciences and Medicine. Dr. Burchard met with Keyvani and encouraged him to think on a grand scale. With the help of Dr. Burchard and his research associates, Keyvani recruited an all-star lineup of speakers from 23andMe, uBiome, Genentech, Genomic Health and the Gladstone Institutes to discuss topics such as pharmacogenetics and genetic ancestry, the human microbiome, classical pharmacology, genome-driven oncology and stem cells. Simultaneously, third-year pharmacy students Pin Xiang and Pharmaceutical Sciences and Pharmacogenomics PhD student Megan Li developed the second initiative while serving as teaching assistants for Dr. Burchard’s pharmacogenetics course. With the aid of Dr. Alan Wu, Department of Pathology and Department of Laboratory Medicine, Xiang and Li are coordinating a pilot study in genetic testing of first-year pharmacy students. They aim to determine students’ attitudes and perspectives towards genetic testing and how getting genetically phenotyped for different metabolic enzymes affects student learning of pharmacogenetics. The development of these precision medicine initiatives was “an organic, student-led movement,” said Dr. Burchard, and is sup-
ported by the School of Pharmacy’s Dean, Dr. Joseph Guglielmo, and the faculty. The success of the initiatives rests largely on the dedication shown by Keyvani, Xiang and Li. “Since I have been teaching the class for 10 years now, this is the first time that I’ve had three students that were super highly motivated to run with it,” said Dr. Burchard. “It’s one thing to have the idea, and another to have it come into play. The students get most of the credit.” It is expected that the success of the initiatives will attract other schools within UCSF to join the movement. The lecture series is already drawing attendees from across disciplines, noted Dr. Sam Oh, a postdoctoral scholar in Dr. Burchard’s laboratory and a supporter of the initiative. “I was waiting in line to get into the [Precision Medicine Discussion] lecture, and I turned to the person behind me and asked, ‘Which department or school are you in?’, and they replied, ‘Transplant medicine,’ ” he said. Pharmacies will soon become the point of contact for clinical labs following recent FDA approval, which will make patient counseling on laboratory and genetic testing within the scope of practice of a PharmD. Companies such as Theranos, the Silicon Valley-based life sciences company that has recently partnered with Walgreens pharmacies, are making diagnostic testing accessible and convenient for patients by providing a full blood workup from just a few drops of blood. Pharmacies are bringing precision medicine to the patients, allowing patients to play an active role in their health care. The first Precision Medicine Discussion lecture was hosted by UCSF alumnus Dr. Bethann Hromatka of 23andMe, who spoke
about the company’s genetic testing service and research platform. She also discussed the power of genetic information and how different tools can be used to help individuals learn about their genetic makeup, including what health risks they are predisposed to and how they will respond to certain medications. The second lecture was hosted by uBiome co-founder Jessica Richman, who described how her start-up crowd-sourcing company sequences the genomes of microbial populations from different sites of individuals’ bodies. By sampling from the nose, mouth, skin, gut and genitals, the company hopes to establish direct correlations between an individual’s microbiome and his or her health. Both companies look to empower individuals to play an active role in their health through gaining more knowledge about themselves. Upcoming discussions this fall include: •• Dr. Joseph Ware of Genentech, November 14; •• Dr. Audrey Goddard of Genomic Health, November 19; •• Dr. Bruce Conklin of the Gladstone Institutes, December 2. All the discussions will be held from noon-1 p.m. in Health Sciences West (HSW) 303. In future, this initiative hopes to spread to other disciplines and include student projects and community outreach. To join the movement or learn more about the Initiatives, email Dor Keyvani, Pin Xiang or Dr. Esteban Burchard.
Priya Jayachandran is a first-year pharmacy student.
NP Student » FROM HOME PAGE
of resources and useful links for Flashcards and Medical Spanish. “I think one of the most helpful sections of the website is the ‘Study by System’ section,” said Rodda. “We really put a lot of care into including conditions that are essential for students in pediatric primary care rotations. You can go to a system and see a well-selected list of conditions that can help you organize a differential — and better yet, click on a condition and learn more about its diagnosis and management!” Rodda added, “Now that I’m working, I have NP Student opened on my computer all day. It's the mother lode of pediatric primary care resources that we never had the time to create while we were in school.” So, for all future nurse practitioners out there (and really anyone interested in pediatric care), check out npstudent.com or facebook.com/ npstudent. It also can make you start to think. What can I do after graduation to help and inspire those still trudging through the trenches of grad school?
Hannah Patzke, RN, is a first-year student in the Advanced Practice Public Health Nursing program.
synapse.ucsf.edu | November 14, 2013 | 5
UCSF JOURNAL CLUB
Recent research by UCSF scientists By Alexandra Greer Science Editor
HEMATOLOGY: Production of Factor VIII by human liver sinusoidal endothelial cells transplanted in immunodeficient uPA mice. Fomin, M.E. et al. (Muench). PLoS One. 8(10):e77255. Both the liver and the kidney filter toxins from the blood; however, they achieve their goals in different ways. The kidneys remove toxins from the blood and send them to the bladder for excretion, while the liver removes toxins through biochemical breakdown of the toxins by liver parenchymal cells. Liver sinusoidal endothelial cells (LSECs) separate the blood with the liver parenchyma and help transport toxins, support the structure of the liver and secrete the procoagulant Factor VIII into the blood. In this paper, researchers comprehensively characterized human LSECs by flow cytometry and immunofluorescence, as well as in vitro cell culture from primary isolates. Furthermore, they were able to successfully transplant human LSECs into an immunocompromised animal model and show physiologically relevant levels of Factor VIII secretion into serum. VIROLOGY: Effects of interferon-a treatment on anti-HIV-1 intrinsic immunity in vivo. Abdel-Mohsen, M. et al. (Pillai). Journal of Virology. October 23. [Epub ahead of print]
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Interferon alpha (IFN-a) is a cytokine produced during viral infection that helps cells fight viruses through a variety of mechanisms, some of which are poorly understood. One way that IFN-a inhibits viral replication is through the induction of genes that can cut up viral DNA in the cell, called restriction factors. IFN-a, therefore, may be a potential antiviral therapeutic because of these functions and has been used with success to treat, and even in some cases prevent, hepatitis B and C. Because of these successes, IFN-a has also been investigated as a potential therapy for HIV. In this paper, scientists looked at levels of anti-viral restriction factors in the blood of patients infected with HIV and hepatitis C. Treatment with IFN-a and ribavirin significantly increased blood levels of restriction factors and correlated inversely with viral load.
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NEUROSCIENCE: Neural encoding and integration of learned probabilistic sequences in avian sensory-motor circuitry. Bouchard, K.E.; Brainard, M.S. Journal of Neuroscience. 33(45):17710-23.
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How does the brain develop complicated verbal communication so seamlessly? Neuroscientists think of complex forms of communication, such as speech and bird song, as sets of variable sequences that can be tied together. But how does our brain tie these sequences together and coordinate sensory input with motor (vocal) responses? Two main hypotheses exist: in one, scientists model the probability of transitioning from speaking “A” sequence to any “X” sequence afterwards. In this paper, though, researchers modeled the probability of speaking “A” sequence after any “X” sequence spoken beforehand, called the “convergence” theory. To test this experimentally, they played a randomized series of vocal sequences to songbirds and compared their vocal responses to their expected model. Overall, they found a significant correlation of the songbird responses with their convergence theory, which was better at predicting responses than the previous (called “divergence”) theory. In conclusion, the convergence theory appears to predict the sensory-motor circuitry of songbird “language” and could be applied to other complex systems.
Alexandra Greer is a sixth-year Biomedical Sciences student. For comments or paper suggestions, email Alexandra.Greer@ucsf.edu.
Science Festival » FROM PAGE 4
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Photo by BASF A guided tour of human organs in the Giants dugout, led by UCSF medical and graduate students, included a hands-on view of a brain.
Produced by the Science & Health Education Partnership (SEP) at UCSF, the 10-day festival involved a number of science institutions, including UC Berkeley, Stanford University, the California Academy of Sciences, the Chabot Space and Science Center and the Tech Museum. While the festival culminated with the
AT&T Park event, families got a chance to play and explore science throughout the Bay Area, with Discovery Day-North Bay at the Sonoma County Fairgrounds and Discovery Day-East Bay hosted by Cal State East Bay. In total, nearly 70,000 people participated in this year’s Bay Area Science Festival events, according to festival director Kishore Hari.
6 | November 14, 2013 | synapse.ucsf.edu
Dia de Los Muertos
» FROM HOME PAGE
Conference catalyzed new working relation- from this perspective, it’s pretty daunting. Just ships with their peers in the other schools. getting to know the faces of the people at this “The great thing about CHE is that it’s a conference, you see yourselves in their shoes, great way to work with dental students and and you think, maybe I can do it too.” nursing students and not be in a classroom, but actually do work on a huge project,” said Quezada. “The faculty have also been huge supporters, because this is not only a way to bring all of the disciplines together, but it’s also a way to recruit under-represented students to UCSF.” Photos by Maria Quezada, MS2 And recruit they did. Some of Folkorico dancers perform at lunchtime in Saunders Court during the 21st the biggest draws annual Dia de Los Muretos conference. for the breakout Reflecting after the conference, Quezada groups were the different workshops in some echoed this sentiment. “This conference reof UCSF’s specialized facilities, allowing stually reminded the UCSF students how it felt dents to watch demonstrations of such medto be pre-med and how much of an impact ical procedures as focused assessment with their guidance and words of encouragement sonography for trauma (FAST, a rapid ultracan make on a young Latino’s dream.” sound technique), to practice CPR on dumAlthough Martinez and her friends probmies and to work with dental drills. Other ably still need some more practice with their breakout sessions covered career developsimple interrupted sutures, at the end of the ment, with mock interviews and MCAT stratday, the 155 or so attendees of the 21st annuegy sessions to help students achieve their al Dia de Los Muertos conference are hopeprofessional goals. fully one step closer to their goal of becoming Perhaps even more valuable was the ophealth professionals. portunity for the attendees to network not “I’ve never had anybody go even as far only with students, but also past participants as college; I guess I’m breaking ground,” said of Dia de Los Muertos conferences who have Carrillo. “So for me, I feel that this confergone on to become health professionals. ence and CHE in general are really helping “I’m most excited about just getting to me thread through this process.” know people who basically have made it to medical school,” said Alfonso Carrillo, a secYi Lu is a second-year medical student. ond-year student at UC Berkeley. “I mean
Spotlight on Psychiatric Pharmacist Patrick Finley By Chris Foo Staff Writer
he most common image of a pharmacist is the person who supplies you with your medications at your local pharmacy. But dig deeper, and you’ll discover that pharmacists, like other health care providers, specialize in managing and treating specific disease states. Dr. Patrick Finley is one of about 625 pharmacists in the United States who specialize in psychiatry. Here at UCSF, he serves as a preceptor to psychiatric pharmacy residents and has authored several scholarly articles relating to the field. His practice centers around the management of psychiatric illnesses using pharmacotherapy, the management of medications. Board-certified psychiatric pharmacists (BCPP) undergo a very specialized type of training. After completing two years of residency, a psychiatric pharmacist spends a minimum of one additional year practicing in a related psychiatric environment before qualifying to sit for the board certification exam. The extensive training needed to qualify explains why BCPPs are a rare breed of pharmacist, but more are becoming certified every year. Their aid is a much-needed resource as well; the current model of mental health has numerous shortcomings in providing patients with proper care. “Emergency rooms and primary care clinics have become mental health centers by default, and these settings are ill-suited for this purpose,” said Dr. Finley. “There is a terrible shortage of in-patient mental health facilities throughout the country, and a cogent argument could be made that
prisons have unwillingly assumed this role.” There is a drastic need to increase the amount of mental health practitioners across the country so that patients receive adequate, specialized care by individuals with proper clinical training. Patients have very complex medication regimens, and often need counseling and adjustments to correctly manage their medications. By utilizing their knowledge of psychopharmacology and ensuring that medications are taken correctly and safely, BCPPs provide much-needed support to the mentally ill population. Critics of the field believe that psychiatric pharmacists focus too specifically on medications without providing more holistic treatments. Psychotherapy and other forms of counseling fall outside the scope of training for BCPPs. Patients are encouraged to seek a correct form of therapy that works for them, and medications may or may not be the right treatment. However, with a large population of patients taking antidepressants daily, the impact that psychiatric pharmacists have on patient counseling can’t be ignored, especially within the context of our current health care system. “In spite of the passage of critical legislation such as the Mental Health Parity Act, individuals suffering from mental illness continue to be among the most neglected and stigmatized segments of our society,” said Dr. Finley. “People are reluctant to seek help, for a variety of reasons, but even when they do, it is very difficult for them to access the specialized skills of mental health specialists.”
Chris Foo is a first-year pharmacy student.
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The Weekly Crossword
ACROSS 1 Dressed for a joust 8 Did a lutz 14 Major or little follower 15 South African leader 16 Nimbly 17 "Arabian Nights" character 18 Stein fillers 19 Button alternative 20 ___ be an honor... 21 Stately trees 22 Easy to break 24 Black gold 25 Stretch the truth 26 Sparkly headpiece 27 Crack up 29 Marvelous 31 Lemon peels, sometimes 32 Umpire's call 33 Commuter's option 34 Burger extra 37 Position of control 43 Big occasion 44 Library taboo 45 One with a habit 46 ___ Lizzie (Model T) 47 Odometer button 48 Flaky rock 49 Body art, briefly 50 Usher's offering 51 Work the soil 52 Tilted type 54 Rural area, slangily
by Margie E. Burke 5
17 18 22
Difficulty : Medium
DOWN 1 Carte lead-in 2 Trappings of royalty 3 Cliff Clavin's coworkers 4 Looks up and down 5 Wishes undone 6 Snakelike fish 7 Martini order 8 Evergreen shrub
9 10 11 12 13 15 19 21 22 23 26 27 28 30 33
Sack starter Dipstick word Boring Snobby sort Bounces a baby "Flashdance" tune Calcutta wrap 2003 Will Ferrell film Solidarity symbol Stool pigeon Talk trash Color of a cloudless sky Work well together Bugs, for one Cream of the crop
HOW TO SOLVE: (Answer appears elsewhere in this issue)
Copyright 2013 by The Puzzle Syndicate
Copyright 2013 by The Puzzle Syndicate
57 Stocking stuffer, maybe 58 Babe in the woods 59 Picturesque cave 60 1981 film, "Mommie _____"
Edited by Margie E. Burke
34 Upping the ante 35 Earhart or Lindbergh 36 Cuban coin 37 On edge 38 Blog update 39 Diner staple 40 Dye ingredient 41 Atomic center 42 Courtroom evidence, sometimes 47 Right-hand page 48 Gold digger? 50 River sediment 51 Frat party garb 53 Give the go-ahead 54 Ebay action 55 Hour after midnight 56 Filming site
Piled Higher and Deeper by Jorge Cham
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Parnassus Poets [untitled] Do? Do not ask: did you not lock all the doors? Not ask me hold you; barely hold myself. Drive me slow home from chemotherapy. Sorry go straight to bed, you eat alone. Get chemo Friday, no play, lost weekends, recover, get back to work.
title: "The True Pace of Research" - originally published 10/23/2013
Grad School Illustrated
by Jillian Varonin
Ask me for more love than I can give; love your asking. Back away from precipice: need you to stay. Wait at curbs for cars to pass: need you home from walk. Have patience with me as you wait for me to die. You may be released, your patience rewarded. Forgive my refusals; did best I could. Shame froze my tongue; mean to you. Will send you herald with my apology. Honor her, she will love you. I do. Daniel Raskin, Parnassus Poet
Jillian Varonin is a fourth-year BMS student.
8 | November 14, 2013 | synapse.ucsf.edu
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Volume 58, Number 10