NEWS
ARTS&CULTURE
IDEA to IPO Class
Charlie Varnon in Feisty Old Jew
Training the new science entrepreneur » PAGE 8
IN THIS ISSUE
News Briefs » PAGE 3 Journal Club » PAGE 5 Puzzles » PAGE 11
Synapse Storytelling from the stage » PAGE 11
The UCSF Student Newspaper
Thursday, May 22, 2014
synapse.ucsf.edu
Volume 58, Number 32
NEWS
NEWS
By Tina N. Tran Contributing Writer
vs. The Right to Know
Congratulations to the School Regulating Direct-toConsumer Genetic Testing of Pharmacy Graduates
L
ast Thursday, beloved families, friends and faculty joined 123 Doctor of Pharmacy (PharmD) graduates at Davies Symphony Hall in an event we had all been anxiously waiting for—the UCSF School of Pharmacy Commencement Ceremony. Dean B. Joseph Guglielmo, PharmD, known to the Class of 2014 as “Dean Joe,” opened the ceremony with a warm welcome speech. As he read aloud a few excerpts from our entrance essays, those written just four years ago about our challenges, hopes, dreams and the kind of pharmacists we were all inspired to become, we couldn’t help but think to ourselves: “Four years have flown by in the blink of an eye! It is hard to believe, but we finally did it!” Ryan Beechinor and Gary Lau, our elected student speakers, delivered two personal reflection speeches on their experiences
By Benjamin Cohn and Dalga Surofchy Staff Writers
F Photo courtesy of Tina Tran/P2014 Tina Tran is a member of the the School of Pharmacy, Class of 2014.
as student pharmacists at UCSF as well as their perspectives on the future of pharmacy. These reflections highlighted the qualities that make up the unique student body at the UCSF School of Pharmacy: diverse, authentic, caring, compassionate, innovative, resource-
PHARMACY GRADUATES » PAGE 3
or about $100, customers can have DNA from their saliva analyzed by the genetic testing company 23andMe for hundreds of gene variants thought to be linked to traits ranging from ancestry and earwax type to warfarin sensitivity and Alzheimer’s disease. While 23andMe gives customers access to their raw genetic data, some would say the real value of their product lies in the interpretation packaged with these data. For gene variants linked to health and disease traits, however, , the U.S. Food and Drug Administration has taken notice as 23andMe has yet to provide them with premarket assurance that these interpretations are clinically validated and accurate. The FDA argues that using 23andMe’s service this way qualifies it as a medical device, and ordered the company to cease marketing their kit as a health management tool until these assurances were met. How should the direct-to-consumer (DTC) genetic testing industry respond to the FDA?
NEWS
Paying it Forward: Sutro Stewards Volunteers Keep Our Mountain Accessible By T. Booth Haley Staff Writer
M
t. Sutro is the most amazing backyard any urban university could ever want. Right in the middle of San Francisco, students and neighbors can enjoy 61 acres of eucalyptus forest, replete with rocky outcrops, a summit meadow, miles of trails and even a seasonal creek. The mountain has experienced many changes throughout the last 150 years, including being owned by two different San Francisco majors, but only recently has it truly become the sparkling emerald of the San Francisco park system. The current set of trails that hikers and bikers enjoy today has been greatly improved in the last seven years, almost entirely due
SUTRO STEWARDS » PAGE 8
The Sutro Stewards help maintain the hiking trails of Mt. Sutro.
Photo by Mason Tran/D4
Last month, the San Francisco Bay Area chapter of Oxbridge Biotech Roundtable (OBR) convened experts at UCSF to debate the FDA’s recent decision to bring DTC genetic testing under its regulatory authority. This decision marks the most recent chapter in five years of largely unproductive communications between the federal agency and 23andMe, culminating in December, when the FDA ordered the company to “immediately discontinue marketing the Personal Genome Service (PGS) kits until such time as it receives FDA marketing authorization for the device.” Arguing in favor of the FDA’s actions were Gianfranco de Feo, VP of Marketing at the Redwood City-based computational genetics company Bina Technologies, and Patricia Zettler, a fellow at the Stanford University Law School Center for Law and the Biosciences. In opposition were Andro Hsu, Director of Product Marketing at Syapse, Inc., a Palo Alto-based data management software company, and Paul Billings, Chief Medical Officer for Life Technologies. They were joined by Glenda Anderson, CEO and cofounder of the healthcare IT company Farsight Genome Systems. A medical device? If a medical device calls to mind images of heart stents and CT scanners, it might seem surprising that the FDA wants to regulate 23andMe’s DNA testing service under this classification. The distinction is worth thinking about, however, because it relates to the type of service 23andMe claims to be offering. Here’s an excerpt from the official FDA definition for a medical device: “An instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including a component part, or accessory which is intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease.” (http:// www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/Overview/ClassifyYourDevice/ucm051512.htm) Patricia Zettler argued that 23andMe’s test unambiguously satisfies the FDA definition because it was marketed as a way to prevent and diagnose disease. Last year, 23andMe ran a television spot which promised—or at least strongly insin-
GENETIC TESTING KITS » PAGE 4
2 | May 22, 2014 | synapse.ucsf.edu
EVENTS MISSION BAY EVENTS FOOD TRUCK THURSDAYS AT MISSION BAY
Thursday, May 22, 11 a.m.-2 p.m., 4th Street & Nelson Rising Lane, Mission Bay Join the food truck lunch party every Thursday at Mission Bay and explore the tasty culinary options to break up your routine. Each week will feature two different vendors, so there will always be something new. Grab some friends, get some food and take your lunch experience up a notch.
SYNAPSE NEWSPAPER
Friday, May 23, 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 Steven Chin, synapse@ucsf.edu.
MUSLIM FRIDAY PRAYER SERVICES
Friday, May 23, 1-2:30 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. Come join your fellow brothers and sisters for prayer, lunch and socializing. All are welcome.
MISSION BAY RIPS
Friday, May 23, 4-5 p.m., Genentech Hall Auditorium, Mission Bay Research In Progress Seminar is a seminar series at 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.
ALTERNATIVE SOURCES OF FUNDING TALK
Tuesday, May 27, 5:30-7:30 p.m., Rock Hall, 102, Mission Bay Learn about sources of funding for your venture that are less well known than angels and venture capital. We will explore the range of investment possibilities, including corporate venture groups, foundations, crowdsourcing, online markets and other alternative sources. A senior representative of AngelList will join us for part of the evening. Cost: $5. ita.ucsf.edu/news-andevents/alternative-sources-funding-andcrowdsourcing-workshop
THE SEASON FINALE OF THE VOCAL CHORDS
Tuesday, May 27, 7 p.m., Genentech Hall Auditorium, Mission Bay Join us for an exciting evening of UCSF's a cappella group singing jazz and contemporary pop hits! Free food and drinks.
MISSION BAY FARMERS’ MARKET
Wednesday, May 28, 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 CHANCELLOR’S CONCERT SERIES Thursday, May 22, noon-12:45 p.m., Cole Hall, Parnassus
Looking for a place to study or relax between classes? CLS Arts & Events has got just what you need. The Chancellor's Concert Series on Thursdays is a great place to set up your laptop and study or just take a break from classes while listening to classical music. Seating begins at noon. If you are unable to come, you can now listen to the music through live stream.
J-1 ORIENTATION
Thursday, May 22, noon-2 p.m., Medical Sciences, 20 , Parnassus J-1 immigration regulations mandate that all new J-1 visa holders who have started their appointment at UCSF must attend one orientation. At orientation, you will learn about traveling during your program, employment and reimbursement policies, extending your program, and other helpful information about living in San Francisco and doing research at UCSF. Bring your passport and your DS-2019.
GRANTS IN CONTEXT: INSIGHTS AND STRATEGIES FOR FUNDING YOUR RESEARCH
Thursday, May 22, 5-7 p.m., Nursing, 225, Parnassus The GSA Social Science Programs Committee is hosting an interdisciplinary panel on grants and funding. Dean Watkins will provide opening remarks. The panel will be followed by a networking reception with food and drinks.
MUSLIM FRIDAY PRAYER SERVICES
Friday, May 23, 1:30-2 p.m., Medical Sciences, 178, Parnassus The Muslim Community at UCSF holds regular Friday prayer services (Jum’a) for the UCSF Muslim community every week. Come join your fellow brothers and sisters for prayer, lunch and socializing. All are welcome.
CAMPUS EVANGELISTIC FELLOWSHIP
Friday, May 23, 7-10:30 p.m., Nursing, 517, Parnassus Join the Campus Evangelistic Fellowship for its weekly meeting, with Bible study, hymn singing and fellowship.
CARRY THE ONE RADIO
Tuesday, May 27, 5-7 p.m., Student Resource Center, Mission Bay Carry the One Radio is a biweekly science podcast produced entirely by UCSF students. The show has featured some of the country's top scientists and it covers a myriad of science topics. If you are interested in community outreach or science communication come to a weekly meeting. No radio experience necessary. Visit our site to learn more: www. ctoradio.org or find us on twitter: @ctoradio.
SYNAPSE NEWSPAPER
Wednesday, May 28, 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 synapse@ucsf.edu to RSVP.
UCSF RUN CLUB
Wednesday, May 28, 5:30-6:30 p.m., Millberry Union Central Desk, Parnassus Please drop by and join UCSF Fit & Rec for a run. Each Wednesday night, the Run Club runs various distances (from 3-6 miles) at 9 to 11 minutes per mile.
IMN MIDWEEK MEDITATION HOUR
Wednesday, May 28, 5:30-6:30 p.m., Library, CL 211, Parnassus The Integrative Medicine Network invites everyone in the UCSF community to experience a weekly guided meditation. All are welcome, whether you are looking to combat day-to-day stress using meditation or you'd like to uncover subtle layers of your self by diving deep. No experience in meditation is necessary. Both regular meditators as well as amateurs are welcome.
ENTREPRENEUR'S CLUB: THE LIFE OF A PHYSICIAN-DEVICE INVENTOR
Wednesday, May 28, 5:30-7:30 p.m., Library, CL-221, Parnassus Al Chin, MD, Co-founder, Pavilion Medical Innovations. Al is a prolific inventor of medical devices, drawing on his background in engineering and UCSF Medical School. During his 36 year history, he has invented products generating $3.2 billion in revenue and holds 182 U.S. patents. Learn about Al’s approach to entrepreneurship and why he can’t stop inventing. Cost: $5. ucsf.edu/ news-and-events/entrepreneurs-club-lifephysician-medical-device-inventor
ENGLISH CORNER
Wednesday, May 28, 6-8:30 p.m., Clinical Sciences, 130, Parnassus English Corner is an informal conversational English class given as a free community service and provided on a voluntary basis by both people born and raised in the United States as well as many people who have, at one time in their lives, experienced life as a new immigrant to the United States.
OFF-CAMPUS CALIFORNIA ACADEMY OF SCIENCES: SKULL NIGHTLIFE
Thursday, May 22, 6-10 p.m., Cal Academy, Golden Gate Park, SF You’ve seen them in tattoos, in processions down Mission Street, and on high-fashion runways. Now, take a closer look at the roles that skulls play in popular culture. http://bit.ly/NightLifeTickets, http://bit.ly/ CLSDiscounts.
FRIDAY NIGHTS AT THE DE YOUNG
Friday, May 23, 5-8:45 p.m., de Young Museum, 50 Hagiwara Tea Garden Dr., Golden Gate Park Friday Nights at the de Young offers a variety of arts programs. Programs are free and open to the public, but do not include admission to the museum's galleries.http://deyoung.famsf. org/programs.
ANNOUNCEMENTS
UCSF FAMILY DAY AT THE SAN FRANCISCO ZOO: TICKETS ON SALE
Saturday, June 7, 11 a.m.-2 p.m., 1 Zoo Road, SF Campus Life Services invites you to come and enjoy UCSF Family day at the San Francisco Zoo. Discounted admission ticket includes: attractions, lunch, and musical entertainment! Cost: $12/adults and $8/ children (4-14yrs), clsonlinestore.ucsf.edu/.
THE SEASON FINALE OF THE VOCAL CHORDS
Tuesday, May 31, 7 p.m., Health Sciences West, 302. Parnassus Join us for an exciting evening of UCSF's a cappella group singing jazz and contemporary pop hits! Free food and drinks.
UCSF BOOK DRIVE
Bring your donations of textbooks, study guides, workbooks, and novels in clean, legible condition to any UCSF Library. The UCSF Library and its affiliates are hosting a book drive with Better World Books. A portion of every donated book sold will help support The National Center for Families Learning. library.ucsf.edu/content/donateused-books-support-family-literacy-1
Student Inside Guide events & programs health & wellness finances` news, reviews & deals community outreach & more!
Get there with one website insideguide.ucsf.edu
UCSF MEMORIAL DAY CELEBRATION
Tuesday, May 27, noon-1 p.m., Saunders Court, Parnassus Join the Student Veterans at UCSF in honoring the members of the UCSF community who have served in the Armed Forces. Light refreshments will be provided.
PARNASSUS FARMERS’ MARKET
Wednesday, May 28, 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.
CASH IN ON YOUR ARAG LEGAL PLAN BENEFITS!!! WILLS, TRUSTS & MORE...
J.P. Harbour, Esq. P: 415-728-7205 legalharbour@gmail.com Olivera Jovanovic, Esq. P: 510-386-2817 jovanovic.esq@gmail.com
U.C.S.F. ARAG Plan Members are entitled to a comprehensive Trust & Estate Plan (including an Advance Health Care Directive) at a ZERO out of pocket cost! Consultations provided at any U.C.S.F. campus or 1795 Union St., 3rd Fl., S.F.
synapse.ucsf.edu | May 22, 2014 | 3
Pharmacy Graduates
NEWS BRIEFS
» FROM HOME PAGE
ful, talented, hard working and always “thinkoutside-the-box!” People outside of the field of pharmacy may not know that for years, the UCSF School of Pharmacy has been considered the top-ranked Doctor of Pharmacy program in the nation. And since there have not been any alien-pharmacists identified up to today, we may safely assume that we are the #1 pharmacy school in the entire Universe. In 1872, the school was the first to be established in the western part of the United States and became the first Doctor of Pharmacy program to train pharmacists to become specialized clinical pharmacists. Since then, our program has been committed to providing a high quality education, innovative research and excellent patient care. So, you might wonder: “What have the Class of 2014 PharmD graduates accomplished in the past four years to live up to this reputation?” We are proud to say that not only have we been able to serve and make an impact on the UCSF campus, we have also expanded the scope of our experiences to the local, national and global levels. Since our first year being student pharmacists, we have assumed the roles of medicine specialists through a wide variety of activities. Through several health projects, we spent our weekends in the community educating our pediatric, adult and geriatric patients about the appropriate use of medications and their associated side effects. Furthermore, we provided vaccinations, disease and lifestyle information and advice on how to save costs on medications to the public. We served as mentors to high school, undergraduate and post-baccalaureate students because we believe it is our responsibility to prepare the next generation of pharmacists. We traveled internationally to learn and participate in advanced pharmacy practice experiences in countries around the world: Honduras, Switzerland, England, Korea, Taiwan, Kenya, Uganda, Haiti and India. Academically, at UCSF, we conducted research projects that spanned the field of pharmaceutical sciences, health services and policy and direct patient care. We were also firm believers in shar-
Synapse
Graduate Students Recognized for Community Service Two UCSF graduate students received awards for their outstanding community service. Charlie Morgan, a sixth-year student in the Graduate Division’s pharmaceutical chemistry PhD program, won the Chancellor’s Award for Public Service. And Carolyn Sufrin, MD, a student in the medical anthropology PhD program—won the Edison T. Uno Award for Public Service in the faculty category. Morgan, who works at the Wells Lab under the guidance ofJames Wells, PhD, has also served as a volunteer with the UCSF Science and Health Education Partnership (SEP) program almost since he first began his degree program in 2008. Since then, Morgan has taught science as a volunteer teacher at Miraloma and Bessie Carmichael elementary schools and at Lowell and Mission high schools, igniting an interest in science among many San Francisco students. Sufrin will graduate from the Graduate Division’s Medical Anthropology PhD program this spring. She also works at San Francisco General Hospital and Trauma Center as an assistant professor in the Department of Obstetrics, Gynecology and Reproductive Sciences.
E-Cigarettes Expose People to More than ‘Harmless’ Water Vapor
The UCSF School of Pharmacy, Class of 2014, celebrate.
ing our drug expertise with health professionals outside of the School of Pharmacy. We did so by collaborating with medical, nursing, physical therapy, dentistry and biomedical graduate students in interprofessional education activities, projects and seminars. Of course, these are just a few high-
500 Parnassus Ave. Millberry Union 108W San Francisco, CA 94143 tel: (415) 476-2211 | fax: (415) 502-4537 synapse@ucsf.edu
The UCSF Student Newspaper synapse.ucsf.edu STAFF
Yi Lu | EDITOR Jenny Qi | EXECUTIVE EDITOR Angela Castanieto | ASSOCIATE EDITOR Akshay Govind | ASSOCIATE EDITOR Steven Chin | MANAGING EDITOR
About
Synapse is the UCSF student-run weekly newspaper, which runs on Thursdays during the academic year and monthly during the summer. Synapse seeks to serve as a forum for the campus community. Articles and columns represent the views of the authors and not necessarily those of the Board of Publications or the University of California.
Submissions
Announcements and letters should be submitted six days before publication. All submissions can be either emailed or mailed. All material is subject to editing. Letters to the Editor must be signed by the author.
Subscriptions Subscriptions cost $20/year ($40/outside US).
Advertising
Paid advertisements do not necessarily reflect the views of Synapse. Synapse and its editorial board reserve the right to decline advertisements promoting false or misleading claims, known health risks, or content deemed by the editors to be antithetical to the interests of UCSF students or the UCSF community. Synapse does not accept advertisements from tobacco or alcohol manufacturers, or sexually oriented personal ads. Synapse reserves the right to run any ad with a disclaimer.
Photo by Elisabeth Fall
lights on the tremendous accomplishments our graduates have been able to achieve. In the final commencement address of the ceremony, Dr. Michael L. Lim, PharmD, MBA, Class of 1999, urged this year’s PharmD graduates to never stop learning and always attempt to break down silos. Doing exactly that, many graduates from the Class of 2014 will become practicing pharmacists in the community settings, while a majority of others will pursue post-graduate training programs around the nation in the following areas: advanced pharmacy practice in acute, ambulatory, and managed care settings, research fellowships, as well as commercial fellowships. We could not be more proud of the PharmD Graduates, Class of 2014 and cannot wait to see what the future of pharmacy will be in the hands of these graduates. My dearest pharmacist, mentor and educator Dr. Tina Brock used to quote the American writer Flanner O’Connor: “When you can assume that your audience holds the same beliefs you do, you can relax a little and use more normal means of talking to it; when you have to assume that it does not, then you have to make your vision apparent by shock— to the hard of hearing you shout, and for the almost-blind you draw large and startling figures.” These 123 pharmacists are ready to shock, shout, and draw large and starling figures wherever we may be practicing… so watch out world! This article is dedicated to the PharmD graduates from the Class of 2014, our Families, Friends, Faculties, Mentors and most of all, our patients.
Tina is a recent graduate from the UCSF School of Pharmacy, Class of 2014.
In a major scientific review of research on e-cigarettes, UCSF scientists found that industry claims about the devices are unsupported by the evidence to date, including claims that e-cigarettes help smokers quit. The review marks the first comprehensive assessment of peer-reviewed published research into the relatively new phenomenon of electronic cigarettes. The devices, which are rapidly gaining a foothold in popular culture particularly among youth, are marketed as a healthier alternative to tobacco smoking, as an effective tool to stop smoking and as a way to circumvent smoke-free laws by allowing users to “smoke anywhere But in their analysis of the marketing, health and behavioral effects of the products, which are unregulated, the scientists found that e-cigarette use is associated with significantly lower odds of quitting cigarettes. They also found that while the data are still limited, e-cigarette emissions “are not merely ‘harmless water vapor,’ as is frequently claimed, and can be a source of indoor air pollution. The authors concluded that e-cigarettes should be prohibited wherever tobacco cigarettes are prohibited and should be subject to the same marketing restrictions as conventional cigarettes. The paper is published May 12, 2014 in the American Heart Association’s journal Circulation.
Harvey V. Fineberg Named UCSF Presidential Chair Harvey V. Fineberg, MD, PhD, MPP, the president of the Institute of Medicine(IOM), will come to UCSF for a yearlong appointment as a Presidential Chair beginning in September. Fineberg is a public health expert with a particular interest in health policy and medical decision making. He has been head of the IOM, which is the health arm of the National Academy of Sciences, for two full terms, and will step down at the end of June. Before that, Fineberg spent many years at Harvard University; first as a college and medical student, and later as a faculty member, dean of the School of Public Health and provost of the University. At UCSF, Fineberg will write and lecture about global health policy and analysis.
4 | May 22, 2014 | synapse.ucsf.edu
Genetic Testing Kits » FROM HOME PAGE
uated—that they could tell customers “hundreds of things” about their health, including their risk for heart disease, arthritis, gallstones and hemochromatosis. (http://www. ispot.tv/ad/7qoF/23-and-me) “Know more about your health,” the sanguine narration goes. “Change what you can, [and] manage what you can’t.” While the FDA doesn’t object to providing customers access to their raw genetic data, they drew the line when 23andMe started marketing the test as a way to manage disease risk. Andro Hsu saw things differently. Despite 23andMe’s agressive marketing, he said that their product can’t be classified as a medical device because the interpretation provided with raw test results gives only a statistical risk for health-related conditions, not a strict diagnosis. As a former writer and early employee of 23andMe, he recalled obsessing over the wording of their online content as they tried to communicate this distinction to customers. They tried, he said, to relay that genetic risk accounts for only a portion—usually a small portion—of the overall risk of developing a certain disease. Other non-genetic factors, like environment and lifestyle, are important too. Even conceding that people may effectively use 23andMe’s test to manage disease, Hsu said that this definition of a medical device “is too broad to be useful.” He argued that gyms and bathroom scales can also be used to prevent and manage disease, but are obviously unregulated by the FDA. Fitbits, and other wearable, fitness-oriented technology are also unregulated. Other services, such as WebMD.com’s symptom checker—a tool which allows users to input symptoms to see a list of possible medical conditions—carry a familiar “for informational use only” disclaimer, and are unregulated by the FDA. Paul Billings said that calling 23andMe’s DNA test a medical device promotes a “vague definition of [the FDA’s] authority and of what a device is.” Given the lack of regulation over other similar entities, he called its action against 23andMe “unusual and capricious.” Medical maternalism or consumer advocacy? The FDA’s decision to regulate 23andMe’s DNA testing kit could be interpreted as an extension of its mandate to “protect and promote the public health.” Specifically, it worries that patients might make hasty medical decisions without consulting their primary care doctor, and of the “potential health consequences that could result from false positive or false negative assessments for high-risk indications.” (http://www.fda.gov/iceci/enforcementactions/warningletters/2013/ ucm376296.htm) Examples might include a patient inappropriately adjusting his or her medication dose or seeking unnecessary prophylactic surgery. Billings said that this concern is overdrawn, and cited published studies which failed to show significant harm in providing customers with their genetic test results. In one study, Stanford geneticist Dr. Uta Francke surveyed women who had tested positive for variants of the gene BRCA1, which is associated with increased risk for breast cancer. She found that all the women surveyed acted appropriately with the information, seeking more information and re-testing. Furthermore, family members who were unaware of their risk were also informed. (https://peerj.com/articles/8.pdf) In another study from Boston University, researchers found that disclosure of APOE genotype (a risk factor for Alzheimer’s disease) to adult children of patients with the disease produced no significant short-term psychological risks. (http://www.bu.edu/alzresearch/files/pdf/
The FDA argues that 23andMe’s interpretation of a customers' data qualitfies it as a medical device, and ordered the company to cease marketing their kit as a health management tool.
Green_NEJMREVEALIpaper_final6.pdf ) Gianfranco de Feo argued that just because knowing test results doesn’t seem to hurt people, it doesn’t obviate the need for these results to be accurate and clinically meaningful. He alluded to studies conducted by researchers at the University of North Carolina at Chapel Hill (http://www.ncmedicaljournal.com/wp-content/uploads/2013/11/74608. pdf) as well as by the U.S. Government Accountability Office (http://www.gao.gov/ assets/130/125079.pdf), which reported discrepancies between test results for the same samples from different leading personal genomics companies, including 23andMe. Furthermore, some of these companies were unable to provide good clinical interpretations for African American and Asian customers, a limitation which they did not communicate well when the kits were sold. Consumer misdirection aside, de Feo emphasized that the science behind genetic testing is not easy. Interpreting raw test results depends on many factors, such as which markers are assayed, which algorithms are used to process the data, and how the clinical trials were designed in which the gene variants were first identified. Many of these original trials were conducted in very small cohorts, many years ago. Since the current model of conducting large clinical trials or genome-wide association studies (GWAS) for each genetic variant might be unfeasible given the quantity of targets, de Feo advocated for using the technology provided by the personal genomics industry to create large translational databases that could link phenotypes to specific gene variants. With enough participation, this approach could streamline better and more clinically relevant test results. Zettler reminded us that the FDA’s regulatory powers have historically been added after public health disasters. Since the agency was formed in the early 1900s, lawmakers added premarket requirements that drugs be shown safe (1938) and effective (1962), following, respectively, hundreds of deaths in the United States due to diethylene glycol-contaminated sulphanilamide and thousands of birth defects in Europe caused by thalidomide. Medical devices were brought under the same umbrella in 1976 after defective intrauterine devices (IUDs) injured thousands of women in the United States. de Feo cautioned
that only one salient public health disaster, even among a small group of individuals, could set back the consumer genetics industry decades, along with any potential benefits for genomics research. In that light, he thought it was worth it to preventatively regulate the industry and ensure that tests are high quality and clinically validated. The right to know, the right not to know Gianfranco de Feo recognized that the issue of genome ownership evokes a strong emotional reaction, and many people feel that access to their genetic information is a basic right. California and Oregon both extend civil or property rights guaranteeing residents access to their available genetic information. Even so, some patients may not actually want to know their genetic status, especially for untreatable diseases. Economist Emily Oster studied the behavior of at-risk individuals for serious diseases. Among people at high risk for Huntington’s Disease (i.e. one parent has or had the disease), she found that only five percent sought genetic testing, despite the near 100 percent predictive power of the test (http://faculty.chicagobooth.edu/emily.oster/ papers/hdbeliefs.pdf). Similarly low rates of voluntary testing are reported for breast, ovarian and colon cancer and Alzheimer’s disease, for which predictive
genetic tests also exist, albeit with less predictive certainty. When the course of medical treatment is the same in either case, some argue that knowing one’s genetic status adds no value. On the contrary, it could diminish the quality of life for these individuals as well as that of close family members, who may share the same gene variants but may not have sought testing themselves. For most customers, however, the central issue may be one of packaging how the information is presented. Glenda Anderson called 23andMe “recreational genomics,” highlighting the fact that the technology’s ability to predict and manage disease remains in its infancy. While 23andMe encourages customers to share their test results with their doctor before making any medical decisions, most doctors are not trained to interpret this information. Building the requisite databases to improve the technology will take time. Meanwhile, companies like 23andMe must help consumers and their doctors understand how well the science supports the clinical interpretation.
Benjamin Cohn is a fifth-year student in Biomedical Sciences at UCSF/Gladstone Institutes and Dalga Surofchy is a first-year pharmacy student. They are correspondents for the Oxbridge-Bay chapter.
synapse.ucsf.edu | May 22, 2014 | 5
UCSF JOURNAL CLUB Recent research by UCSF scientists By Taylor LaFlam Staff Writer IMMUNOLOGY: Host cell polarity proteins participate in innate immunity to Pseudomonas aeruginosa infection. Tran, C.S., Eran, Y., et al. (Engel). Cell Host Microbe. 2014. 15(5):636-43.
Skin and mucosal surfaces form a critical first barrier to infection. They serve not simply as a passive wall but as a sentry, often detecting impinging pathogens and calling for help from immune cells. The opportunistic bacterium Pseudomonas aeruginosa is a frequent and potentially lethal cause of hospital-acquired infections. Previous research has shown that bacterial aggregate binding to the apical surface of epithelium causes it to change to resemble basolateral membrane. In this paper, Tran and colleagues reported the mechanism underlying this change. They found that the flagellum and type III secretion system needed to be present in the bacteria. They further discovered that binding led to recruitment to the membrane of Par6, Par3, Rac1 and aPKC and that PI3K signaling is required for membrane transformation. CELL BIOLOGY: The kinase regulator mob1 acts as a patterning protein for Stentor morphogenesis. Slabodnick, M.M. et al. (Marshall). PLoS Biol. 2014. 12(5):e1001861. Polarization of cells is essential to life—consider the long axons of neurons, the flagella of sperm, or the apical secretion of goblet cells. Most research on this topic has focused on multicellular organisms, in which both signals from inside and outside the cell control its polarization. Here, however, the authors focused on the extremely large unicellular ciliate Stentor coeruleus, which has a consistent, complex shape. They first demonstrated that they could effectively use RNA interference to manipulate Stentor. When they used this technique to deplete the kinase Mob1, which is located at the posterior of the cell, they found it led to major defects in cell shape. They also noted that Mob1 was required for the cell to regenerate normally from a small fragment. CANCER BIOLOGY: Mechanistic rationale for targeting the unfolded protein response in pre-B acute lymphoblastic leukemia. Kharabi Masouleh, B. et al. (Müschen). PNAS. 2014 May 12. Epub ahead of print. Acute lymphoblastic leukemia (ALL) is one of the most common childhood cancers. It usually develops from cells in the B cell lineage, frequently from the pre-B cell stage. Recently, a clinical trial found an endoplasmic reticulum (ER) stress-inducing drug had a strong anti-ALL effect. The UPR was not previously known to be important in pre-B cells, but here the researchers found that ablation of this pathway led to the death of normal pre-B cells. The authors investigated the role of the UPR pathway in pre-B ALL. They found that an inhibitor of XBP1, which is associated with the UPR, killed pre-B ALL cells in vitro and lengthened survival of mice transplanted with pre-B ALL cells. This research further suggests that the UPR pathway may be a useful target for pre-B ALL treatment. NEUROSCIENCE: Krüppel mediates the selective rebalancing of ion channel expression. Parrish, J.Z., et al. (Davis). Neuron. 2014. 82(3):537-44.
THE STRENGTH TO HEAL
starts with our scholarship.
Capt. Ana Morgan, M.D., HPSP Medical Recipient Brooke Army Medical Center, Texas
You can begin training for the career you’ve always dreamed of with financial assistance from the U.S. Army. Through the Health Professions Scholarship Program (HPSP)*, you could be eligible to receive a full tuition scholarship for an accredited medical program. The HPSP provides reimbursement for books, laboratory equipment and academic fees. You’ll also receive a sign-on bonus of $20,000 and a monthly stipend of $2,157. During breaks, you’ll have the opportunity to train alongside other members of our health care organization. To learn more, call (650)347-3967 or visit San Mateo Medical Recruiting Center 400 S. El Camino Real, STE 450 San Mateo, CA 94402 Email: usarmy.knox.usarec.list.9e3j@mail.mil www.goarmy.com/amedd.html
*Certain requirements and eligibility criteria apply. ©2013. Paid for by the United States Army. All rights reserved. Information subject to change.
Neurons use multiple ion channels to achieve very particular action potential firing characteristics and receptiveness. Disruption of one ion channel gene generally does not disrupt this state, as the expression of other ion channels adjust to compensate. The mechanism by which the cells are able to respond to restore normal neural firing properties is not well understood. In this paper, Parrish and colleagues reported their study of this phenomenon in fruit flies. They showed that loss of the potassium channel Sha1 led to increased expression of the channels Shaker and slowpoke. They found that the transcription factor Krüppel was essential for this response. Moreover, this response was specific in that Krüppel was induced by loss of Sha1 but not in five other potassium channel mutants.
Taylor LaFlam is a fifth-year MSTP student.
6 | May 22, 2014 | synapse.ucsf.edu
come hang out at the
zoo!
UC San Francisco Family Day at the SF Zoo
Saturday, June 7, 2014 UCSF Reserved Area: Patas Lawn 1 Zoo Rd, San Francisco 11:00 am-2:00 pm Discounted tickets: Adults, $12; Children $8 (4-14 years of age) Children 3 & under are free* ✦ Catered Lunch ✦ Live Entertainment ✦ Playground ✦ Nature & Animal Exhibits ✦ Giveaways ✦ Meet & Mingle with UCSF Friends & Family Discounted tickets are limited and available to UCSF affiliates only.** Order yours now: http://clsonlinestore.ucsf.edu/ Deadline to purchase tickets is Friday, May 30, 2014
For details visit: campuslifeservices.ucsf.edu/artsevents *Children 3 and under are not eligible for a meal ticket **You must use a UCSF campus computer or have VPN to access our campus online store. Computer kiosks are available at both UCSF Fitness Center lobbies.
FREE Gift of Choice With Custom Products Order from Sigma® Through BearBuy!
Order Custom DNA & RNA Oligos, qPCR Probes, siRNA and PEPscreen® peptide libraries and receive a FREE gift of your choice when placing a $50 minimum order. Reference promo code 250 when ordering. Offer valid for University of California San Francisco customers placing orders through BearBuy. Customers with qualifying purchase will be contacted in order to select their free gift. Gift options include a T-shirt, acrylic tumbler with lid & straw, or insulated travel mug. Please allow 6-8 weeks for receipt of your gift. One gift per customer. Valid until May 16, 2014.
Oligos for your application,
sigma.com/oligos
For questions, please contact: Lory Tan Account Manager | Phone: (650) 847-7220 | Lory.Tan@sial.com
©2014 Sigma-Aldrich Co. LLC. All rights reserved. SIGMA and SIGMA-ALDRICH are trademarks of Sigma-Aldrich Co. LLC, registered in the US and other countries. Where bio begins is a trademark of Sigma-Aldrich Co. LLC. PEPscreen is a registered trademark of Sigma-Aldrich Co. LLC.
81755 UCSF Synapse Newspaper Ad Update.indd 1
81755
2/25/14 11:09 AM
l l e . l n l a o r b t . i r s C cce hip c o S rtilla rs. . o e s T eak air h p c S wn La oler. et. t. s o e k C cce lan Bo nic b ses. c s i a P ngl ps. Su lo cu . o e S sbe i r F rka. r e a P m m u . S d e F r S live e D
synapse.ucsf.edu | May 22, 2014 | 7
S:10"
google.com/express
.
S:16"
When you can get all of your favorite stores delivered today, some outdoor fun is never more than a few clicks away.
8 | May 22, 2014 | synapse.ucsf.edu
Sutro Stewards » FROM HOME PAGE
to an industrious volunteer group called the Sutro Stewards, founded in 2006. Their latest efforts include a new Stanyan Street trailhead, which leads up to the Historic Trail traversing high on the west slopes, and the lovely summit meadow, an urban paradise filled with sunshine and birdsong. While this tireless group certainly has sponsors—the Rotary Club, UCSF and others—thousands of hours of labor are all provided by volunteers. Students are often too busy to hike up the Sutro trails let alone to help build one, so the assemblage of volunteers is mostly comprised of residents. However, one can’t study ALL the time, and helping build trails or propagate plants is a perfect break for busy pre-professionals. With the Sutro Stewards, a student can do three great things—spend time in nature, get some exercise and give back to one’s community—all in a single morning. Joining the work parties doesn’t require any experience or even an RVSP. Every first and third Saturday of the month volunteers meet at 9 a.m. at the Woods Lot, halfway up Medical Center Way. Craig Dawson, longtime local resident, hiker and leader of the Stewards, greets everyone and then divides the workers into teams. A nursery full of everything from native columbines to coast redwoods has been built to supply the planting projects. A truck full of trail building tools is unloaded at various sites around the mountain for trail projects. The work is fun, the folks are friendly and the session is always followed by good pizza and even better beer (recently Lagunitas IPA and Redhook Audible Ale) at the Aldea Center. Third-year dental students Max Jensen and Ramon Gutierrez joined last month. Their group removed weeds from the summit meadow and then improved water drainage on the North Ridge Trail. “I had
a great time, got outside and got a workout. I’m going to come again,” said Max. Dawson says he would love to see more participation from UCSF students. The longrange plan for the forest includes more trails and the need for plant stewardship is as great as ever, so there will always be plenty of work for spirited volunteers. Damon Lew, from the Office UCSF Community Relationships, reports on one future project: “a new trailhead to Sutro from the western side of campus . . . is in the early stages of planning. In fact, this new stairway/ trailhead is mentioned in the upcoming Long Range Development Plan (LRDP) . . . So keep an eye out, it should be happening soon.” Recently a small trail was built on the west slope of the mountain which was not approved by either UCSF or the Sutro Stewards. While perhaps well intended, renegade projects like this do not ultimately help improve access because they are not up to the safety standards required for an urban trail, said Dawson. Hikers eager to see more trails on Mt. Sutro should let the Office of Community Relations know that they support plans for better access and then channel their zeal for trail building into Sutro Steward volunteer events. Yet while some may be overly enthusiastic, it is astounding how many folks have never felt the joy of exploring our backyard forest. You may think you’re not a hiker, but experience just once the afternoon light filtering through the silvery tree trunks, listen for a moment to the wind in the leaves, close your eyes and hear the birds, smell the earth. Soon you’ll be walking up the mountain more often. And then before you know it, you may even want to join the Stewards and help to maintain our beautiful and unique preserve. For more information on Mt. Sutro, visit sutrostewards.org. T. Booth Haley is a fourth-year dental student.
Photo by Mason Tran/D4 Sutro Stewards meet every first and third Saturday of the month at 9 a.m. at the Woods Lot, halfway up Medical Center Way.
NEWS
IDEA to IPO Class Incubates Science Entrepreneurs By Rosa Chan Staff Writer
A
re you interested learning more about science and business? “IDEA to IPO” is an experiential, team-based entrepreneurship class. This course teaches faculty researchers, clinicians, residents, PhD students, Masters and medical students how to move an idea from the lab/clinic/digital world to the business world. Charles Craik, UCSF professor and entrepreneur, teaches the intensive, 12-week course, which is offered every winter quarter. Craik is the director of the Quantitative Biosciences Consortium (QB3) and the Chemistry and Chemical Biology Graduate Program. Anthony O’Donoghue took Craik's class in 2010 and has since started his own company, Alaunus Biosciences. He developed a technique to simultaneously assay all proteases in a biological sample at exquisitely low concentrations. This global identification of protease specificity allowed him to determine the proteolytic signatures of cancer cells and parasitic organisms and to subsequently identify the major proteolytic enzymes involved. For industrial applications he is using the method to characterize native or recombinant proteases and to screen microbial strains for proteases with desirable characteristics. Synapse: Can you tell me how the IDEA to IPO course initially started? Craik: The class initially started with the support of QB3. QB3 was created to make sure that ideas in the laboratory get into the real world. Now this course has expanded. Synapse: Do I need to have an idea or team
prior to enrolling in the course? Craik: No, you don’t need to have an idea or a team. Synapse: How big is your class? How difficult it is for UCSF students to enroll? Craik: We had 110 applicants this year and we had room for about 60-70 people. There is a preference for people at UCSF. Synapse: What makes this course different than a business class at UC Berkeley or Stanford? Craik: Classes in business school very seldom talk about science. These students are already aware they just need to know how to start a business. This course is designed to people who want to do health related research and have great ideas. Synapse: Is this a good time for startups? Craik: Steve Burrill, CEO of Burrill & Company, a leading life sciences investment talked about how 52 companies went IPO last year and that is a huge number compared to previous years. Synapse: How does this class work? Craik: Topics cover the full range of life science/healthcare entrepreneurship subjects for therapeutics, devices, diagnostics, tools, and digital health ventures. Participants apply classroom learning as they form a team to focus on an idea, assess market potential, create a business model and learn about market assessment, the FDA, reimbursement, IP, basic finance, legal structures, capi-
tal sources and pitching investors. In the end 10 teams present to a jury of individuals that represent top tier Silicon Valley investors. Synapse: Why did you decide to take this class? O’Donoghue: It's been four years since I took the class. As a scientist you spend all this time doing science and along the way you think, “Oh, wow! I think I could commercialize this. Someone in industry might find this useful. But to go from the lab to having a product to sell—nobody teaches that. It's not high on any mentors' agenda. When I heard about this course, I remembered there were a few things from my PhD work that I felt if I could commercialize. There are two kinds of people who take the course. One group has a pretty advanced idea and is looking to build a team, sort of on the cheap, because you can’t hire someone with no money. They might need someone to help develop a business plan. They want to see if as a team they can go from an idea to something that they can pitch to investors. And then there are people like me who are just enthusiastic about understanding the process of going from an idea to a product. So when I started on day one, the people with the ideas pitched their ideas to the group to see if anyone wanted to join their team. There were 15 pitches that day and the rest of the class wrote their order of preference which team they would be most interested in joining. And essentially for the rest of two months, you joined that team and you had different assignments: one person looks at all the IP, another person at financial strategy, the other looks at the science. My job for my team was to understand the IP landscape.
With patents, you may have an idea, but you need to protect a bubble of ideas around that central idea because it is not worth patenting if someone comes and makes a tiny tweak and has a new product. Synapse: Did you see science differently after you took the course? O’Donoghue: Absolutely. In fact the group I joined had pretty advanced ideas. Two guys came in with an idea from their PhD work, a biofuel-related project. No matter what, those two guys were going to start a company and essentially they were just looking for extra hands to move it forward. At the end of class there was a pitch in front of investors. The investors weren’t actually going to invest, but we got the highest score. The investors gave $50,000 as really early seed money to get it to the next stage. Synapse: Are you still involved in this? How did you apply this knowledge? O’Donoghue: No, I was always in the periphery of this project. A year later, I started my own company based on my own technology that I developed. A protease Lab. Charlie and I developed a technology that can globally characterize all protease activity from any biological sample—human tissue, secreted material from bacterial, fungal culture. We are a protease lab and a particular disease. The company exists. We have a client lined up, source of revenue. Fee for service, and we will process them and give them the data.
Rosa Chan is a second-year PSPG graduate student.
synapse.ucsf.edu | May 22, 2014 | 9
ARTS&CULTURE
Charlie Varnon: Storytelling from the Stage By Akshay Govind Associate Editor
B
ernie Schein lives in a Jewish retirement home in San Francisco. He hates yoga, boutique shops, $6 cups of coffee and the people who drink them. Bernie, at 83 years young, has just hitched a ride from a trio of Tesla-driving 20-somethings and bet them $400,000 he can catch a wave his first time surfing. Writer and actor Charlie Varon gives us an engaging blend of humor and social commentary through Bernie’s colorful story, Feisty Old Jew, which he performs as a solo stage work at The Marsh Theater (1062 Valencia St.) in the
Mission. It runs on weekends between now and July 13 and is well worth the $25-$35 ticket prices, available at www.themarsh.org. Varon and his work have been featured on KQED's Forum with Michael Krasny and in the SFGate. In short, Feisty Old Jew is a joy to watch, and Varon is a master at using the physical space of the stage, the dynamics of his voice, and beautifully chosen language to paint vibrant images of his characters and their predicaments. Bernie is one of several imaginary elderly folks living in the same retirement home, and Varon has recently found himself writing volumes about their eccentric views and life experiences, which he refers to as a love letter to his parents’ generation. When I spoke with Varon, we discussed what makes the theater-going experience so unique. After all, why should anyone bother changing out of their pajamas, battling crowds and buying tickets to a play when they can access a nearly unlimited supply of movies, television shows and other entertainment virtually for free these days? Vigorish
Photo courtesy of Charlie Varon Charie Varon performs in Feisty Old Jew, playing at The Marsh Theater through July 13.
Vigorish. The word was used several times during the performance. It sounds strong, hardy, bold. At the end of his performance, Varon asked the audience how many people thought it was a real word. I snickered as nearly half the audience raised their hands. He followed with who would be willing to define it, and majority of the hands dropped. A few stayed up in the air, and I braced myself as I expected someone to be humiliated. “The vigorish, or the vig, is the cut taken by the bookie during a bet,” said a man. I got what he was doing—saying something com-
pletely unrelated to draw attention away from the minor embarrassment of having pretended earlier that he knew the word. “That’s exactly right,” replied Varon. I was stunned. There was no script to how Varon, the audience, or the man would react. Some laughed, some offered their gambling habits as reasons they had heard the word, but everyone did something—all together. It is this real time interaction among humans all in a room together that makes the experience of live theater so magical. In our discussion, Varon quoted Mark Kenward, also a Marsh writer and performer, “our audience is going to leave with more energy than they walked in with.” I know I did. Writers’ Workshop at UCSF? This got me thinking about the stories we are privileged enough to hear about or to be a part of in healthcare, and how great a medium the stage would be to tell them. I discussed the idea with Varon, who would be open to holding a workshop for writers to adapt their stories to be read on stage.
The project would culminate in a night of medical theater, either at UCSF or at The Marsh, depending on availability and interest. We would require some sort of financial support as well as enough interest from writers, performers, and theater-goers. If you would like to be part of this in any capacity, please send me an email at Akshay.Govind@ ucsf.edu, and in the meantime, get thee to a theater.
Akshay Govind is a third-year resident in the Department of Oral and Maxillofacial Surgery.
Arden, the third residence in Bosa Development’s
san francisco’s NEWEST
MODERN RESIDE NC E ,
naturally.
best-selling Mission Bay collection, is a decidedly modern high-rise residence inspired by the natural surroundings of Mission Creek and enlivened by the growing Mission Bay neighborhood.
REGISTER NOW TO BE AMONG THE FIRST TO RECEIVE EXCLUSIVE ANNOUNCEMENTS AND AN INVITATION TO THE UPCOMING SALES CENTER PREMIERE.
ArdenMissionBay.com
This is not an offer to sell, but is intended for information only. The developer reserves the right to make modifications in materials, pricing, specifications, plan, designs, scheduling and delivery of the homes without prior notice. Exclusively represented by The Mark Company. BRE #01235902.
FOOD 10 | May 22, 2014 | synapse.ucsf.edu
The Scoop
A Frozen Section of Holy Gelato! By Dawn Maxey and Theresa Poulos Staff Writers
It’s strange how we tend to overlook gems in our own backyard, so for this installment of The Scoop, we brought one of UCSF’s finest pathologists along to a nearby gelato shop, so that we wouldn’t miss even the most microscopic of details.
H
oly Gelato! is located just blocks away from UCSF’s Parnassus campus, and it was only recently that the Scoop team realized that we had never given it a hard-hitting, newsworthy review. We were accompanied by guest reviewer Dr. Raga Ramachandran, a pathologist beloved amongst UCSF medical students, to help us analyze a sweeter variety of frozen sections. A storefront sign on 9th Street announces that in addition to 18 regular gelatos to choose from—with flavors like Tiramisu, Vanilla Bean and Chocolate Hazelnut—the store features 12 vegan flavors including Mango Sorbet, Thai Tea and the soy-based Charlie Brown’s Nightmare (Chocolate, Peanut Butter & Cookies). We walked in and were greeted by a cooler Holy Gelato! filled with heaping mounds of gelato, neatly 1392 9th Ave separated into vegan and non-vegan halves. (415) 681-3061 The Scoop team ordered a total of nine holygelato.com flavors, including Cinnamon Sin, Dark Open Daily, 1 p.m. to 11 p.m. Chocolate, Vanilla Bean, Fresh Strawberry, Caramelo Chocolate Crunch, White Pistachio, Sea Salted Caramel, White Raspberry Chocolate,and Honey Lavender. Run-away favorites were the White Raspberry Chocolate which team members described as “a perfect combination of flavors” and the Caramelo Chocolate Crunch, chocolate ice cream with caramel and friable toffee pieces distributed throughout. The White Pistachio was also a crowd-pleaser with its large, satisfying nut pieces. The team was more divided in its opinion of the Fresh Strawberry, which had a remarkable strawberry flavor but too icy a texture for some. Dr. Ramachandran described the Sea Salted Caramel as having “more salt than caramel— and I like it the other way around... I’d pick Bi-Rite’s Salted Caramel over this one.” In addition, she noted that the flecks of spice in the Cinnamon flavor bore the appearance of “highly
EACH MIND
MATTERS
stippled chromatin,” while the Dark Chocolate remained “largely acellular.” Just goes to show that you can take the pathologist out of the lab, but she’ll still be on call. The actual scooping and arranging of the flavors was notable, as Dr. Ramachandran pointed to how in her four-flavor medium size order ($4.99) the chocolate was packed into the bottom, with her other three flavors triangularly scooped atop. Even in a “mini” size ($2.99) you could request up to two flavors—a nice option for those of us who are less decisive. Despite the overall satisfying taste and great variety of flavors, you might have noticed that this gustatory delight doesn’t come cheap, as a small (one to three flavors) will set you back $3.99. While enjoying our gelato, the team took careful note of the eclectic surroundings. In addition to frozen treats, patrons are able to purchase a variety of curious items including mugs shaped like ducks, loose-leaf tea, superhero lunchboxes, a perplexing variety of T-shirts and a travel pet carrier ($34.95). Dr. Ramachandran concluded that she was ”confused by their business model.” She also noted that if she lived in the neighborhood and showed up to a birthday party for one of her daughter’s friends with a Hello Kitty lunchbox as a gift, everyone would know that it was likely picked up on the way over. Final report? Holy Gelato! delivers a pretty good gelato if you’re willing to pay top dollar. And if you ever need an Elvis cookie jar, you know where to find one.
Dark Chocolate packed at the bottom with White Pistachio, Honey Lavender and Salted Caramel triangulated on top.
EVERYBODY’S GOT PROBLEMS. YOU ARE NOT ALONE. TALK IT OUT AT
REACHOUT HERE .COM or text ‘reachout’ to 877-877 Monday and Tuesday 4-8 p.m.
Funded by counties through the voter-approved Mental Health Services Act (Prop 63).
15818-01 CalMHSA14 Mobilization Print 5x8 BW.indd 1
Photos by Dawn Maxey/MS4 Holy Gelato! offers 12 non-dairy options in addition to 18 gelato flavors.
5/8/14 12:36 PM
Theresa Poulos and Dawn Maxey are fourthyear medical students.
synapse.ucsf.edu | May 22, 2014 | 11
PUZZLES
The Weekly Crossword
by Margie E. Burke
1 2 3 4 5 6 7 8 9 10 11 12 13 ACROSS 1 Cold-shoulder 14 15 16 5 End of a threat 17 18 19 9 Barfly's perch 14 Fine-tune 20 21 15 New driver, 22 23 24 25 26 27 usually 16 Reprimand 28 29 30 31 17 Leave out 32 33 34 35 36 18 Fiction genre originated in the 37 38 39 40 41 42 '20s 43 44 45 46 20 Is in the past? 21 Philanthropic gift 47 48 49 50 51 52 53 22 Boastful person 57 58 54 55 56 24 In theory only 28 Concerning the 59 60 61 kidneys 62 63 64 65 29 Be in hock 31 Greek vowel 66 67 68 32 Feel bad about 70 71 34 Show the ropes 69 to Copyright 2014 by The Puzzle Syndicate 37 High school 68 Fight site 10 Feature of high 39 Shed feathers class 40 Kind of bed 69 Canterbury 41 Caped cartoon summits 42 Most common 11 Furnace fuel coins canine 70 Like spoiled 12 Laudatory verse 44 Earth-shaking English word 43 Something to tie 13 Headed up 46 Slammer meat 71 Tiny bit 19 Storage spot 49 "Lose Yourself" up 45 Small-dog sound 21 Water down rapper 47 Eye DOWN 23 Paving material 51 Slowly, in music 48 Turn red, maybe 1 "Psycho" scene 25 Sulky look 52 Fairly new 50 Mountain goat 26 Make an 53 Dig (up), as setting 2 Respectful feature impression? information Week of 5/19/14 - 5/25/14 54 Handkerchief 27 Fixed 55 Rubberneck tribute charge 3 What a choir 30 Weather 56 Half a score fabric 57 Wind lazily 58 Contest form often sings in forecast 59 Grade of silver 4 Bottom line 33 Before, 60 Kilauea output 61 Playing card 5 Community spirit 62 Whistle blower? poetically 62 Military leader 6 Primitive shelter 35 Underhanded 63 Small bill 65 Like fine wine 7 Hospital fluids 36 Pekoe packet 64 Chess piece 66 TV studio sign 8 In a tight row 37 Lumpish mass 65 Hand holder? 67 Kaput 9 Inside story 38 Hindu discipline
Edited by Margie E. Burke
Difficulty : Easy
HOW TO SOLVE: (Answer appears elsewhere in this issue)
Copyright 2014 by The Puzzle Syndicate
Piled Higher and Deeper by Jorge Cham
Solution to Sudoku
title: "Check it" - originally published 3/31/2014
THE
VOCAL CHORDSAT UCSF THE SEASON FINALE SPRING A CAPPELLA SHOW
ARTS&CULTURE
Contemplating a Good Death REVIEW: Knocking on Heaven’s Door: The Path to a Better Way of Death, by Katy Butler
By Hannah Patzke Associate Editor
A
n old man lies prostrate in bed, his lips ringed in blue. His chest rises and falls erratically and his eyes flutter occasionally. His daughter holds his hand as he takes his last few breaths. She kisses his forehead and draws the sheet over his face. Is this a good death? Would slipping away during sleep with no warning be better? As medical professionals we spend years learning how to preserve life. But how does one learn when it is time to die? Journalist Katy Butler discusses this question and others in her book Knocking on Heaven’s Door: The Path to a Better Way of Death. Butler’s parents both want “a good death” but are prevented by the very medical advances that save lives in the short term. Should families be allowed to turn off the pacemaker keeping a demented parent alive? Butler illustrates the pain that comes with watching her father die the slow death of dementia following a massive stroke, coupled
www.phdcomics.com
with her and her mother’s inability to ease his passing. A pacemaker keeps his heart beating strongly as his mind fades away. She discusses the spiritual and legal ramifications of helping a loved one die in the United States. It is estimated that roughly 25 percent of our healthcare dollars are spent in the last six months of life. Billions of dollars are poured into desperately keeping bodies alive as they try to shut down. I do not disagree with the right to choose to fight for life, but what about those who are ready to die? Should we force them to keep fighting as well? Too often our fears keep us from discussing and notating these important issues until it is too late. Knocking on Heaven’s Door is a thought-provoking book for medicals professionals, for people whose parents are aging, and for those who wish to consider how they themselves would like to die. What is a good death? How do you want to die?
Hannah Patzke is a first-year Master’s student in Health Policy.
12 | May 22, 2014 | synapse.ucsf.edu
Solutions
Solution to Sudoku
Vision Optical Look sharper. See better. Find us easier, too. Contemporary prescription glasses, sunglasses, and contact lens fitting Millberry Union, B1 For appointment & information 415.476.3100 Hours: M-F 8:30 am-5:00 pm
look sharper Vision Optical
Open at Parnassus & Mission Bay Campuses
for your convenience we accept: All major Credit Cards • Recharge for catering Bear Hugs • UCSF Resident Meal Card
breakfast, lunch, or dinner…
Parnassus: Millberry Union I Level, Parnassus, 415.661.0199 Open Daily 7:00 am-10:00 pm Mission Bay: 550-B Gene Friend Way, Mission Bay, 415.865.0423 Mon-Fri 7:00 am-9:30 pm / Sat-Sun 8:00 am-9:00 pm
You’re Funding Fun! A portion of every dollar you spend at campus retail vendors helps support Arts & Events at UCSF
Get a gourmet taste of Italy. panini, insalate, zuppa, hot pasta, gelato, dolci We offer student discounts. Millberry Union, Plaza Level 415.681.9925
Mon-Thu, 6:30 am-6:00 pm Fri, 6:30 am-4:00 pm Closed Sat & Sun
You’re Funding Fun! A portion of every dollar you spend at campus retail vendors helps support Arts & Events at UCSF
You’re Funding Fun! A portion of every dollar you spend at campus retail vendors helps support Arts & Events at UCSF