COLUMNS
COLUMNS
Dental students get their 15 minutes with the latest installment in our popular ‘Life of … ’ series. » PAGE 3
UCSF’s Ebola treatment center at Mt. Zion is one of 50 (and counting) ready to respond to dangerous infectious diseases. » PAGE 5
BRUSH WITH FAME
GOING VIRAL
IN THIS ISSUE
Calendar » PAGE 2 Puzzles » PAGE 8 The Scoop » PAGE 8 Comics » BACK PAGE
Synapse Newspaper The UCSF Student
synapse.ucsf.edu | Thursday, January 22, 2015 | Volume 59, Number 7
Town hall meeting exposes alienation among UCSF students over race issues
Jenny Qi/Synapse UCSF medical students show solidarity with protestors nationwide at a Die-In in December following the recent deaths of Michael Brown and Eric Garner at the hands of police officers.
By Jenny Qi Editor-in-Chief Students at the Town Hall meeting reported feeling “isolated and alienated” in the wake of decisions on the Michael Brown and Eric Garner cases in late 2014. “As we become more educated, we get more and more segregated,” said a student attendee to aggressive nods of agreement around Cole Hall. It was largely this sense of isolated helplessness that spurred UCSF medical students to organize in a mere five days a national “White Coats 4 Black Lives” DieIn, held on Wednesday, Dec. 10 to spread awareness of the tremendous health issue presented by violence and racism.
On the Friday following the Die-In, organizers—led by second year medical students Frederick Jamison and Sidra Bonner—held the Town Hall meeting to share reflections on violence, racial bias and personal experiences with diversity at UCSF, and to plan the next steps after the Die-In. The majority of Town Hall attendees were from the School of Medicine, but all UCSF students were invited. Given the short time frame in which organizers planned events, some simply learned about them too late. Earlier in the week, students on social media pointed out the need for greater interprofessional communication. “It is imperative that we work across colleges and disciplines at UCSF when it comes to
these issues,” said Florencia Rojo, a sociology doctoral student, in the “National White Coat Die-In @UCSF” Facebook group. “[Greater collaboration] is particularly important given that many people in research programs are working on…issues of racial inequalities, violence prevention, health impacts of violence and trauma, anti-racist direct action and community organizing.” Die-In organizers echoed these sentiments during the Town Hall meeting. This remained a common thread throughout discussion of action items. Ideas suggested included hosting an annual gun violence and health conference, a Tumblr blog featuring student stories of racism, and the creation of an interprofessional student space. Event organizers will meet in the near future (date TBD) to finalize the action plan. Students who want to get involved are asked to e-mail Amanda Onyewuenyi, first year medical student and Student National Medical Association co-president, at Amanda.Onyewuenyi@ucsf.edu. Improving avenues for interprofessional communication in this and other issues is a primary goal of the Graduate and Professional Students Association. To get involved, e-mail gpsa@ucsf.edu.
Jenny Qi is a fourth year BMS student. Action items at the town hall meeting were categorized as follows:
1) Social health accountability 2) Medical school curriculum development 3) Human resources/faculty diversity 4) Policy and advocacy 5) Interprofessional curriculum 6) Sustained dialogue 7) National movement
Mark Citret/UCSF News & Media Services The brand-new Mission Bay Medical Center will officially open for business on Feb. 1
UCSF receives $40 million for new outpatient facility at Mission Bay Medical Center
UCSF will receive a $40 million donation for its new Medical Center at Mission Bay from philanthropist and investor Ron Conway. The medical center, part of a $1.5 billion hospitals project at Mission Bay, is set to open Feb. 1 with some of the clinics opening on Monday, Jan. 26. In honor of Conway’s support, UCSF will name its new 207,500-foot outpatient facility the UCSF Ron Conway Family Gateway Building. The building is expected to have at least 1,500 outpatient visits daily. It will contain a cancer clinic, women’s health clinic and pediatric clinic. Conway’s investment firm, SV Angel, has helped startup companies like Google, Facebook, Square, Twitter, Dropbox, Pinterest and Airbnb. He currently sits on the UCSF Medical Center Campaign Cabinet. He also has served as a board member on the UCSF Foundation and has been a supporter of the Neurosciences Initiative. “We have watched UCSF Medical Center at Mission Bay grow from a concept to a magnificent hospital complex, and can think of no better investment than supporting patients who are accessing needed outpatient medical services,” Conway said in a press-release statement. —Bryne Ulmschneider
Long-range development plan sets goal of expanding campus housing Editor's Note: Finding affordable housing is a struggle for many in the Bay Area, and UCSF students are no exception. Over the next few issues, Synapse will be exploring the present and future of student housing at UCSF.
By Taylor LaFlam and Bryne Ulmschneider Staff Writers Taylor LaFlam/Synapse UCSF plans to turn the upper three floors of UC Hall into housing, starting around 2019.
UCSF has some work to do. The school is accustomed to accomplishing its goals, but right now, by its
own admission, it is falling well short when it comes to housing. In its long-range development plan, approved late last year, the UCSF administration set goals of substantially increasing housing over the next 20 years. Campus housing currently consists of 921 beds spread across 653 units, about two–thirds at Mission Bay and the remainder near Parnassus. As noted in the long-range development plan, “Occupancy is generally 100 percent, with a wait-list of over 700 individuals. There is a correlation between the steep increases
in the number of people on the wait-list and rising rents in the city over the past few years.” A similar proportion of postdocs and students—just shy of 20 percent of each—currently live in campus housing. It is with students and faculty, though, that UCSF wants to make the greatest improvements. Their goal is to provide housing to 40 percent of students, 25 percent of postdocs, 25 percent of clinical residents and 10 percent of the faculty.
HOUSING » PAGE 10
2 | January 22, 2015 | synapse.ucsf.edu
» Calendar Events
MISSION BAY STUDENT SERVICES OPEN HOUSE
Thursday, January 22, 3:30-5:30 p.m. Mission Hall, First Floor, Mission Bay An open house with staff, faculty and students to celebrate the opening of the new Student Services center. Refreshments will be served.
MUSLIM FRIDAY PRAYER SERVICES
Friday, January 23, 1:30-2 p.m., Byers Hall, 211, Mission Bay Friday, January 23, 1-1:30 p.m., Medical Sciences,157, Parnassus The Muslim Community at UCSF holds regular Friday prayer services (Jum’a) every week. Come join your fellow brothers and sisters for prayer and socializing. All are welcome!
CAMPUS EVANGELISTIC FELLOWSHIP Friday, January 23, 7-10:30 p.m., Nursing, 517, Parnassus Join the Campus Evangelistic Fellowship for their weekly meeting with Bible study, hymn singing, and fellowship.
MISSION BAY RESOURCE FAIR
Tuesday, January 27, 9-10:30 a.m., Rutter Center Lobby, Mission Bay Come and learn about various campus services and find a Register Campus Organization (RCO) that is right for you!
FAITH AND REPRODUCTIVE CHOICE SEMINAR Tuesday, January 27, noon-1 p.m., Nursing, 417, Parnassus
Jon O’Brien, President of Catholics for Choice, will speak on the how faith can interplay with reproductive health and choice in this country. Sponsor: Students for Choice.
CARRY THE ONE RADIO WORKSHOP
Tuesday, January 27, 5 -7 p.m., Mission Hall, 1107, Mission Bay Carry the One Radio is a UCSF-based science podcast. The show is run completely by a dedicated group of young scientists who want to share their enthusiasm for research with a wider audience. The group meets weekly to workshop various pieces. All are welcome, no experience needed.
FARMERS’ MARKET
Wednesday, January 28, 10 a.m.-2 p.m., Gene Friend Way Plaza, Mission Bay Wednesday, January 28, 10 a.m.-3 p.m., ACC, 400 Parnassus Ave. Shop the Farmers’ Markets on Wednesdays (rain or shine) to pick up locally grown produce and more. Sponsor: Pacific Coast Farmers’ Market Association
SYNAPSE MEETING
Wednesday, January 28, noon-1 p.m., Millberry Union, 111w, 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.
MEDICAL ANTHROPOLOGY SPEAKERS SERIES: ‘FRESH FRUIT, BROKEN BODIES: MIGRANT FARMWORKER HEALTH IN THE UNITED STATES’ Wednesday, January 28, 5-7 p.m., Toland Hall, Parnassus Explore how market forces, anti-immigrant sentiment, and racism undermine health and health care. Dr. Seth M.
Holmes is a cultural anthropologist and physician whose work focuses broadly on social hierarchies, health inequalities, and the ways in which such inequalities are naturalized and normalized in society and in health care. RSVP Deadline: January 27. holmes-seminar-ucsf.eventbrite.com
UCSF RUN CLUB
Wednesday, January 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 (3-6 miles) at a 9-11 minute per mile.
IMN MIDWEEK MEDITATION HOUR
Wednesday, January 28, 5:30-6:30 p.m., Library, CL215, 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.
ENGLISH CORNER
Wednesday, January 28, 6-8:30 p.m., Nursing, 527, 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 U.S.
FOOD TRUCK THURSDAYS
Thursday, January 29, 11 a.m.-2 p.m., Fourth 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. Rumor has it: come early and don’t miss out! campuslifeservices.ucsf.edu/ retail/services/dine/food_trucks
WILS-TETRAD MALA MURTHY LUNCH Thursday, January 29, noon-2 p.m., Rock Hall Auditorium, Mission Bay Women in Life Sciences (WiLS) invites you to lunch with Dr Mala Murthy. Dr. Murthy is an assistant professor at Princeton’s Neuroscience Institute and department of molecular biology. Dr. Murthy will be speaking about her career, how she got to where she is today, her advice to young scientists, and about supporting women in the sciences.
UC ORACLES TOASTMASTERS
Thursday, January 29, noon-1 p.m., Nursing, 417, Parnassus Toastmasters empowers people to achieve their full potential. Through the Toastmasters’ meetings, people throughout the world can improve their communication and leadership skills, and find the courage to change. Be the speaker and leader you want to be! Attend one of the Toastmasters’ meetings to learn more. Meetings are open to UCSF students, faculty, staff & volunteers.
GPSA FORMAL
Saturday, January 31, 9 p.m-1 a.m., Westin St. Francis, 335 Powell St., SF (off Union Square)
Join the Graduate & Professional Student Association for the annual semi-formal All School Gala and enjoy a night filled with dancing, desserts and photobooths! ucsfformal2015.eventbrite.com
STUDENT REGENT LUNCH AND LEARN Monday, February 2, noon-1 p.m., Multicultural Research Center, MU-123w, Parnassus The UC Student Regent and UC Student Regent Designate will be visiting UCSF on February 2 and are looking forward to meeting with various student groups on campus. Join the Student Regents for lunch and learn more about the UC Student Regent application and interview tips as well as discuss with them how your Student Regents can better advocate for you!
GPSA MONTHLY MEETING
Monday, February 2, 5:30 p.m., Library, 220, Parnassus Meet your assembly members at the monthly Graduate & Professional Student Association meeting and be a part of the discussion on topics relating to student priorities. The agenda will include student representation on committees, the annual formal, the sweeten beverages tax, upcoming events and officer reports. Dinner provided with RSVP.
Announcements
APPLY TO BE THE 2016-17 UC STUDENT REGENT!
The student Regent is a voting member of The Regents of the University of California, attends all meetings of the Board and its Committees and serves for two years (one year as a designate and one year as a voting member) commencing July 1. All mandatory University fees and tuition are waived for the student Regent during the academic years in which he or she serves as a Regent-designate and as a member of the Board. Submit applications by February 22 at 5 p.m.
ARE YOU A FIRST GENERATION TO COLLEGE STUDENT (FG2C)?
Register with the First Generation Support Services Office to give you access to all of the First Generation Support Services and helps the office advocate for you! bit.ly/ firstgenregister
BAGEL TUESDAY
Tuesday, February 3, 9 a.m., Student Lounge, Genentech Hall Second Floor, Mission Bay Come enjoy some free bagels and coffee each month and learn about campus services and events.
CHANCELLOR’S CONCERT SERIES
Thursday, February 5, 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. Lunch will be served while supplies last.
HELP US IMPROVE SYNAPSE AND WIN AN AMAZON GIFT CARD! Attention students: The annual Synapse student survey is coming! For answering a few simple questions about what you would like to see more (or less) of in Synapse, you could win one of 10 Amazon gift cards ranging from $25 to $100 in value! Check synapse. ucsf.edu on Monday, Jan. 26 and stay tuned for details in your e-mail inbox.
BREAKING INTO THE LAB: ENGINEERING PROGRESS FOR WOMEN IN SCIENCE
Thursday, February 5, noon-1 p.m. Rock Hall Auditorium, Mission Bay Why do elite institutions have so few women scientists and engineers tenured on their faculties? How can this problem be addressed? Dr. Sue Rosser, provost at SFSU, will discuss her research on women in academic science. Open to the entire UCSF community. Lunch will be served.
GPSA Presents: A semi formal all school gala
January 31, 2015 @ 9 p.m. westin st. francis
The Annual
UCSF Formal Dancing Desserts Photo Booths No host bar 21 & over $28 per ticket until 1/14 $35 per ticket after 1/14 2 Tickets Per Student I.D. ucsfformal2015.eventbrite.com
synapse.ucsf.edu | January 22, 2015 | 3
» Student Life
» Life of a Dental Student
GPSA Jan. 4 General Meeting Summary Polina Pulyanina GPSA VP Diversity Affairs, Synapse Liaison Annual Winter Formal: Winter Festivities Not Over!
GPSA cordially invites all UCSF students to put on their most fabulous outfits (and their most comfortable dancing shoes) and come to the Annual Winter Formal. Come enjoy an interprofessional night of dancing, desserts, drinks, and photo booths at the Westin St Francis (conveniently located right off Union Square, and three blocks from the Powell Street Muni station) on Jan. 31. As always, please partake in this UCSF tradition responsibly!
Last Lecture: Nominate Faculty by Feb. 2
Every year the student body nominates two to three faculty for the honor of giving a lecture to answer the question “What would you say if it was the last lecture you were to ever give?” Students will vote in February for the faculty they would like to hear. To allow for adequate planning time, nominations must be made by Feb. 2. GPSA looks forward to the address of our voted mentor in the year 2015.
Student Health Insurance: Dependent Coverage, Specialty Rx and Waiver Criteria
Kate Darling of the Student Health Advisory Committee (SHAC) spoke during the GPSA meeting about the UC Student Health Insurance Plan (UC SHIP) and the current issues. The cost of coverage for dependents of UC students is approximately twice as high as the cost of insurance for the students themselves. Prohibitive dependent insurance costs pose a serious financial burden on student caregivers, which may
drive some to leave the UC health plan in favor of alternative insurance coverage. UC SHIP is a self-sustaining plan, meaning that maintaining student enrollment is necessary to ensure stable premium costs. UC SHIP is considering cost-sharing strategies to offset the cost of dependent coverage. A UC SHIP premium cost increase of $19–$40 per UC student would make a significant impact on the cost of dependent coverage. UC SHIP accountants are re-structuring coverage of specialty prescription drug cost. The SHAC would like to hear from students using specialty prescription medications, and how they are affected by the cost of their medication. Due to implementation of the Affordable Care Act (ACA), the UC SHIP updated the insurance waiver criteria to accommodate students who purchased insurance coverage through the exchange. SHAC is looking for experiences students may want to share regarding the new health insurance waiver criteria. Please forward comments to GPSA at gpsa@ucsf.edu
Campus Housing Changes: Term Limits
Cost of living of the area surrounding an educational institution can be an important determinant of which institution a new student will choose to attend. With limited housing options in San Francisco, finding affordable housing close to the UCSF campus is becoming more difficult. Students who move from another area are at a particular disadvantage due to lack of local housing connections. The UCSF Housing Association is considering implementing changes to housing term limit policy in order to accommodate the growing number of students in need of living spaces in the upcoming years. Currently, residency term limits of up to two years are present for some residents. There is discussion on reducing the limit on stay in UCSF housing to one year, as well as giving priority housing to new incoming students.
GPSA » PAGE 5
Synapse
The UCSF Student Newspaper synapse.ucsf.edu
500 Parnassus Ave. Millberry Union 108W San Francisco, CA 94143 tel: (415) 476-2211 | fax: (415) 502-4537 synapse@ucsf.edu | synapse.ucsf.edu
Staff
Jenny Qi | EDITOR-IN-CHIEF Hanna Starobinets | WEB EDITOR Taylor LaFlam | SCIENCE EDITOR Yi Lu | ASSOCIATE EDITOR Bryne Ulmschneider | STAFF WRITER Ilka Fensen | STAFF WRITER
Theresa Poulos | STAFF WRITER Yarrow Madrona | STAFF WRITER Sean Treacy-Abarca | STAFF WRITER Akshay Govind | STAFF WRITER Polina Pulyanina | GPSA LIAISON Ben Sellers | MANAGING EDITOR
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Synapse is UCSF's student-run biweekly newspaper and public forum for the campus community. It runs on Thursdays during the academic year and publishes online in between print issues. Articles and columns represent the views of the authors and not necessarily those of the Board of Publications or the University of California.
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Announcements and letters should be submitted seven days before publication. All submissions must be e-mailed to synapse@ucsf.edu. All material is subject to editing.
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. Visit synapse.ucsf.edu to view the publication schedule and to submit an ad.
Write for Synapse
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In this column we interview students from each year of the Dental School anonymously in order to highlight their experiences, similarities and differences.
Student 1: First Year, Female Tell us about your UCSF experience so far.
Overall, I’ve had a really positive experience at UCSF so far. I have found inspiring mentors and role models to guide me in becoming the welcoming, thorough, passionate dentist I want to become. I loved anatomy lab and simulation lab because I love working with my hands and seeing my skills develop. The hardest part of my first quarter was actually homesickness because I’m a crybaby!
How did you choose dental school?
At 18, I thought I knew what the next 10 years were going to look like. Then, my mom was diagnosed with cancer, and I was suddenly considering delaying college to work, but my parents would not let the disease dictate our lives. In college, I tried medicine, teaching various subjects, industry, and was almost fully committed to pursuing a Ph.D. at one point, but I could never envision doing it for the rest of my life. Then, I tried dentistry. Everything clicked. I wanted to do something innovative to protect health in the whole person while also being academically stimulated, working with my hands, and providing individualized care. For me, dentistry was the perfect combination of art, science and people, and I am lucky to be pursuing my passion.
Is it different from what you originally expected? If so, how?
One of the great things about the dentists that contributed to my decision to pursue dentistry is that they were dedicated to my success, so they weren’t shy about telling me all the good, the bad and the ugly to make sure I knew what I was getting into. I had heard all the horror stories, and I also had very close friends in dental school, so I was prepared. The only thing that really amazes me every day is the wonderful people in my class.
What do you wish someone had told you in the beginning?
Collect more carious [decayed] teeth. We collect natural teeth that have been extracted at dental offices for various exercises in simulation lab. A lot of these exercises seem to require carious teeth, and my teeth are all clean. You also can’t fly with these teeth because they are human body parts, so plan ahead!
What advice would you give other students?
Prepare all your lab sessions in advance. I would definitely sacrifice a little sleep to prepare for labs. You will be more efficient (so it’s a time saver in the end), you will more likely remember what you dissected and performed in the long term, and you can help others.
Looking forward, what excites you the most?
Injections on my friends next year! Just kidding, that’s terrifying. I’m most looking forward to my last two years of clinic when I can help operate on patients for the dental school. Everything now is building toward that work, so I can’t wait to see these efforts come to fruition.
Student 2: First Year, Female Tell us about your UCSF experience so far.
I love the school and the city. I love how I can see the Golden Gate Bridge every morning when I walk to school, even when it is foggy. I love watching the sun setting from the fourth floor of dental clinic. I really enjoyed my classes this past quarter, especially anatomy. The material is difficult, no doubt. … But I am grateful for every day I get to spend here.
How did you choose dental school?
I decided to go into dentistry during a dental implant surgery in my freshman year of college. I had numerous cavities and root canals treated before then, but I never felt a sense of urgency to care for my teeth. During the implant procedure, as the surgeon began drilling into my jaw, that was when I finally came to my senses—I need to start taking care of my oral health seriously. And what better way is than going to dental school to become a dentist?
Is it different from what you originally expected? If so, how?
The only thing would be dental school is harder than I expected. There is a lot to learn and everything is equally important, so time management can easily become an issue.
What do you wish someone had told you in the beginning?
I wish someone told me that it’s OK to not get something on the first few tries. We are [learning] pretty darn hard, tedious procedures—so we should not expect ourselves to do it perfectly on the first, second or, sometimes, even the third try. We should not feel bummed when we mess up, because how else are we supposed to learn, if not through trying and failing and trying again? It is as much about the process as the outcome—so, take our time and as many tries to get the technique down, because in no time, we will be performing these procedures on real patients, and we will not want to depend on pure luck to get the procedure right.
What advice would you give other students?
Learn to be happy for your classmates. Learn to be happy for their accomplishments. Try not to think of it as a competition. We are all in dental school because we want to be able to provide dental care to those in need. If that is our common goal, and if our classmates can provide better care for them, then we should be happy for and supportive of them, and vice versa. In the end, we will all get a DDS degree. Amidst the crazy amount of readings and exams, do not lose sight of your ultimate goal: to become a health care provider and to be happy.
4 | January 22, 2015 | synapse.ucsf.edu
» Student Life
Students with kids: How can UCSF help?
because the caregivers are licensed doesn’t mean they are easy to locate. One would hope that you could find them on Yelp or Google, but in reality many licensed, family child care homes do not even have a website. That’s where the UCSF Child Care Referral Service comes in handy. Bright Horizons Sittercity Program You simply e-mail Bright Horizons Sittercity Program is one of the programs available through them your child’s UCSF that helps students and postdocs who are parents find babysitters. age, start date and Mayya Shveygert any geographical/financial preferences, and Staff Writer in a couple of days you will receive a list of various child care options that you can then All good things in life come with a screen and evaluate according to your needs. price. Children are not exception. According to a recent report from the BRIGHT HORIZONS CARE U.S. Department of Agriculture, it will ADVANTAGE/SITTERCITY cost an estimated $241,080 for a middle If you choose to leave your child with income couple to raise a child from birth a babysitter or if you need emergency to 18 years old. Such data gives a lot of backup care, UCSF provides you with a food for thought to those who are considfree access to Sittercity, which is an online ering starting a family, particularly those balancing a busy professional life or rigor- database of pre-screened sitters and other types of home help (regular subscription is ous degree program. $140/year). You can also use this service if Despite all the odds, some students you are looking for a reliable caregiver for and postdocs at UCSF decide to spice up an elder family member—or you can even already turbulent years of training with search for a pet sitter. In addition to servjoys and challenges of child-raising. As a ing postdocs, this program was expanded mother myself, I was curious about how to serve graduate students in September, UCSF supports its trainees with children. and it has since been used by students at UCSF Family Services oversees several least 110 times. services for UCSF parents, most of which aim at helping families to find affordSTUDENT CHILD CARE able and high-quality child care (A piece SUBSIDIES of somewhat bitter advice—make your choice between affordable and high-quali- Graduate students might be eligible to receive financial assistance to cover ty, because you can rarely have both.) Locating reliable people with whom you reasonable child care costs if they can prove that they have a financial need and would entrust your child for 8–10 hours a are either single or have a partner who is day, five days a week is not a small feat, fully employed, thus is unable to take care and most of the parents find this process of the child. nerve-racking. To get the information In general, UCSF’s graduate division firsthand, I met with Suzie Kirrane, who does a good job of caring for its Ph.D. stuis a family services manager at Campus dents with children. Apart from the child Life Services. “If I had only one minute care grants, it provides that Ph.D. students to talk to postdocs and students, I would may take up to 10 weeks of paid parental want them to know about the Child Care Referral Service, the new Care Advantage/ leave for childbirth, the adoption of a Sittercity program, and the Graduate Divi- child or the placement of a foster child under their care. These students continue sion Child Care Grant program. The camto receive their current level of support pus is working to meet a variety of child care needs, recognizing the high demand,” during the 10 weeks of paid parental leave, regardless of the fund source. In Kirrane said. contrast, some other UC campuses, such as UC Berkeley and UCLA, secure only UCSF CHILD CARE RESOURCE six weeks of paid parental leave. AND REFERRAL SERVICE You would be surprised how difficult it can be to find child care providers in your area. In brief, parents have three options: leaving your children with a baby sitter, taking them to a licensed family child care (care is provided in the house of a caregiver) or enrolling them in a commercial, private or nonprofit child care centers. By law, most types of out-of-home child care providers have to be licensed, and the option you choose depends on your personal preferences. However, just
If you want to learn more, check out myfamily.ucsf.edu. This is a great starting point to learn about UCSF and community resources, including information on planning dependent care leave, parent education events, family events and more. You can also join the Family Services’ enewsletter to receive monthly news and services updates.
Mayya Shveygert is a second-year postdoctoral fellow.
Postdoc selected as FameLab finalist
Ed Roberts is now a regional FameLab finalist.
Andrea Villaroman Staff Writer
UCSF postdoctoral scholar Ed Roberts championed the third season of FameLab USA’s San Francisco regional heat in December, earning a spot as a finalist in the Spring 2016 national finals. Described as “American Idol for scientists,” FameLab originally was established in 2005 in the United Kingdom to promote scientific communication to the public and encourage public engagement with science. Since 2012, FameLab has partnered with NASA to host competitions in the U.S. The two-day event hosted 14 early career scientists who were passionate about science in conjunction with the 2014 American Geophysical Union Fall Meeting. FameLab competitors were given three minutes to present sans PowerPoint, printed images, or other forms of visual or electronic media. Captivating the crowd with his talk on using our own immune systems to fight cancer, Roberts was also voted audience favorite. A few props, his passion for outreach, and a voice were the only things at his disposal. Roberts’ first-round presentation was on vaccination. He and seven other participants then were chosen for an evening round at
Rickshaw Stop, where Roberts drew further from his expertise in tumor immunology. “I think there are a lot of public misunderstandings around vaccination so I wanted to talk about that and I think that tumor immunology is an exciting field but that people are generally not well informed about it,” Roberts said. Roberts’ own experience with outreach began while he was a doctoral student at Cambridge University and a part time youth worker in the U.K. “I was struck by how many [young people] hated science and thought it was boring, and so I started doing workshops with kids in youth groups about immunology to try and engage them with science,” he said. In this mode of action, other UCSF students are taking advantage of opportunities to engage the community and share their passions and interests. Freeman Lan, a bioengineering Ph.D. student, also participated. Lan’s presentations were on how to survive a nuclear winter and viruses as deadly mutants. Creating the groundwork for a great FameLab talk often involves framing scientific concepts through a relatable lens. Other contestants spoke of counting stars for gravity, pole vaulting for quantum tunneling, and diet and exercise for Planet Earth. FameLab USA’s first regional heat was in Troy, N.Y. Future participants will have the chance to compete at regional heats held in Stony Brook, N.Y.; Chicago; and online. The winner of the April 2016 nationals will go on to the Famelab International Final in June 2016.
Andrea Villaroman is a a research coordinator in the School of Medicine.
UCSF Students: Need help at home? Join the free program that has been used by UCSF students over 100 times since September. UCSF students have free access to Bright Horizons Care Advantage (Sittercity) • find self-selected, pre-screened sitters and caregivers for all ages • eldercare resources and planning • pet care - dog walkers, pet sitters
UCSF students interested in providing sitter or services such as tutoring, can also register as providers at no cost.
Register online in one minute and use this service today:
www.careadvantage.com/ucsfstudent
synapse.ucsf.edu | January 22, 2015 | 5
» Patient Care Perspective
» UCaSeFiles
Ms. L adjusts to life without ‘the f word’
Street drugs: Nothing sweet about ’em
By Akshay Govind Staff Writer Try saying the F word without using your teeth. We’ll get back to that. Acute myeloblastic leukemia explained Ms. L’s recent complaints of fatigue and weight loss. An aggressive form of white blood cell cancer, it is fatal within weeks to months without treatment. For this reason, patients must decide quickly whether they undergo the intense chemotherapy regimens that stand a chance of curing the disease or whether they choose to focus on palliative measures. Although the expected course would be arduous, Ms. L and her oncology team decided to give it a try. I met her as part of the consulting oral surgery team to help determine whether her teeth would likely be a source of infection after chemotherapy thoroughly depleted her body’s ability to mount an immune response. Unfortunately, the answer was yes, and so on top of the life changing diagnosis of cancer she had just received and the knowledge that she would lose her hair and her energy from the recommended treatment, here were we, recommending she take all her teeth out in a day or two. Ms. L loves to eat. I take that back. Ms. L loved to eat before she had no teeth. Pizza and scrambled eggs with shredded cheese were among her favorites, but between her extended surgical recovery time and the mucositis (inflammation of the lining of the mouth) from the chemotherapy, Ms. L has had constant, intractable burning pain in her mouth for over six weeks, only minimally assuaged by the combinations of rinses and medications we recommended. I should take a moment to describe Ms. L’s personality. She’s a character, to say the least. Perhaps related to a cardiac event she suffered as a teenager, or perhaps just the way her mind was programmed, Ms. L’s thought patterns are very concrete and disinhibited. She’s talkative and focuses on specific details more than concepts as she describes people or situations. My Attending was known as “The Man with the Silver Hair,” and I am lovingly yet viciously known as “The Tooth Puller.” She uses profanity at times without any change in her affect. When I first met her, she let me know that if I touched one of her arms a certain way, she might assault me. This wasn’t a
threat, it was just important information she thought I should know. After her surgery, I checked on her periodically to follow the healing of her gums. She healed without infection, although the pace was about five times as slow as for those with good immune systems. Every time she saw me, she’d want to know about when she could get dentures. I did discuss this with her, but in the end, when she could get dentures from a physiologic perspective, when she would get dentures from a logistic perspective were different stories. I guessed between March and May. She told me about her recurring dreams. In one, many of her deceased family members are “calling her to join them in heaven, hell, or wherever they are.” In another, she’s watching her own funeral, the casket is open, and there is a set of dentures next to her dead body. I have never been a part of any decision making about the general direction of Ms. L’s cancer therapy (nor should I have been), but it stays with me when she tells me the fight went out of her weeks ago. When daily reality doesn’t meet expectations laid out weeks ago by clinicians’ best guesses, it would affect anyone, but Ms. L’s way of observing and interacting with the world brings this to light. I can’t minimize the gravity of the feelings Ms. L is having during this struggle, but given that this is direction she has chosen, how can I not encourage her to keep going? In reality, neither of us knows if this is going to save her life. I visited Ms. L just the other day. I was actually done with the rotation where I was taking care of her. I just stopped by to chat, to check on her burning mouth, to see how she was feeling, and to get her permission to write about her. It had been over a month and a half since she came into the hospital. She had been moved to a room on the eleventh floor, overlooking the city and the Golden Gate Bridge. I commented on the nice view, and she let me know she is afraid of heights. Her mouth still burned. Constantly. I noticed an open container of Boost (a nutritional supplement). At least she was taking something by mouth. She made mention of “the F word.” I asked her, “You say it all the time. Why not now?” She said, “no, not f!*%, FOOD! Don’t say that word around me.” She reminded me of her dreams, checked in on my speculation about her dentures, and asked me, “Since you’re here, do you want to say hello to my gums and see how they’re doing?" They’re doing well, Ms. L. And so are you. I’m proud of you.
Case submitted by Theresa Poulos, MS4 The Patient
A young man with a known history of recreational drug use was found unresponsive and brought in by ambulance to the ED. In the field, paramedics noted that he had a serum glucose of 6 mg/dL (normal range is between 70-140 mg/dL) and they administered dextrose 50 percent. The patient’s serum glucose levels responded and increased to 97 mg/dL, although the patient remained unarousable. Family members reported that after snorting cocaine and then using Valium pills earlier that day, the patient began reporting dizziness, confusion and difficulty speaking before going to his room to lie down. The family called paramedics when they were not able to arouse him from bed. The patient had no history of diabetes, renal insufficiency, cirrhosis or any other endocrine abnormality. A second critically low serum glucose in the ED again responded to dextrose 50 percemt, but the patient remained in a comatose state. The patient’s brother identified the “Valium” pill the patient had ingested as matching the picture of Glyburide 5mg (Novapharm USA Inc., Birmingham, AL). The Diagnosis Hypoglycemia is a medical emergency in which there is an abnormally low level of glucose in the blood. It can lead to a variety of symptoms, but the most notable effects occur when there is a lack of glucose to the brain, a state called neuroglycopenia. Patients can be asymptomatic or have symptoms such as dizziness, fatigue,
GPSA » FROM PAGE 3 According to the recent housing survey sent to all students, most agreed that one year was a sufficient amount of time to adjust to San Francisco. Students agreed that attending UCSF outweighs the cost of living in this city. The deliberations on housing policy continue.
Screening of ‘Gravity’ GPSA may hold an indoor screening
Akshay Govind is a fourth-year resident in the Department of Oral and Maxillofacial Surgery.
of the movie “Gravity” if students show interest in the event. If you and your friend would like to attend this event, please write to GPSA at the e-mail below. Raffle prizes and popcorn will accompany the event.
“Typically speaking, when you have an Ebola patient you can’t keep going in and out, so now everything is regulated and up to standards by the state and [the facility] is good to go,” said Tim Groves, the UCSF lead nurse for the project. As of today the facility is capable of treating one patient, with the eventual goal of having two isolation rooms. Groves and more than 30 other health care providers have taken exhaustive, state-of-the-art training to use the facility. In the event that UCSF may need to treat an Ebolastricken patient, these highly trained personnel will perform the intricate pro-
cedures that will safely transport patients from specially designed AMR ambulances to the fourth floor Mt. Zion treatment facility. UCSF Mt. Zion was chosen due to its location, as well as its relative isolation from large patient populations that will exist at the Mission Bay Medical Center and that currently exist at UCSF’s Benioff Children’s Hospital at Parnassus. “If we were to receive an Ebola patient, the entire fourth floor would be isolated to personnel required for treatment,” said Groves. “We’ll even have dormitories for volunteer health providers to stay during their 21-day period of monitoring.”
emotional lability, seizures and coma. Hypoglycemia can result from a variety of etiologies; this patient suffered from druginduced hypoglycemia. Sulfonylureas are medications used in patients with type-2 diabetes to increase the release of endogenous insulin. They are very useful medications when ingested in therapeutic doses, but overdose or poisoning can lead to hypoglycemia, a dangerous extension of the agent’s normal pharmacology. There has been a startling increase in the number of nondiabetic patients presenting to care with critically low serum glucose measurements as a result of taking oral sulfonylureas sold under the guise of benzodiazepines. Benzodiazepines (Valium in this case) are anti-anxiety medications that produce a sedative effect. Some drug users will take benzodiazepines to counter the stimulant effects of cocaine or methamphetamines. The mainstay treatment for severe hypoglycemia is the intravenous administration of glucose, with the goal of restoring serum glucose to normal levels. Octreotide, a hormone that inhibits the release of insulin, can also be added to prevent insulin release after glucose is administered. Furthermore, patients with sulfonylurea overdose must be admitted to the hospital and observed with serial blood glucose checks, as these drugs have a long half-life. Patients and providers alike need to be aware that oral hypoglycemics are being sold as benzodiazepines on the street, and be vigilant in questioning anyone presenting with altered mentation or symptoms consistent with hypoglycemia.
Theresa Poulos is a fourth-year medical student. Transportation Seeking Student Reps The Transportation Committee is looking for students to participate in three lunch meetings: Feb. 19, March 5 and March 19. Students will provide input on how the Transportation Association can best address student transportation needs in the upcoming opening of the UCSF Mission Bay hospital.
GPSA Wants to Hear Your Opinion.
If you are moved to take action regarding a student issue or would like to respond to inquiries in this column, e-mail GPSA at gpsa@ucsf.edu. We are listening! For more on GPSA-sponsored events and monthly meetings visit gpsa.ucsf.edu.
Polina Pulyanina is a third-year pharmacy student.
Ebola treatment center a permanent commitment Sean Treacy–Abarca Staff Writer
As UC San Francisco transitions its personnel and operations from the Mt. Zion campus to Mission Bay, one critical piece of UCSF infrastructure will remain behind: the newly constructed Ebola treatment center. The center is one of 49 throughout the country (including five in the UC system) designated for treating Ebola by the Centers for Disease Control and Prevention as of Jan. 15—though the list is updated weekly, according to the CDC website.
One of the many features that make this unit distinct is the use of technology to both isolate the patient and prevent exposure to health care providers. The patient’s room is equipped with negative air pressure, as well as an array of dedicated equipment to reduce the risk of cross-contamination. Just outside the patient room is a specialized anteroom with a charge nurse dedicated to ensuring proper donning and doffing procedures are followed. Any materials that enter the patient’s room, such as scrubs and shoes, are either disposed of or autoclaved; even
EBOLA » PAGE 10
6 | January 22, 2015 | synapse.ucsf.edu
» Health
» Journal Club By Taylor LaFlam Science Editor NEUROSCIENCE: An estrogenresponsive module in the ventromedial hypothalamus selectively drives sex-specific activity in females. Correa, S.M., et al. (Ingraham, H.A.). Cell Rep. 2015. 10(1):62-74
Efforts to identify intrinsic, biological causes for differences in the behaviors typical of men and women (or boys and girls) must also carefully consider the role of culture. In mice, you can feel a lot safer about just pinning it on the biology. Previous research has found that estrogen-receptor-alpha neurons in part of the ventromedial hypothalamus in the brain are essential for multiple sexspecific behaviors. Here, the authors found evidence that different subsets of these neurons control different behaviors. Specifically, they identified Nkx21-expressing neurons that support locomotion in females; loss of these neurons leads to fatter, less active females. In contrast, this subset of neurons does not control fertility or brown fat thermogenesis, both of which are known to be dependent on estrogen-receptoralpha neurons.
NEUROSCIENCE: Pharmacological induction of the 70-kDa heat shock protein protects against brain injury. Kim, N., Kim, J.Y., and Yenari, M.A Neuroscience. 2015. 284:912-919.
» This Date in UCSF History
By Taylor LaFlam Science Editor
From 20 Years Ago: Vol. 39, No. 16, Jan. 19, 1995: The ongoing Ebola crisis in Guinea, Liberia and Sierra Leone has been by far the deadliest Ebola outbreak in history with more than 8,000 deaths so far. This outbreak makes a front-page story of Synapse from 20 years ago seem especially timely. In “Science Fiction Turned Real,” Robert Rosenbloom reviewed “The Hot Zone,” a nonfiction thriller by Richard Preston about viral hemorrhagic fevers, including Ebola. Rosenbloom called it “a book that I just can’t put down.” He wrote that “Preston’s anthropomorphic accounts of the virus and its modus operandi gave me a sense of why and how such awful creatures might develop and survive for eons. I was filled with respect for these infectious agents, as well as gratitude for the scientists who conduct research on them.” Rosenbloom also noted that the book explored the possibility that such diseases might spread worldwide, particularly if a mutation rendered the one of these viruses transmissible through airborne droplets, something
that, fortunately, has not occurred (and is an event that some experts have suggested would be quite unlikely). Preston concluded with a warning, paraphrased by Rosenbloom: “We need to be better equipped and faster to mobilize in the event of an outbreak of new pathogens, no matter what segment of the population is affected.” Recalling the tardy and uncoordinated initial international response to the outbreak makes these words unfortunately prescient.
Taylor LaFlam is a sixth-year MSTP / fourth-year BMS student.
ALSO FROM 20 YEARS AGO:
Life can be hard out there for a cell. Between extremes in temperature and solute concentrations, misfolding proteins and a host of other factors, things can get stressful. Fortunately, eukaryotes have many different heat shock proteins, which protect cells from some of these stresses. Here, the authors reported on an investigation into how inducing one of these heat shock proteins (HSPs) affected the ability of an entire tissue to respond to injury. They began by demonstrating that injecting the drug 17-AAG led to increased HSP70 in microglia, a major type of cell in the nervous system. They examined how treatment with 17-AAG affected how mice reacted to experimentally induced traumatic brain injuries. Promisingly, they observed that the treated mice had decreased bleeding and better neural function.
IMMUNOLOGY: JUNB is a key transcriptional modulator of macrophage activation. Fontana, M.F., et al. (Kim, C.C.). J Immunol. 2015. 194(1):177-186.
A successful immune response is a balancing act. It needs to be very sensitive to germs but not so sensitive it attacks the body. It needs to be strong enough to eliminate the infection but not so strong that it destroys healthy tissue. In this article, Fontana and colleagues identified a control switch that helps regulate how macrophages, a type of white blood cell, react when they are activated. They first analyzed publicly available data high-throughput data to create a model for a macrophage regulatory network; their model included the transcription factor Junb. They found that Junb is necessary for full expression of an important immune molecule that is produced during classical inflammation. At the same time, Junb also plays a role in so-called alternative activation of macrophages, which occurs, for example, during wound healing, indicating that this gene is an important general modulator of macrophage activity.
DEVELOPMENTAL BIOLOGY: Chd1 is essential for the high transcriptional output and rapid growth of the mouse epiblast. Guzman-Ayala, M., et al. (RamalhoSantos, M.). Development. 2015. 142(1):118-127.
Fetal growth during the last few months of pregnancy seems dramatic, but it pales in comparison to the rapid rate of growth that occurs in the first phases of development. Cells very vigorously divide in the epiblast, an early stage of development. It has been hypothesized that such proliferation must require a very high rate of transcription, but how this high rate of transcription occurs was unknown. In this paper, Guzman–Ayala and colleagues reported one important driver. They noticed that mice lacking Chd1 have decreased cell division and increased cell death in the epiblast. Further research showed that there was a genome-wide decrease in transcription in these cells. They found decreased binding of RNA Pol II to DNA and less ribosomal RNA.
Taylor LaFlam is a fourth-year BMS / sixth-year MSTP student.
Sugar scientists weigh in at expo
Hanna Starobinets/Synapse The average American consumes 66 pounds of sugar each year. For a visual demonstration, Cristin Kearns holds up a 4 pound bag of sugar during the SugarScience Expert Panel. The panel presentation was part of the ‘Living Well at UCSF’ Wellness Expo on Jan. 14.
synapse.ucsf.edu | January 22, 2015 | 7
» [Exit, Pursued by Science]
Taking control: Destabilizing cancer DNA and stablizing a falling rocket By Hanna Starobinets Web Editor
Targeting Tumor Telomeres If you break an aglet—the plastic cap on the end of your shoelace—the lace will fray. Then it’ll rip. Soon you won’t be able to tie your shoe properly. Before you know it, the shoe falls off as you’re running frantically down the sidewalk trying to catch a bus. As you watch the bus drive away, you’ll wish you’d kept that aglet intact. Aglets are to shoelaces as telomeres are to chromosomes. Ah, the memory of the analogy section (rest in peace) on the SAT and GRE. To avoid losing bits of genetic code at the ends of chromosomes during DNA replication and cell division, cells use the telomerase enzyme and an RNA template to add a repeating pattern of DNA to cap each chromosome: the telomere. These discoveries earned UCSF’s Elizabeth Blackburn (as well as Carol Greider and Jack Szostak) the Nobel Prize in physiology or medicine in 2009. Telomerase is active during normal development but is largely turned off in adult cells. However, by some estimates, nearly 90 percent of human cancers reexpress this enzyme. Turning telomerase back on allows a growing tumor, just like a developing organ, to keep its telomeres and chromosomes intact. Blocking telomerase, whose activity is almost exclusively limited to cancer cells, is not a new idea. However, using a telomerase inhibitor (e.g. imetelstat sodium) in the absence of any other
therapy means that the patient has to wait for his or her cancer cells to continue to divide, shorten their telomeres, and reach a crisis state of DNA damage and growth arrest. That lag in therapeutic efficacy requires the drug to be used for a long period of time, widening the window for developing adverse side effects. Even clinical trials combining telomerase inhibition with chemotherapy have been hampered by these problems. The groups of Jerry Shay and Woodring Wright at UT Southwestern Medical Center have co-published a novel telomerase therapy in this month’s issue of Cancer Discovery. Instead of blocking telomerase activity directly, as therapies have attempted in the past, these researchers created a small molecule that mimicked the normal RNA template. In cells, it is phosphorylated and then mistaken for the normal template and incorporated into telomeres. This changes the biochemical structure of telomeres instantly, destabilizes their interactions with other proteins and sends DNA damage signals that cause growth arrest and cell death. 6-thio-dG treatment of normal and cancer cells in vitro led to telomere shortening, DNA damage and cell death. 6-thio-dG treatment of mouse xenograft models of human cancer led to both telomere damage and tumor shrinkage, with little to no side effect. While the authors appear to be ready to take their 6-thio-dG into the clinic, it seems to me that any potential telomeretargeting therapy should first be tested in a fully immunocompetent mouse model. Their mouse study was performed in
immunocompromised mice to permit the growth of human cancer cells and would certainly miss any toxicity or impaired function in the absent immune cells. Nonetheless, altogether this study represents a much-needed revival for the field of telomere-based cancer therapies. Just like great musicals that flopped in the ‘80s, therapeutic approaches that failed past clinical trials may be revived to great success.
Sources: Cancer Discovery, EurekAlert!
SpaceX developing reusable rocket
On Jan. 10, SpaceX successfully launched its Falcon 9 rocket, sending the Dragon spacecraft to the International Space Station. It also almost succeeded in landing the first stage of Falcon 9, vertically, onto a raft—autonomous spaceport drone ship, I should say—200 miles off the coast of Florida. With its fifth successful ISS resupply mission (and no failures), SpaceX has shouldered most of the responsibility of sending and returning ISS cargo after the retirement of NASA’s space shuttle. SpaceX is critical (read: awesome) both because it allows the U.S. space program to avoid relying on the Russian space program and because the privatization of parts of the space program drives down costs. A rocket’s first stage is the lower portion that carries the enormous amount of fuel required to propel the payload into space. Until now, this stage has either crash landed in the ocean or been ripped apart in the air. Controlling the first stage’s descent in a way that would
make it recoverable and reusable was considered impossible. Elon Musk—the company’s founder, CEO and CTO—is a true visionary. He takes ideas that seem impossible and turns them into reality. For the past few years, SpaceX has been practicing launching two practice rockets—Grasshopper and F9R Dev—and landing them vertically right back onto the launch pad. This month’s mission was the first attempt to fully recover the rocket. “At 14 stories tall and traveling upward of 1,300 meters per second (nearly 1 mile per second), stabilizing the Falcon 9 first stage for re-entry is like trying to balance a rubber broomstick on your hand in the middle of a wind storm,” said Musk in preparation for the mission. “Close, but no cigar,” he tweeted on Jan 10. While SpaceX engineers were able to control the rocket’s descent enough to find the spaceport raft floating off the coast of Florida, it came down too hard and was destroyed upon impact. The cause appears to be that the hydraulic fluid used to control the rocket’s fins ran out just before landing. Musk said he remains confident about the next landing attempt (the rocket will have more hydraulic fluid), which will take place during the launch slated for Thursday, Jan. 29. You can watch the launch on the live webcasts on SpaceX. com and SpaceflightNow.com. Sources: SpaceX, Slate
Hanna Starobinets is a fourth-year BMS student.
SpaceX As many companies race to privatize the space program, SpaceX remains on the forefront in rocket development. The company, which recently launched its fifth successful re-supply run (with no failures) to the International Space Station is moving closer to its aim of landing reusable rockets vertically on an autonomous spaceport drone ship the size of a football field.
8 | January 22, 2015 | synapse.ucsf.edu
» The Scoop
Ice cream fans ‘swich’ it up
A walnut fudge cookie with chocolate ice cream and coconut proved the highlight at Swich.
By Theresa Poulos and Dawn Maxey Staff Writers At a recent residency interview, a
program director asked me if I had tried Swich, a new dessert destination in the Central Sunset. As a Scoop writer, I was embarrassed to say I hadn’t even heard of it. Upon further investigation, I discovered that Swich took over the storefront that formerly housed a well-loved TuttiFrutti frozen yogurt shop. It is part of the trend of pick-your-owncombo ice cream sandwich shops infiltrating The City. Despite our horrid experience at CREAM, that insufferable Bay Area ice cream sandwich chain, Theresa and I decided to cast aside our doubts about ice cream sandwiches and give it a whirl. Before I go any farther, I should make one thing clear: Cookies are at the bottom of my dessert hierarchy. Ice cream is stuff of the Gods; why ruin it with a cookie that neither enhances the flavor nor serves as an appropriate vehicle for eating more ice cream? Swich offers a selection of pre-made sandwiches as well as the create-yourown-combo variety ($3.75). They have five varieties of square-shaped cookie to choose from—chocolate chip, oatmeal raisin, red velvet, butterscotch and walnut fudge. Ice cream selections include vanilla, chocolate, strawberry, coffee and mint. For an extra 25 cents, you can choose to have your “swich” dipped into your choice of rainbow sprinkles, toasted coconut, chocolate pearls or slivered almonds. Theresa opted for walnut fudge cookies, chocolate ice cream and coconut. I went for chocolate chip cookie, coffee ice cream on the inside and all topped with chocolate pearls.
Now, the worst part about an ice cream sandwich is that if the cookies aren’t just the right consistency, one bite can cause the ice cream to squish out the back end, leaving you with a horrible mess, panicked feeling of I-have-to-finish-the-restof-this-right-now—and wasted, precious ice cream filling. Fortunately, these cookies didn’t do that—not quite. Theresa’s walnut fudge cookies were warm and straight from the oven. They caused a little bit of a cascading melting effect, but it wasn’t too bad, particularly because they were deliciously fudgy. In fact, the crunch of walnut in a rich, dark chocolate cookie might have been the highlight of the sandwich. The chocolate ice cream itself was rather tasteless but provided the variety of texture and temperature that one seeks in an ice cream sandwich. The coconut dip was a nice addition for just a quarter, but definitely wouldn’t be worth anything beyond that. The ice cream is made with a generic base, which was a little discouraging given San Francisco’s hot ice cream scene. I was also disappointed by the amount of extra topping given to my sandwich—it only covered one side. On the plus side, the presentation was pleasing, and all of the flavors went well together. You’d be hard-pressed to order a terrible flavor combination. Swich also offers other dessert options, such as pudding, tapioca and slices of pie. Overall, Swich is a decent place to stop by if a) you’re a child, b) you need to placate one or c) if you happen to be in the area. Personally, I’d rather sandwich my ice cream between layers of more ice cream—but, hey, to each his own.
Dawn Maxey is a fourth-year medical student.
» Puzzles The Crossword
ACROSS 1 Type of chowder 5 Son of Abraham 10 A whole bunch 14 Knowledge 15 Printing proof 16 Gait 17 Newspaper bio 18 Old-time anesthetic 19 Job safety org. 20 June birthstone 22 Sycophants 24 Clumsy one 26 Start of a March holiday 27 Advertising acronym 30 Foundation 32 Future soldier's exam 36 Plant part 38 Panetta's post 39 Give in 40 Sheds clothes 42 Shopper's guide 43 Scoundrels 44 Golf score 45 Naive person 46 Bette Davis co-star George 47 River ride 49 NY slugger 50 Hunter's aid 52 Kobe's org. 54 Handguns, eg. 58 ____ This House 62 Chrysler trademarked engine 63 Like prices at a five-star restaurant
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Edited by Margie E. Burke
Difficulty : Easy
HOW TO SOLVE: (Answer appears elsewhere in this issue)
SOLUTIONS » PAGE 10
Copyright 2015 by The Puzzle Syndicate
The RAMP UCSF Staff and Students Please bring this in for a 15% discount on food Monday-Friday Solution to Sudoku at The RAMP restaurant! (excluding special offers) Join us for our Happy Hour Monday-Friday 5-7pm
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» Let’s Get Physical … Therapy » Health
Got neck pain? Here's what to do about it Address tight muscles pulling on your neck.
Ilka Felsen Columnist
Similar to the low back, it’s difficult to determine the definitive cause of neck pain. However, neck pain can present with the following pain problems, with a likely cause listed next to the pattern:
• Sharp pain localized to one side of the
neck » dysfunction in one of the cervical spinal facets
• Stiffness around the neck, often with
pain during rotation and side bending the neck » acute or repetitive muscle strain
Alexandra Greer Staff Writer
arm » radiculopathy (i.e. cervical spinal root irritation)
• Pain specifically with looking up and/or
over the shoulder » discogenic (i.e. irritation from compression of the disc)
Four tricks to combat pain
Regardless of the specific etiology of neck pain, the contributing factors—such as muscle length and strength imbalances—that contribute to increased loading, need to be identified and addressed. The following are the top four suggestions I make regularly in the clinic when treating neck pain:
Examine your sleep posture.
`(Hopefully) you spend 8 hours a night resting in bed—that’s a third of your day in which your neck posture could be compromised! The goal is to keep your neck neutral, not too flexed and not too extended. If you’re a back sleeper, make sure your pillow is not too thick, causing your chin to tuck towards your chest. If you’re a side sleeper, watch out for the opposite: not having a thick enough pillow. Your pillow should exactly fill the space between your shoulders and head, so you’re not side-bending your cervical spine in your sleep. Also, beware of curling your wrist toward you; this increases tension on your nervous system, which can also contribute to radiating neck pain and carpal tunnel.
Third-year PT student Aaron Ortiz has been spotted with forward head posture.
Recruit your shoulders.
Many neck muscles cross the shoulder, making it essential to address these in order to attain good neck posture. In addition to performing basic rotator cuff exercises, engage your middle traps and rhomboids with this simple scapular squeeze exercise: Sit or stand up tall, and squeeze your shoulder blades together. Hold for 10 seconds, and repeat 10 times.
Ilka Felsen is a third-year physical therapy student who enjoys talking about all things physical therapy, palpating joints and watching people walk.
Support your neck.
Most of us exist in a state of perpetual forward head posture (pictured at right). This extends the cervical spine, thereby cramming the facets together and compressing the discs between vertebrae. Fix this by performing five chin retractions every hour. To do a chin retraction, sit up tall and bring your shoulder blades together. Bring your chin backward (directly backward—not a downward nod!) until you have an attractive double chin, and hold for three seconds.
Third-year PT student Andrew Tran demonstrates stretching his right pectoralis major.
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Many muscles of the shoulder girdle contribute to faulty neck posture. Stretch your pectoralis minor by lying on your back and having a friend push your shoulders towards the floor. Stretch your pectoralis major by lifting your arm to the side 90 degrees and bending your elbow to 90 degrees, see picture below. Place this arm against a doorway and walk forward until you feel a stretch across your chest. Hold both stretches for three sets of 90 seconds.
• Pain from the neck radiating down the
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synapse.ucsf.edu | January 22, 2015 | 9
Red/green colorblindness is a genetic, X-linked trait that affects upward of 7 percent of the male population in the U.S. While it usually does not pose serious restrictions to daily life, there has never been a way for those affected to experience red and green colors—until now. Enchroma, a Berkeley-based company, recently unveiled a new device that uses color-blocking lenses to force the separation of red and green colors for those with red/green colorblindness. When you look at the technology behind their breakthrough, it starts to look very familiar. Our eyes respond to the presence of light via light-sensitive proteins that activate a retina cell when they are hit by photons. The retina of the eye contains rod and cone cells, which help to see light/ dark and color, respectively. Cone cells contain three different types of lightsensitive proteins, or opsins, that respond to different colors of light. Each cone cell expresses only one type of opsin, meaning that we have “red,” “green” and “blue” cones. When blue light hits the opsins of a blue cone, it initiates a signaling cascade that ultimately sends a signal to the brain that blue light was seen by that cone in that specific part of the retina. Blue opsins respond to the highest energy wavelength of light (420–444 nanometers) and are found in short cones, green opsins respond to 534–545 nanometer light and are found in medium cones, and red opsins in long cones respond to light of 560–584 nanometers in length. The discovery and study of opsins, rods and cones won three scientists a Nobel Prize in 1967. In the most common form of red/green colorblindness, known as deuteranomaly, the green opsin expressed in medium cones is slightly mutated. While the protein is still expressed normally in the cell, it now responds to wavelengths of light closer to the 560–584 nanometer range. For these individuals, it becomes difficult to distinguish red and green colors because the two different types of cone cells are now responding to very similar wavelengths of light. However, while the mutated green opsin responds much more efficiently to yellow/ orange light, it can still respond to green light—albeit at a much lower efficiency
compared to the wild-type allele. Enchroma’s Cx sunglasses use this information to generate a pair of lenses that force your eyes to see only tight, small ranges of wavelengths of light in the blue, green and red colors by making what are commonly referred to
as “interference lenses.” Interference lenses, like regular mirrors, reflect light. However, what makes them special (not to mention expensive and hard to manufacture) is that they reflect most light, but allow a certain range of wavelengths to pass through. The beautiful simplicity of Enchroma’s technology is that by using interference lenses, they can force incoming light to become restricted only to the three individual ranges of wavelengths (420–444, 534–545 and 560–584) that are detected by our eyes. For those with regular color vision, Enchroma lenses do not significantly alter the appearance of color. For those with deuteranomaly, the mutated green opsin—which would normally respond to more yellow and orange wavelengths of light—can respond only to light in the truly green 534–545 nm range because the yellows and oranges have been blocked by the interference lens. What used to look green/red is now only green, resulting in a dramatic change in the visual perception of color. Colors look vibrant and there is no loss in the variety of colors you can see, because it’s the combination of red, green and blue that makes up our visible spectrum. Because the lenses restrict a significant portion of incoming light, though, it is recommended that they be used only in bright sunlight. For scientists with a background in imaging or flow cytometry, interference lenses are nothing new. Early naturalists in the 1800s made dichroic mirrors by coating glass with heavy metals such as lead or cadmium. By putting the glass up to the light, scientists noticed that while some wavelengths of light were reflected (hence the glass looking like a mirror), some light would get through, leading to a colored tint to the mirror and a shadow in a specific color. These materials, however, went largely unused until the advent of fluorescent technology in the 1960s. Flow cytometers are machines that take up samples of cells in liquid suspension and let them flow, one-by-one, past lasers that shoot a specific wavelength of light through the cell. If the cell has a dye on it that responds fluorescently to that wavelength of light, the cytometer’s detector
‘The beautiful simplicity of Enchroma’s technology is that by using interference lenses, they can force incoming light to become restricted only to the three individual ranges of wavelengths’
COLORBLIND » PAGE 10
10 | January 22, 2015 | synapse.ucsf.edu
» Continued HOUSING
» FROM FRONT PAGE
RENOVATIONS TO UC HALL AMONG THE PROPOSALS
Currently, only 1 percent of the faculty lives in campus housing. To meet this goal by 2035, UCSF anticipates creating housing for an additional 1,600 people. The LDRP proposes construction of a 523-unit apartment complex at the north end of Mission Bay. At Parnassus, the largest proposed changes are the converting much of UC Hall and Millberry Union into student housing, creating a few hundred new units. The first step will likely be the conversion of the upper three floors of UC Hall, projected to begin within several years. Such solutions will be of help to future, not current, students. However, it is expected that early in 2015, UCSF will identify some steps that it will take in the short-term to try to alleviate the unmet campus housing demand.
UCSF HOUSING HISTORY
UCSF housing has been expanding and contracting for years. From 1919 to 1972, there was a multistory residence hall at Third and Parnassus avenues (where the Marilyn Reed Lucia Child Care Center now stands); it fell victim to increased building standards and was torn down. When Millberry Union was opened in 1958, it included student housing, which was gradually phased out beginning in the late 1980s. During the 1990s, UCSF owned an apartment building north of Golden Gate Park, at Turk and Willard streets. In the past decade, UCSF housing has more than doubled, thanks largely to construction of the large apartment complex at Mission Bay. In 1976, in response to neighborhood criticism of an ever-growing campus, UCSF agreed in a long-range development
EBOLA
» FROM PAGE 5
SCHOOL PLANS VARIETY OF USES FOR CENTER dedicated undergarments and socks have been purchased and will not be reused. Lateral to the patient’s room is the support area, separated by a large, glass wall. There, a health care provider will monitor the patient and the provider who is directly interacting with the patient to ensure all procedures are followed and to avoid accidental exposure. A dedicated lab space in the facility ensures that routine lab work done for the patient using infectious material never leaves the confines of the facility. Coordination between UCSF policymakers, the CDC, California’s Department of Public Health, and the San Francisco Department of Public Health helped garner UCSF’s distinction as a designated
plan not to lease or acquire any additional properties in a space extending approximately six blocks in all directions from the boundaries of the Parnassus Heights campus; this restriction still stands and was a major contributor to the decision to build the Mission Bay campus. In the course of acquiring and developing the Mission Bay campus, UCSF has entered into a several agreements covering topics such as building height limitations and contributions to public infrastructure. For example, they committed to contributing to the development of a fire station at Third and Mission Rock streets, and will donate a specified portion of northwest corner of the campus to the San Francisco Unified School District should it request it by 2027.
UCSF HOUSING CONTEXT
In comparison with two other urban health sciences campuses, UCSF is taking a middle course—unsurprising given that nearby housing costs are in the middle as well. Currently, Rockefeller University and Weill Cornell Medical College, located adjacent to each other in the Upper East Side of Manhattan, guarantee housing to all students. For first-year students, this is generally dormitory-style housing. For older students, there are studios, one-bedroom and two-bedroom apartments available. In contrast, there is no campus housing at the Chicago campus of Northwestern University, the site of its medical school. There is a limited amount of housing for graduate students available at its main campus, based in Evanston, Illinois. The full LRDP, which covers much more just campus housing, and highlights can be viewed at ucsf.edu/about/cgr/ current-projects/lrdp.
» Puzzle Solutions » FROM PAGE 8
Solution to Crossword:
C L O P
L O B E
A R I A
B L U R B
T E N O R
L A R G E
S H O T
M E M O
A M E N
M I E R T E R L O A F B A F C O B E U E S N T D E C L L A I S N T G E
S E T H
A P H A S S I I A S P C A O Y R M T E E N X T
A R E N A S C A N S E E R
C S O P R O G E R I N T A S A C C A T A R R O E N B A B L P O T H A A
L A S S
E C H O
W E A N
V E L U M
A D O B E
B E G E T
E V E N
S E R E
S N O W
Solution to Sudoku
Crossword Sudoku
COLORBLIND » FROM PAGE 9
SPECIAL COATING RESTRICTS LIGHT makes a note of the response’s intensity. Cells can be treated with many different types of dyes and markers that respond with slightly different spectra of fluorescence to one laser’s wavelength. To separate these different spectra and allow a cytometer to identify many different types of markers on each cell, light that passes through each cell goes through a series of interference lenses that siphon off each range of fluorescence, one by one, until each color can be separated and quantified. Fluorescent microscopes behave in a similar way, but with usually only three or four interference lenses, allowing for the imaging of cellular fluorescence into a UV, green, red and blue channel. Given the prevalence of interference lenses in biomedical imaging, it may be surprising to learn that not any of the founders at Enchroma began as optical biologists. It may also be surprising that it
has taken this long to repurpose interference lenses as glasses. In fact, interference lenses have been incorporated into glasses before as anti-reflective coatings. The trick to Enchroma’s technology that makes it so special is the combination of thin-layer coatings that restrict three unique ranges of light (red, green and blue) without completely blocking incoming light. Similar combined “band-pass” filters for microscopy—which accept only discrete red, green, blue and UV wavelength ranges—have only recently been developed for research. Enchroma’s Cx lenses will not cure colorblindness, but the results are still breathtaking. Astonishing, too, is the simplicity of the technology behind the breakthrough. For more information on Enchroma Cx, visit www.enchroma.com.
Alexandra Greer is a is a postdoctoral scholar at Genentech and a BMS alumna.
Synapse wants to get a better understanding of students’ housing experiences on and off campus. Look for our brief survey that will arrive in your inboxes soon.
Taylor LaFlam is a fourth-year BMS / sixth-year MSTP student. Bryne Ulmschneider is a fourth-year Tetrad student. Ebola treatment center. Yet, with such an outpouring of UCSF investment into this facility in the form of personnel and more than a million dollars, its utility will extend beyond the current Ebola epidemic. “This facility was built for Ebola, but we can use it for any disease requiring respiratory isolation, anything that would require biocontainment—like back when we had H1N1, this facility would have been ideal,” said Groves. UCSF’s commitment to the Ebola epidemic is far-reaching with around 11 campus members aiding in Ebola-stricken regions of western Africa. More than 70 medical personnel have volunteered to enter Ebola training. Currently the campus has more than 30 fully trained providers on call to respond in the case that UCSF receives an Ebola patient. Although reports have indicated that the Ebola outbreak is trending downward, the experience treating and preparing for Ebola patients will invariably become important in many other infectious diseases with high mortality. “This facility and response is definitely a part of [UCSF’s] legacy, in its commitment to global health and infectious disease,”
Sean Treacy–Abarca/Synapse
A negative air pressure room is one of many safety features at the Ebola treatment ceneter.
said Associate Chancellor Theresa O’Brien. Even beyond the current epidemic, UCSF will remain committed to research in prevention of another outbreak, as well as better diagnostics and treatment for Ebola patients. The community can follow the efforts of UCSF volunteers at
globalhealthsciences.ucsf.edu/educationtraining/blogs. “We want to be able to tell the story of our volunteers, to let the community know what they are doing,” said O’Brien.
Sean Treacy–Abarca is a research specialist at the Hooper Foundation.
synapse.ucsf.edu | January 22, 2015 | 11
Saturday and Sunday
Come and see the future of biomedical research at the Free Exhibition
BiOS EXPO
BiOS TECHNICAL CONFERENCE
Saturday and Sunday, 7–8 February 2015 The Moscone Center · San Francisco, California, USA
BiOS EXPO
TECHNICAL CONFERENCE
EXHIBITION IS FREE
2,200 PRESENTATIONS Registration fees vary
The world’s largest biomedical optics and biophotonics exhibition. See the latest devices, components, and instrumentation for diagnostics and therapeutics. Find solutions for your lab or company.
The latest information on biomedical optics, diagnostics and therapeutics, biophotonics, molecular imaging, optical microscopy, optical coherence tomography, and optogenetics is presented and discussed.
SATURDAY HOT TOPICS · 7:00 to 9:00 pm Symposium Chairs
James Fujimoto
Massachusetts Institute of Technology (USA)
Part of
SPIE Photonics West 2015 7–12 February 2015 SPIE Photonics West is the most influential conference for biomedical optics, biophotonics, translational research, industrial lasers, 3D printing, optoelectronics, microfabrication, MOEMS-MEMS, displays, and more.
www.spie.org/biosexpo
R. Rox Anderson, M.D. Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard School of Medicine (USA)
· 20,000 attendees · 2 free exhibitions · 1,250 exhibiting companies · 4,700 technical presentations · 20 plenary presentations (Including recent Nobel Prize Winners) · 40 technical and networking events · 65 courses, and more
12 | January 22, 2015 | synapse.ucsf.edu
» Dear Mama M
» Comics
Third year is a lot like buying car in Senegal
xkcd By Randall Monroe
Dear Mama M,
I am early into my third year medschool clinical rotations now, and I am embarrassed to say that I am still so much more than overwhelmed. There is so much to know, and it is not all just “medicine.” That’s hard enough, but no one really prepared us for the rest of “real life” getting things done on the wards: I am always getting lost in the hospital. There are always new forms for everything you order. I am supposed to text-page certain people and numeric-page others. Some forms you have to hand-carry to radiology or the lab, others you have to get in by 11 a.m. or else forget about it. Some consults that I call can be very rude and intimidating and make me feel terrible for my ignorance. I feel so crazy and so stupid so much of the time and this is Every. Single. Day. Even after I kind of figure out how things work in a few weeks on one rotation, I then have to switch rotations and start the whole freaking thing all over again. I won’t lie to you—this is killer. I never knew how hard this part would be, let alone the learning serious medicine on the wards too. How am I ever going to survive? How does anyone survive third year? Sincerely, Hopeless and Harried Hey H Squared! You forgot to mention that you are also starving, exhausted, and the fax machines don’t work. The most exciting and deep learning experiences seem to be covered in chaos. There are absolutely no reference points for where you are. Know that. I was trying to buy a car in Senegal once. I had just arrived and didn’t speak any of the local or colonial languages. There were lepers crawling into the street and livestock moving freely about. Everywhere I turned, someone was asking me to “take tea.” And, I had to keep track of the man who was taking me to buy the car. This meant following him from one part of town to get
a piece of paper that allowed me to get a stamp that sent me to another part of town for a permit—but then we had to meet the man’s cousin who also had a car I had to look at even though I didn’t want to buy it—all while trusting that, in a few days, I might have a car that didn’t catch on fire in the desert (which it did). This is similar to being a third-year medical student, except you don’t get a car in the end. But, when I reflect back, I just laugh at all that I learned about buying a car in a developing country where I was simply lost in the chaos of the unknown. I learned a lot. I survived. I grew. I laughed. You also will learn a lot. You will survive. You will grow. And you should start laughing as soon as you can, when you are not crying. Now, do you want some practical advice (not my strong point)? 1. Make Friends with friendly people. (There are a lot of unfriendly people. Avoid them. They will bring you down.) 2. To the best of your ability take care of yourself: Eat. Pee. Get outside for five minutes. 3. Forgive yourself for not knowing everything (or anything). 4. Locate a nurse and a social worker on each unit as your go-to Love Bugs. They will help you figure the tedious stuff out that makes no sense and save you hella time. 5. Trust the process. Everyone who looks like they know what they are doing … once didn’t. Everyone has felt like crying … or quitting … or checking out emotionally … or getting mad/frustrated. You will do these things—It’s Ok. You will find your stride and rock it! No one skips this step of being a third-year medical student—all the ones you admire were here. Trust me darlin’, you are fine. Being hopeless and harried is a temporary state of being. Chaotically yours, Mama Need some soul advice from Mama M? E-mail your question to synapse@ucsf.edu.
Results from Dec. 11 caption contest
Winner: “After successful Medusa transgenic experiment, exposed research facility animals become stone..” –Kathy Bailey Runner-up: “Honey, I shrunk the transgenic cats!” –Gabrielle Rizzuto
Piled Higher and Deeper
By Jorge Cham
» Caption Contest Caption this health crisis
If you have a funny or clever caption to describe the scene below, submit it online to Facebook (www.facebook.com/UCSFSynapse) or Twitter (@UCSF_Synapse) using the hashtag #SynapseCaption. The winning captions will be printed in the next issue, and the best overall UCSF student caption winner will receive a $5 BearHug redeemable at many campus vendors (to be picked up in-person at the Synapse office in Millberry Student Union, Parnassus). Also, if you have a funny original photo of life around UCSF that you’d like to share, or any other content or ideas to contribute, feel free to email us at synapse@ucsf.edu.