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of the genetic differences influence traits such as height, weight or vulnerability to certain diseases. But precisely what these genetic variants are and how they exercise their impact is still mostly unknown. However, UCLA researchers have developed a novel approach to study how these differences between individuals affect how strongly genes are expressed, or translated into the proteins that do the actual work in cells. Researchers developed their approach using different strains of yeast called Saccharomyces cerevisiae, a single-celled fungus excellent for the study of cellular and molecular biology and genetics. They studied hundreds of thousands of genetically different yeast cells - orders of magnitude more than previously examined - making their approach statistically powerful and revealing more about how genetic differences influence gene expression than was previously known. Researchers also directly studied protein levels, differing their approach from earlier work that focused on the levels of messenger RNA (mRNA), intermediate molecules cells use to read genes and translate them into proteins. mRNAs are easier to measure than proteins, but their levels don’t always correspond to protein levels.
Legislation calls for safety warning labels to highlight health risks of sugary drinks

“When the science is this conclusive, the state of California has a responsibility to take steps to protect consumers,” stated Senator Monning. “As with tobacco and alcohol warnings, this legislation will give Californians essential information they need to make healthier choices.”

SB 1000 would place a simple warning on the front of all beverage containers with added sweeteners that have 75 or more calories per 12 ounces. The label, developed by a national panel of nutrition and public health experts, would read: STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.

“The science on the harmful impacts associated with drinking soda and other sugary drinks is clear and conclusive. An overwhelming body of research has unequivocally shown that sugary drinks are major contributors to obesity, diabetes, and tooth decay,” explains Dr. Harold Goldstein of the California Center for Public Health Advocacy, which is sponsoring the legislation. “These diseases cost California billions of dollars in health care and lost productivity every year. When any product causes this much harm, it is time to take action.”

Sugary drinks are the biggest contributor of added calories in the American diet, responsible for 43 percent of the added calories in the American diet over the last 30 years. Drinking just one soda a day increases an adult’s likelihood of being overweight by 27 percent and a child’s by 55 percent. Research shows that a soda or two a day increases the risk of diabetes by 26 percent.

“As physicians, we’re desperate to break the cycle of diabetes and obesity we see in our offices every day,” explains Dr. Ashby Wolfe of the California Medical Association, which is also sponsoring the legislation. “Americans drink more than 45 gallons of sugary beverages a year. These drinks have become a major part of the American diet, and we drink them without a second thought to the damage they do to our health. Consumers have a right to know about the unique health problems associated with soda and other sugary drinks.”

The health implications are felt most acutely by California’s communities of color, which are the largest consumers of these sugary drinks. Unless the obesity epidemic is reversed, one in three children born after 2000 – and nearly half of Latino and African-American children – will develop type 2 diabetes in their lifetime. For that reason, the Latino Coalition for a Healthy California and the California Black Health Network have also joined as sponsors of the legislation.

Complete information on the legislation, including fact sheets on the science linking sugary beverages to diabetes, obesity and cavities, is available at: www.sodawarninglabel.org.
Public HealthAdvocacyState Legislative AdvocacySacramento - Armed with overwhelming research linking soda and sugary drink consumption to skyrocketing rates of obesity, diabetes, and tooth decay, the nation’s first legislation requiring safety warning labels on sugary drinks sold in California was introduced today by State Senator Bill Monning (D-Carmel).
Treating Stroke Patients with Intravenous Magnesium within an Hour of Symptom Onset Fails to Improve Stroke Outcome
Study Does Show that Working with Paramedics Allows Intravenous Medications to be Given within “Golden Hour”

improve stroke outcomes, according to research presented today at the American Stroke Association’s International Stroke Conference.

However, the eight-year study found that, by working with paramedics in the field, intravenous medications can be given to stroke patients within the “golden hour,” the window in which patients have the best chance to survive and avoid debilitating, long-term neurological damage. That finding is a “game changer,” said study co-principal investigator Dr. Jeffrey Saver, director of the UCLA Stroke Center and professor of neurology at the David Geffen School of Medicine at UCLA.

“Stroke is a true emergency condition. For every minute that goes by without restoration of blood flow, two million nerve cells are lost,” Saver said. “Since time lost is brain lost, we wanted to develop a method that let us get potentially brain-saving drugs to the patient in the earliest moments of onset of the stroke.  If these patients don’t get protective drugs until two, three or four hours later, irreversible brain damage has already occurred.”

While the Phase III Field Administration of Stroke Therapy – Magnesium (FAST-MAG) clinical trial found that magnesium does not improve stroke-related disability, the search is on now for new drugs and treatments that can be administered in the field to improve long-term outcomes. The infrastructure to treat patients quickly was created by the study and is in place, Saver said, and that is a major accomplishment.

FAST-MAG involved collaboration between 315 ambulances, 40 emergency medical service agencies, 60 receiving hospitals and 2,988 paramedics. Conducted between 2005 and 2013, the study showed that 74 percent of the 1,700 study patients in Los Angeles and Orange counties were treated within the first hour, with the magnesium administered within a median time of 45 minutes.

“With this study, we were able to reach the threatened brain faster than ever before,” said co-principal investigator Dr. Sidney Starkman, co-director of the UCLA Stroke Center and professor of emergency medicine and neurology at the David Geffen School of Medicine at UCLA. “The study has really opened up opportunities to treat patients in the pre-hospital setting in the earliest minutes after symptoms appear.”

Starkman said that the study would not have been possible without the approval and confidence of the California and local emergency medical service agencies and the administrations of the participating hospitals.

Today, the only immediate treatment for strokes caused by blockage of blood vessels is the clot-busting drug tissue plasminogen activator (tPA). But tPA cannot be given until the patients arrive at the hospital and undergo a CT scan to rule out bleeding in the brain. Giving tPA in an ambulance without a CT scan first is not an option because it could harm patients whose strokes are caused by brain bleeds, Saver said. However, neuroprotective drugs can be administered in the field because they’re safe for both blockage and the bleeding strokes.

For the FAST-MAG trial, magnesium was chosen because it dilated blood vessels in the brain in animal studies, increasing blood flow. It also countered the damaging calcium build up that occurs in cells deprived of oxygen. It was already approved to treat medical conditions in people, and it was known to have a good safety profile. 

Saver said FAST-MAG researchers are extremely indebted to the nearly 3,000 paramedics involved in the study, as well as the emergency medicine physicians, neurologists, neurosurgeons and nurses who participated.

“Now we are tasked with finding a different agent or combination of agents that can improve stroke outcomes within that golden hour,” Saver said. “We developed a treatment platform that works and can be used around the world to test promising agents. FAST-MAG has opened a new, earlier-than-ever window for treatment that has the potential to significantly improve outcomes for the hundreds of thousands of people each year who suffer a stroke.”

The National Institute of Neurological Disorders and Stroke (NINDS) is “extremely grateful to the investigators, emergency medical technicians and patients who participated in this landmark study demonstrating how to test therapies in stroke patients before they arrive at the hospital,” said Dr. Walter Koroshetz, deputy director of the NIH NINDS, the sponsor of the FAST-MAG study.  

“NINDS has just set up a new national stroke trials network which can incorporate the lessons learned in FAST-MAG, but also increase the likelihood that the treatments we test will improve patients’ lives,”  he said.

Stroke is the fourth leading cause of death in the United States and is a major cause of adult disability. About 800,000 people in the United States have a stroke each year. One American dies from a stroke every four minutes, on average.

The study was funded by the National Institutes of Neurological Disorders and Stroke.

The UCLA Department of Neurology, with over 100 faculty members, encompasses more than 20 disease-related research programs, along with large clinical and teaching programs. These programs cover brain mapping and neuroimaging, movement disorders, Alzheimer's disease, multiple sclerosis, neurogenetics, nerve and muscle disorders, epilepsy, neuro-oncology, neurotology, neuropsychology, headaches and migraines, neurorehabilitation, and neurovascular disorders. The department ranks in the top two among its peers nationwide in National Institutes of Health funding. For more information, see http://www.neurology.ucla.edu/
In the first study of its kind, a consortium led by UCLA physicians found that giving stroke patients intravenous magnesium within an hour of symptom onset does not
Heart & Vascular Center at Good Samaritan Hospital Performs New TAVR Procedure to Help High-Risk Patients Avoid Open-Chest Surgery

replaced. Having already undergone a quadruple bypass in 1988 and an angioplasty in 2011, Dr. Cannom believed it was far too dangerous for Baker to undergo open-chest surgery at his advanced age, so he proposed a new, less invasive procedure called Transcatheter Aortic Valve Replacement (TAVR).  

Spearheaded by Dr. Steven Burstein, Interventional Cardiologist and Director of the Cardiac Catherization Laboratories at Good Samaritan Hospital and Dr. Ali Gheissari, Cardiothoracic Surgeon, Chief of the Department of Surgery, and Medical Director of the Cardiothoracic and Vascular Surgery Program, the Heart & Vascular Center at Good Samaritan Hospital is one of the first facilities in California to perform the FDA-approved TAVR procedure on patients suffering from severe aortic stenosis, or the narrowing or obstruction of the aortic valve. 

“While open-chest surgery to replace the aortic valve is considered the gold standard treatment for severe aortic stenosis, there is a growing number of high-risk patients who are not eligible for this more invasive surgery,” explains Dr. Burstein.

The TAVR procedure enables the placement of a balloon-expandable heart valve into the body with a tube-based delivery system called a catheter. This tube-based system allows the valve to be inserted through an incision in the leg and into an artery (transfemoral procedure), or through an incision between the ribs and then through the bottom end of the heart called the apex (transapical procedure). The transapical procedure is available to certain high-risk patients such as Baker, who are not candidates for the transfemoral procedure because they do not have appropriate access through their leg artery.

Dr. Burstein and Dr. Gheissari performed Baker’s TAVR procedure using the Edwards SAPIEN transcatheter heart valve in March 2013. Baker spent five days in the hospital and today, he is feeling better than ever. “My heart doesn’t hurt anymore,” says Baker. “I am back walking everyday and not feeling nearly as tired, which for a 98-year-old man is really saying something.”

“This innovative approach is a real game-changer for aortic valve replacement,” adds Dr. Burstein. “We can now offer a viable, less invasive treatment alternative for elderly patients such as Mr. Blake who want to enjoy an active lifestyle.”

For more information about the TAVR procedure, please call the Heart & Vascular Institute at Good Samaritan Hospital at (213) 977-2239 or go to www.goodsam.org.
Louis Baker, 98, of Los Angeles knew there was no other alternative when his cardiologist Dr. David Cannom, Director of Cardiology at Good Samaritan Hospital, informed him that he needed his aortic valve
Keck Medicine of USC experts available to discuss new stroke treatments and research

and a leading cause of disability in the United States. Even more chilling: Fewer than 1 in 5 people in the country can recognize one symptom of the disease.

Two of the nation’s leading stroke experts are available prior to and during the International Stroke Conference, Feb. 12-14 in San Diego, to discuss new stroke research and treatment findings under embargo. These Keck Medicine of USC faculty physicians can also address recent American Heart Association and American Stroke Association guidelines for women.

Nerses Sanossian, MD, will present research on emergency care of stroke and the potential effects of giving paramedics magnesium to use in the field for acute stroke. Amytis Towfighi, MD, will present research that explores the ideal diet for stroke prevention, rising rates of metabolic syndrome among stroke survivors and trends in stroke hospitalization.

Sanossian is assistant professor of neurology at the Keck School of Medicine of USC, president of the American Heart Association’s Los Angeles chapter and director of the Roxanna Todd Hodges Comprehensive Stroke Clinic & TIA Program at Keck Medicine of USC.

Towfighi is assistant professor of clinical neurology at the Keck School of Medicine of USC and chair of neurology at Rancho Los Amigos National Rehabilitation Center.

The American Heart Association’s International Stroke Conference is the world’s largest meeting dedicated to the science and treatment of the disease.

ABOUT KECK MEDICINE OF USC: Keck Medicine of USC is the University of Southern California's medical enterprise, one of only two university-owned academic medical centers in the Los Angeles area. Encompassing academic, research and clinical entities, it consists of the Keck School of Medicine of USC, the region’s first medical school; the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established in the United States; the USC Care Medical Group, the medical faculty practice; the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes outpatient facilities in Beverly Hills, downtown Los Angeles, La Cañada Flintridge, Pasadena, and the USC University Park Campus. USC faculty physicians and Keck School of Medicine departments also have practices throughout Los Angeles, Orange and Riverside counties. The Keck Medicine of USC world-class medical facilities are staffed by nearly 600 physicians who are faculty at the renowned Keck School of Medicine of USC and part of USC Care Medical Group. They are not only clinicians, but cutting-edge researchers, leading professors and active contributors to national and international professional medical societies and associations. For more information on Keck Medicine of USC, go to http://www.keckmedicine.org
By the time you read this, someone in the United States has had a stroke. Stroke happens every 40 seconds in the U.S. and is the No. 4 cause of death
How our brain networks: Research reveals white matter “scaffold” of human brain
USC researchers create first map of core white matter connections; find not all brain connections are equally important

Their work, published Feb. 11 in the open-source journal Frontiers in Human Neuroscience, has major implications for understanding brain injury and disease. By detailing the connections that have the greatest influence over all other connections, the researchers offer not only a landmark first map of core white matter pathways, but also show which connections may be most vulnerable to damage.

“We coined the term white matter ‘scaffold’ because this network defines the information architecture which supports brain function,” said senior author John Darrell Van Horn of the USC Institute for Neuroimaging and Informatics and the Laboratory of Neuro Imaging at USC.

“While all connections in the brain have their importance, there are particular links which are the major players,” Van Horn said.

Using MRI data from a large sample of 110 individuals, lead author Andrei Irimia, also of the USC Institute for Neuroimaging and Informatics, and Van Horn systematically simulated the effects of damaging each white matter pathway.

They found that the most important areas of white and gray matter don't always overlap. Gray matter is the outermost portion of the brain containing the neurons where information is processed and stored. Past research has identified the areas of gray matter that are disproportionately affected by injury.

But the current study shows that the most vulnerable white matter pathways – the core “scaffolding” – are not necessarily just the connections among the most vulnerable areas of gray matter, helping explain why seemingly small brain injuries may have such devastating effects.

“Sometimes people experience a head injury which seems severe but from which they are able to recover. On the other hand, some people have a seemingly small injury which has very serious clinical effects," says Van Horn, associate professor of neurology at the Keck School of Medicine of USC. "This research helps us to better address clinical challenges such as traumatic brain injury and to determine what makes certain white matter pathways particularly vulnerable and important."

The researchers compare their brain imaging analysis to models used for understanding social networks. To get a sense of how the brain works, Irimia and Van Horn did not focus only on the most prominent gray matter nodes – which are akin to the individuals within a social network. Nor did they merely look at how connected those nodes are.

Rather, they also examined the strength of these white matter connections, i.e. which connections seemed to be particularly sensitive or to cause the greatest repercussions across the network when removed. Those connections which created the greatest changes form the network "scaffold."

“Just as when you remove the internet connection to your computer you won’t get your email anymore, there are white matter pathways which result in large scale communication failures in the brain when damaged," Van Horn said.

When white matter pathways are damaged, brain areas served by those connections may wither or have their functions taken over by other brain regions, the researchers explain. Irimia and Van Horn's research on core white matter connections is part of a worldwide scientific effort to map the 100 billion neurons and 1,000 trillion connections in the living human brain, led by the Human Connectome Project and the Laboratory of Neuro Imaging at USC.

Irimia notes that, “these new findings on the brain’s network scaffold help inform clinicians about the neurological impacts of brain diseases such as multiple sclerosis, Alzheimer’s disease, as well as major brain injury. Sports organizations, the military and the US government have considerable interest in understanding brain disorders, and our work contributes to that of other scientists in this exciting era for brain research."

The research was supported by NIH grants 2U54EB005149-06, 1RC1MH088194, R41NS081792-01.

For a PDF of the study, press images or to arrange an interview with a researcher, contact Suzanne Wu at suzanne.wu@usc.edu.

About the USC Institute for Neuroimaging and Informatics: The Institute for Neuroimaging and Informatics aims to enhance discovery through the application of imaging and information technologies in the study of the brain. The Institute is dedicated to excellence in data acquisition, analysis, stewardship and computational innovation for the purpose of biomedical research.

About Digital USC: Digital USC is a university-wide initiative of $1 billion over 10 years towards gathering, interpreting and applying digital data on a massive scale. An international leader in fields from artificial intelligence to game design, with the largest computer science research program among American universities, USC is advancing knowledge in the development of virtual humans for therapy, entertainment, or historic preservation; the simulation and modeling of earthquakes and other complex systems; brain mapping; archiving, indexing and analysis of visual material; visual storytelling and data visualization; and in creating advanced online platforms for distance education and professional development.
For the first time, neuroscientists have systematically identified the white matter “scaffold” of the human brain, the critical communications network that supports brain function.
Understanding the biology of bipolar disorder
Scientists from UCLA, UC San Francisco, Costa Rica and Colombia take steps to identify genetic component to mental illness

understand the illness's genetic causes, researchers at UCLA tried a new approach. 

Instead of only using a standard clinical interview to determine whether individuals met the criteria for a clinical diagnosis of bipolar disorder, the researchers combined the results from brain imaging, cognitive testing, and an array of temperament and behavior measures. Using the new method, UCLA investigators — working with collaborators from UC San Francisco, Colombia's University of Antioquia and the University of Costa Rica — identified about 50 brain and behavioral measures that are both under strong genetic control and associated with bipolar disorder. Their discoveries could be a major step toward identifying the specific genes that contribute to the illness.

The results are published in the Feb. 12 edition of the Journal JAMA Psychiatry.

A severe mental illness that affects about 1 to 2 percent of the population, bipolar disorder causes unusual shifts in mood and energy, and it interferes with the ability to carry out everyday tasks. Those with the disorder can experience tremendous highs and extreme lows — to the point of not wanting to get out of bed when they're feeling down. The genetic causes of bipolar disorder are highly complex and likely involve many different genes, said Carrie Bearden, a senior author of the study and an associate professor of psychiatry and psychology at the UCLA Semel Institute for Neuroscience and Human Behavior. 

"The field of psychiatric genetics has long struggled to find an effective approach to begin dissecting the genetic basis of bipolar disorder," Bearden said. "This is an innovative approach to identifying genetically influenced brain and behavioral measures that are more closely tied to the underlying biology of bipolar disorder than the clinical symptoms alone are."

The researchers assessed 738 adults, 181 of whom have severe bipolar disorder. They used high-resolution 3-D images of the brain, questionnaires evaluating temperament and personality traits of individuals diagnosed with bipolar disorder and their non-bipolar relatives, and an extensive battery of cognitive tests assessing long-term memory, attention, inhibitory control and other neurocognitive abilities. 

Approximately 50 of these measures showed strong evidence of being influenced by genetics. Particularly interesting was the discovery that the thickness of the gray matter in the brain's temporal and prefrontal regions — the structures that are critical for language and for higher-order cognitive functions like self-control and problem-solving — were the most promising candidate traits for genetic mapping, based on both their strong genetic basis and association with the disease.

"These findings are really just the first step in getting us a little closer to the roots of bipolar disorder," Bearden said. "What was really exciting about this project was that we were able to collect the most extensive set of traits associated with bipolar disorder ever assessed within any study sample. These data will be a really valuable resource for the field."

The individuals assessed in this study are members of large families living in Costa Rica's central valley and Antioquia, Colombia. The families were founded by European and native Amerindian populations about 400 years ago and have a very high incidence of bipolar disorder. The groups were chosen because they have remained fairly isolated since their founding and their genetics are therefore simpler for scientists to study than those of general populations. 

The fact that the findings aligned so closely with those of previous, smaller studies in other populations was surprising even to the scientists, given the subjects' unique genetic background and living environments. 

"This suggests that even if the specific genetic variants we identify may be unique to this population, the biological pathways they disrupt are likely to also influence disease risk in other populations," Bearden said.

The researchers' next step is to use the genomic data they collected from the families — including full genome sequences and gene expression data— to begin identifying the specific genes that contribute to risk for bipolar disorder. The researchers also plan to extend their investigation into the children and teens in these families. They hypothesize that many of the bipolar-related brain and behavioral differences found in adults with bipolar disorder had their origins in adolescent neurodevelopment.

The study's other authors include Dr. Nelson Freimer, a UCLA professor of psychiatry and director of the UCLA Center for Neurobehavioral Genetics, and Scott Fears, assistant professor in the Center for Neurobehavioral Genetics. Please see the paper for a full list of co-authors. The research was supported by National Institute of Health grants R01MH075007, R01MH095454, P30NS062691, K23MH074644-01 and K08MH086786, and by Colciencias (Colombia's Administrative Department of Science, Technology and Innovation) and the Committee for the Development of Research (CODI) at Colombia's University of Antioquia.

The Semel Institute for Neuroscience and Human Behavior is an interdisciplinary research and education institute devoted to the understanding of complex human behavior, including the genetic, biological, behavioral and sociocultural underpinnings of normal behavior, and the causes and consequences of neuropsychiatric disorders. In addition to conducting fundamental research, the institute faculty seeks to develop effective strategies for prevention and treatment of neurological, psychiatric and behavioral disorder, including improvement in access to mental health services and the shaping of national health policy.
Scientists know there is a strong genetic component to bipolar disorder, but they have had an extremely difficult time identifying the genes that cause it. So, in an effort to better
Blood Test Serves as 'Crystal Ball' for Heart Transplant Patients, UCLA-Led Study Finds

Reporting in the online edition of the peer-reviewed journal Transplantation, researchers demonstrate how the AlloMap test, which uses a blood sample to measure changes in the expression of roughly a dozen genes, can be used over a period of time to assess the risk of dysfunction or rejection of a transplanted heart — months before such an event may occur.  

"For the first time, we can use genomic testing over multiple patient visits to go beyond intuition to understand not just how patients are doing now but how they are likely to be a few months from now," said Dr. Mario Deng, medical director of UCLA's Integrated Advanced Heart Failure–Mechanical Support–Heart Transplant Program and the study's principal investigator. "It's another step toward personalized medicine."    

The discovery that transplant recipients' white blood cells contain this prognostic information on rejection, independent of how their transplanted heart may be functioning currently, could potentially improve care and outcomes, the researchers said. The findings represent a significant step in the movement toward using genomic-based testing to predict future clinical events and bolster the importance of similar tests being developed for recipients of other organs.    

In the U.S., approximately 2,000 patients receive lifesaving heart transplants each year, and monitoring their immune systems for signs of rejection is a critical part of follow-up care. Until recently, however, the only way to diagnose rejection was through a heart-muscle biopsy, a painful and potentially risky procedure in which a heart catheter is inserted through a vein in the neck.   

That changed with the development of the AlloMap gene-expression profiling test, which received clearance from the Food and Drug Administration in 2008. The test is now routinely used by a majority of U.S. heart transplant centers to monitor low-risk patients during follow-up care, resulting in a substantial reduction in the number of biopsies.  

AlloMap, which is based on research Deng led in conjunction with more than a dozen of the largest U.S. heart transplant centers and the Brisbane, Calif.–based biotech company XDx, measures the expression levels of 11 genes from a patient's blood sample, each of which is known to be associated with rejection risk.    

"The AlloMap was the first FDA-cleared test allowing transplant centers to rule out rejection at the time of the visit," Deng said. "But until now, it has never been used to predict future events."    

The current study is based on data originally collected by leading transplant centers and published in the New England Journal of Medicine in 2010. For that study, 600 heart transplant recipients were randomly assigned to be monitored for potential episodes of rejection either through routine biopsy or through the AlloMap test. The study found that AlloMap was equally as effective as biopsy at detecting rejection or dysfunction, and it resulted in increased patient satisfaction because it was less invasive.    

The new study demonstrates for the first time the ability of the AlloMap test, when used over time, to predict future events.    

Deng and colleagues noted that using gene-expression profiling to predict the future likelihood of patients experiencing rejection-related problems with their transplanted heart could change the way such patients are treated.    

For example, those deemed to be at low risk for adverse events could be given lower doses of immunosuppressive drugs, which could reduce the significant side effects. On the other hand, patients found to be at high risk could be evaluated at shorter time intervals to determine the causes of the test-result variability, specifically to rule out rejection.    

As of now, there are no similar tests to monitor the potential for rejection in other types of transplanted organs, but Deng said that active collaborative and multidisciplinary research programs at UCLA and elsewhere are working to bring genomic testing to these fields.    

Deng received research support and consultancy fees from XDx.    

For more news, visit the UCLA Newsroom and follow us on Twitter.                            
A new UCLA-led study shows that a blood test commonly used to determine whether heart transplant recipients are rejecting their new organ can also predict potential rejection-related problems in the future.   
Field Poll shows broad voter support for health warning labels on sugar sweetened beverages

The poll, which was conducted by The Field Poll and The California Endowment, found that 74 percent of voters support the requirement to apply health warning labels to sugar sweetened beverages, with 52 percent of voters “strongly” endorsing the requirement. Support for the labeling of potentially harmful beverages was also bipartisan, with 80 percent of Democrats, 64 percent of Republicans and 75 percent of non-partisan voters endorsing the labeling requirement.

These results come only a week after Senate Bill 1000, the Sugar-Sweetened Beverages Safety Warning Act, was introduced in the state legislature. The bill, authored by state Senator Bill Monning (D-Carmel) and co-sponsored by CMA, would require bottles, cans, vending machines, dispensers and restaurateurs offering high calorie drinks with added sugar to display a warning label outlining the health risks associated with such beverages.

“California voters are now echoing what the scientific and medical communities have been saying for some time, that sugar sweetened beverages pose serious, and unique, health risks and should be treated as such,” said Richard Thorp, M.D., president of the California Medical Association.

Sugar-sweetened beverages are the number one source of added sugars in the American diet, making up at least 43 percent of the 300 additional calories added to the average American’s daily consumption since the 1970s. These beverages are also one of the leading causes of preventable diabetes, a disease which has seen its rate among American adults double over the past 30 years.

If current obesity trends continue, one in three children born today is expected to develop preventable diabetes in their lifetime. The problem is worse for communities of color, where nearly half of children born since 2000 would develop type 2 diabetes in their lifetime should current trends continue.
Public HealthAdvocacyState Legislative AdvocacySacramento- The California Medical Association (CMA) is pleased to see the recently released poll figures suggesting that California voters support the notion of applying health-warning labels on sodas and other sugar sweetened beverages.
Use of acetaminophen during pregnancy linked to ADHD in children, UCLA researchers say

considered mostly harmless. Over recent decades, the drug, which has been marketed since the 1950s, has become the medication most commonly used by pregnant women for fevers and pain.

Now, a long-term study by UCLA, in collaboration with the University of Aarhus in Denmark, has raised concerns about the use of acetaminophen during pregnancy. 

In a report in the current online edition of JAMA Pediatrics, researchers from the UCLA Fielding School of Public Health and their colleagues show that taking acetaminophen during pregnancy is associated with a higher risk in children of attention deficit hyperactivity disorder and hyperkinetic disorder. The data raises the question of whether the drug should be considered safe for use by pregnant women. 

ADHD, one of the most common neurobehavioral disorders worldwide, is characterized by inattention, hyperactivity, increased impulsivity, and motivational and emotional dysregulation. Hyperkinetic disorder is a particularly severe form of ADHD.

"The causes of ADHD and hyperkinetic disorder are not well understood, but both environmental and genetic factors clearly contribute," said Dr. Beate Ritz, professor and chair of the department of epidemiology at the Fielding School and one of the senior authors of the paper. "We know there has been a rapid increase in childhood neurodevelopmental disorders, including ADHD, over the past decades, and it's likely that the rise is not solely attributable to better diagnoses or parental awareness. It's likely there are environmental components as well." 

"That gave us the motivation to search for environmental causes that are avoidable," said the University of Aarhus' Dr. Jørn Olsen, another senior author and former chair of the UCLA Fielding School's epidemiology department. "Part of the neuropathology may already be present at birth, making exposures during pregnancy and/or infancy of particular interest. Because acetaminophen is the most commonly used medication for pain and fever during pregnancy, it was something we thought we should look at."

The UCLA researchers used the Danish National Birth Cohort, a nationwide study of pregnancies and children, to examine pregnancy complications and diseases in offspring as a function of factors operating in early life. The cohort focuses especially on the side effects of medications and infections. 

The researchers studied 64,322 children  and mothers who were enrolled in the Danish cohort from 1996 to 2003. Acetaminophen use during pregnancy was determined using computer-assisted telephone interviews that were conducted up to three times during pregnancy and then six months after childbirth.

The researchers next followed up with parents when their children reached the age of 7. They first assessed parental reports of behavioral problems in their children using the Strength and Difficulties Questionnaire, a standard behavioral screening questionnaire used by scientists. The test assesses five domains, including emotional symptoms, conduct problems, hyperactivity, peer relationship and pro-social behavior in children and adolescents between the ages of 4 and 16. 

In addition, they obtained diagnoses of hyperkinetic disorder among the cohort's children (at an average age of 11) from the Danish National Hospital Registry or the Danish Psychiatric Central Registry. Last, they identified if ADHD medications, mainly Ritalin, were redeemed for the children using the Danish pharmaceutical prescription database.

More than half of all the mothers reported using acetaminophen while pregnant. The researchers found that children whose mothers used acetaminophen during pregnancy were at a 13 percent to 37 percent higher risk of later receiving a hospital diagnosis of hyperkinetic disorder, being treated with ADHD medications or having ADHD-like behaviors at age 7. The longer acetaminophen was taken — that is, into the second and third trimesters — the stronger the associations. The risks for hyperkinetic disorder/ADHD in children were elevated 50 percent or more when the mothers had used the common pain killer for more than 20 weeks in pregnancy 

"It's known from animal data that acetaminophen is a hormone disruptor, and abnormal hormonal exposures in pregnancy may influence fetal brain development," Ritz said. 

Acetaminophen can cross the placental barrier, Ritz noted, and it is plausible that acetaminophen may interrupt fetal brain development by interfering with maternal hormones or through neurotoxicity, such as the induction of oxidative stress, which can cause the death of neurons.

"We need further research to verify these findings, but if these results reflect causal associations, then acetaminophen should no longer be considered a safe drug for use in pregnancy," Olsen said.

Other authors of the study included Zeyan Liew (first author) and Pei-Chen Lee of UCLA, and Cristina Rebordosa of the University of Arizona. Funding was provided by the Danish Medical Research Council (09-069178).

The UCLA Fielding School of Public Health, founded in 1961, is dedicated to enhancing the public's health by conducting innovative research, training future leaders and health professionals from diverse backgrounds, translating research into policy and practice, and serving our local communities and the communities of the nation and the world. The school has 650 students from more than 35 nations engaged in carrying out the vision of building healthy futures in greater Los Angeles, California, the nation and the world.
Acetaminophen, found in over-the-counter products such as Excedrin and Tylenol, provides many people with relief from headaches and sore muscles. When used appropriately, it is
After death, twin brains show similar patterns of neuropathologic changes

happening in the brain often varies widely from patient to patient, and a trigger for one person may be harmless is another.

In a unique study, an international team of researchers led by USC psychologist Margaret Gatz compared the brains of twins where one or both died of Alzheimer’s disease. They found that many of the twin pairs not only had similar progressions of Alzheimer’s disease and dementia prior to death, but they also had similar combinations of pathologies — two-or-more unconnected areas of damage to the brain.

The paper is part of Gatz’s landmark body of work on aging and cognition with the Swedish Twin Registry, a large cohort study of more than 14,000 Swedish twins, now over the age of 65. Across nearly 30 years, Gatz’s work with twins — including genetically identical pairs — has shifted the study of Alzheimer’s disease to include the entire lifespan, including the effects of developmental exposure, periodontal disease, mental health, obesity and diabetes on later-life Alzheimer’s risk.

The current paper provides more evidence that there may not be a single smoking-gun cause of Alzheimer’s, but rather a range of potential causes to which we may be susceptible largely depending on our genetics. It appears in the current issue of the journal Brain Pathology.

“We try to make inferences based on tests and diagnoses, but we have to assume that what we’re seeing is a manifestation of what’s going on in these twins’ brains,” said Gatz, professor of psychology, gerontology and preventive medicine in USC Dornsife College. “For this reason, we wanted to compare the brains of twins to ask whether identical twins’ brains are actually more identical?”

The researchers had the rare opportunity to directly autopsy the brains of seven pairs of twins who both died after being receiving diagnostic evaluations over many years, including a pair of identical twins who were both diagnosed with Alzheimer's and died within a year of one another at the age of 98.

“There may be risk factors that start to accumulate but don’t lead to a clinical diagnosis,” explained lead author Diego Iacono of the Karolinska Institute in Sweden and the Biomedical Research Institute. “We found that the presence of Alzheimer’s disease doesn’t preclude the presence of other damage. Looking at co-pathologies in twin pairs may present new areas for research aside from the typical factors.”

For example, while there’s wide consensus among experts about the course of Alzheimer’s disease and the presence of amyloid plaques and tangles in the brain, what starts the process going is less clear, including the role of lesions, Lewy bodies and vascular or ventricle damage, more often associated with specific types of dementia such as Parkinson’s disease.

“Identical twins tended to have similar combinations of pathologies. We looked not just at the hallmark indicators of Alzheimer’s, but at all the other damage in the brain. Across the whole array of neuropathological changes, the identical twins appeared to have more similar pathologies,” Gatz said. “This is fascinating: it’s not just a key pathology related to the twins’ diagnoses but the combination of things happening in their brains. We’re going to keep looking for what these combinations are.”

The research was funded by the NIH grants R01 AG08724, AG04563, AG10175 AND AG08861.
Despite widespread use of a single term, Alzheimer’s disease is actually a diverse collection of diseases, symptoms and pathological changes. What’s
Internal Logic: Whole-Brain Atlas of Neural Networks Reveals Eight Distinct Subnetworks in Mouse Cerebral Cortex
“Think about it: the brain is built for logic, so its organization must be logical.”

Researchers have identified eight distinct neural subnetworks that together form the connectivity infrastructure of the mammalian cortex, the part of the brain involved in higher-order functions such as cognition, emotion and consciousness.

“This study is the first comprehensive mapping of the most developed region of the mammalian brain: the cerebral cortex. The cortex is highly complex and made up of many densely interconnected structures, but when you strip it down, is organized into a small number of subnetworks,” said senior author Hongwei Dong of the USC Institute for Neuroimaging and Informatics.

The cerebral cortex is the outermost layer of neural tissue in the brain and is one of the most extensively studied brain structures in the field of neuroscience. However, before this study, its underlying organizational principle was still largely unclear.

“Think about it: the brain is built for logic, so its organization must be logical. The brain’s architectural organization is arranged such that all of its substructures most efficiently work in conjunction to produce appropriate behaviors, ” said Dong, associate professor of neurology at the Keck School of Medicine of USC. “We want to find the code to how the brain is structurally organized.”

The study is also a reminder that while there is more data than ever, the quality and reliability of information still matters. In contrast to past patchwork attempts, Dong and his team undertook an effort to directly develop a whole-brain mouse atlas of brain pathways. Across the cortex, they injected fluorescent molecules. These molecules were then transported along the brain’s “cellular highways” — the neuronal pathways — and meticulously tracked using a high-resolution microscope.

The uniformity and completeness of the scientists’ effort across the entire cortex not only provided for a searchable image database of cortical connections, which the researchers are making open-access and publicly available.

It also allowed them to reliably see patterns: the seemingly inscrutable mass of connections in the cerebral cortex is highly organized, consisting of eight distinct subnetworks that are relatively segregated.

“The systematic and comprehensive manner in which the data were collected lent itself to a detailed analysis through which these subnetworks emerged,” explained co-lead author Houri Hintiryan of the USC Laboratory of Neuro Imaging.

So that scientists around the world may continue to look for fundamental structural insights, the full, interactive imaging dataset is viewable at Mouse Connectome Project, providing a resource for researchers interested in studying the anatomy and function of cortical networks throughout the brain.

“It really is quite tedious,” Dong said of collecting the data, “and labor-intensive, and it requires highly specialized skills and technology. But think of the Human Genome Project and how much it accelerated the process of discovery and the whole field when infrastructures existed for people to share and compare. That was our motivation.”

How these subnetworks interact will provide a crucial baseline from which to better understand diseases of “disconnection” such as autism and Alzheimer’s Disease, in which the manifestations of symptoms are potentially a result of disordered or damaged connections.

The researchers’ map of the mouse cerebral cortex can be compared to data on disease-affected brains, brains in development and genetic information. It will also offer necessary context for some of the particularities of being human, who behaved just like other mammals only a few thousand years ago and who still share most underlying basic behavioral characteristics such as hunger and pain.

“The fundamental logic of mammalian brains is the same, particularly when it comes to basic behaviors such as eating, sleeping, and social behaviors” said Dong, who notes that similar studies in humans have thus far not gotten to the cellular level. “There are lots of organizing principles to brain structures that we are just beginning to understand.”

The researchers identified the brain subnetworks based on their high degree of interconnectivity — though relatively independent, several structures provide communication routes through which the subnetworks interact. Combined with behavioral data from past research and information about subcortical targets, these interconnections imply remarkable functional significance for the subnetworks.

Four of the eight identified subnetworks in the mouse cortex relate to sensation and movement of the body, what the researchers dub somatic sensorimotor. In particular, the researchers identified separate subnetworks for movements in the face, upper limbs, lower limbs and trunk, and whiskers. Together, these networks facilitate motor behaviors such as eating and drinking, reaching and grabbing, locomotion and exploration of the environment.

Two other subnetworks are comprised of structures located along the midline of the cerebral cortex. These medial subnetworks seem devoted to the integration of visual, auditory and somatic sensory information, according to the study. Several other structures located along the side of the brain form two lateral subnetworks, one of which potentially serves to regulate the internal status of the body (i.e. taste, hunger, visceral information) and the other as a “mega-integration” subnetwork that allows the interaction of information from nearly the entire cortex.

The research was supported by the National Institute of Mental Health of the National Institutes of Health (grants: MH094360-01A1 and 3P41RR013642-12S3). Brian Zingg of the Zilkha Neurogenetic Institute at USC was co-lead author of the study. Arthur Toga, director of USC INI, was also an author of the study.

For more information or to request an interview with a researcher, contact Suzanne Wu at suzanne.wu@usc.edu.

About the USC Institute for Neuroimaging and Informatics: The Institute for Neuroimaging and Informatics aims to enhance discovery through the application of imaging and information technologies in the study of the brain. The Institute is dedicated to excellence in data acquisition, analysis, stewardship and computational innovation for the purpose of biomedical research.

About Digital USC: Digital USC is a university-wide initiative of $1 billion over 10 years towards gathering, interpreting and applying digital data on a massive scale. An international leader in fields from artificial intelligence to game design, with the largest computer science research program among American universities, USC is advancing knowledge in the development of virtual humans for therapy, entertainment, or historic preservation; the simulation and modeling of earthquakes and other complex systems; brain mapping; archiving, indexing and analysis of visual material; visual storytelling and data visualization; and in creating advanced online platforms for distance education and professional development.
The mammalian cerebral cortex, long thought to be a dense single interrelated tangle of neural networks, actually has a "logical" underlying organizational principle, reveals a study appearing Feb. 27 in the journal Cell.
Experimental stroke therapeutic developed at Keck Medicine of USC also shows promise for people with Lou Gehrig’s disease (ALS)

March 3, 2014, online edition of the Proceedings of the National Academy of Sciences of the United States of America, the official scientific journal of the U.S. National Academy of Sciences.

“We know that both people and transgenic rodents afflicted with this disease develop spontaneous breakdown of the blood-spinal cord barrier, but how these microscopic lesions affect the development of the disease has been unclear,” said Berislav V. Zlokovic, M.D., Ph.D., the study’s principal investigator and director of the Zilkha Neurogenetic Institute at USC. “In this study, we show that early motor neuron dysfunction related to the disease in mice is proportional to the degree of damage to the blood-spinal cord barrier and that restoring the integrity of the barrier delays motor neuron degeneration. We are hopeful that we can apply these findings to the corresponding disease mechanism in people.”

In this study, Zlokovic and colleagues found that an experimental drug now being studied in human stroke patients appears to protect the blood-spinal cord barrier’s integrity in mice and delay motor neuron impairment and degeneration. The drug, an activated protein C analog called 3K3A-APC, was developed by Zlokovic’s start-up biotechnology company, ZZ Biotech.

Lou Gehrig’s disease, also called amyotrophic lateral sclerosis, or ALS, attacks motor neurons, which are cells that control the muscles. The progressive degeneration of the motor neurons in ALS eventually leads to paralysis and difficulty breathing, eating and swallowing.

According to The ALS Association, approximately 15 people in the United States are diagnosed with ALS every day. It is estimated that as many as 30,000 Americans live with the disease. Most people who develop ALS are between the ages of 40 and 70, with an average age of 55 upon diagnosis. Life expectancy of an ALS patient averages about two to five years from the onset of symptoms.

ALS’s causes are not completely understood, and no cure has yet been found. Only one Food and Drug Administration-approved drug called riluzole has been shown to prolong life by two to three months. There are, however, devices and therapies that can manage the symptoms of the disease to help people maintain as much independence as possible and prolong survival.

The international research team included scientists from the The Scripps Research Institute, University of Rochester Medical Center, Sichuan University’s West China Hospital, and Ludwig Institute for Cancer Research at the University of California, San Diego. Grants from The ALS Association (1859) and National Institutes of Health (AG039452, AG23084, NS34467, HL031950, HL052246, NS27036) supported their research.

ABOUT KECK MEDICINE OF USC: Keck Medicine of USC is the University of Southern California's medical enterprise, one of only two university-owned academic medical centers in the Los Angeles area. Encompassing academic, research and clinical entities, it consists of the Keck School of Medicine of USC, the region’s first medical school; the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established in the United States; the USC Care Medical Group, the medical faculty practice; the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes outpatient facilities in Beverly Hills, downtown Los Angeles, La Cañada Flintridge, Pasadena, and the USC University Park Campus. USC faculty physicians and Keck School of Medicine departments also have practices throughout Los Angeles and Orange counties. The Keck Medicine of USC world-class medical facilities are staffed by nearly 600 physicians who are faculty at the renowned Keck School of Medicine of USC and part of USC Care Medical Group. They are not only clinicians, but cutting-edge researchers, leading professors and active contributors to national and international professional medical societies and associations.
Keck School of Medicine of USC neuroscientists have unlocked a piece of the puzzle in the fight against Lou Gehrig’s disease, a debilitating neurological disorder that robs people of their motor skills. Their findings appear in the
How ACA affects vulnerable Americans living with HIV/AIDS

a.m. For more information, contact Debbie Boylan at dboylan@projecthope.org.

The issue features several studies by researchers with the USC Schaeffer Center for Health Policy and Economics, one of the nation’s premier policy research centers dedicated to promoting health and value in healthcare delivery through innovative research and policy, including:

When it comes to HIV treatment, timing is everything

Dana P. Goldman, Leonard D. Schaeffer Chair and Director of the USC Schaeffer Center for Health Policy and Economics, and coauthors modeled HIV transmission and prevention based on when HIV-positive individuals started combination antiretroviral treatment (cART). The researchers estimate that from 1996 to 2009, early treatment initiation in the United States prevented 188,700 new HIV cases and avoided $128 billion in life expectancy losses.

In particular, the researchers highlight treatment at “very early” stages as responsible for four-fifths of prevented cases. They define early treatment as when CD4 white blood cell counts are greater than 500, consistent with current treatment guidelines in the United States.

Early treatment both reduces morbidity and mortality in people living with HIV/AIDS, and decreases the transmission of the disease to the uninfected. The authors conclude that early treatment has clear value for both HIV-positive and HIV-negative populations in the United States.

Early treatment of HIV can add valuable years to life—if guidelines are followed

In another study, John A. Romley of the USC Schaeffer Center and coauthors analyze the effects on life expectancy of people initiating combination antiretroviral therapy at early stages of the disease, when CD4 white blood cells are 350 or higher. In recent years, U.S. treatment guidelines have been revised to recommend treatment at all CD4 counts.

The authors found an average gain in life expectancy of 6.1 years for people who initiated therapy when CD4 counts were 350 to 500, and a gain of 9 years for those initiating treatment when CD4 counts were above 500.

The authors found a much higher mortality risk among HIV-positive individuals if treatment was initiated when CD4 counts were less than 350. For HIV-positive individuals whose treatment was initiated when CD4 counts were less than 350, mortality risk was 28 percent higher than those who started treatment when counts were 350 to 500, and 1.16 times higher than those who started when counts were greater than 500.

The researchers estimate the value of survival gains from early initiation from 1996 to 2009 at $80 billion, with each life year valued at $150,000. Those who initiated treatment the earliest — following the current U.S. treatment guidelines — could expect to live another 39.7 years.The authors point to the importance of treatment guideline adherence and to investment in scientific investigation to support rigorous guideline development.

The ACA could help the fight against HIV/AIDS, particularly if more states expand Medicaid

Zachary Wagner and colleagues at the USC Schaeffer Center modeled the effects of the Affordable Care Act and found that by 2017, an additional 466,153 people in the United States will be tested for HIV.

With increased testing among the newly insured under the ACA, the population of HIV-positive people who are unaware of their status will decline by 22 percent, the researchers estimate. By 2017, they estimate 2,598 new cases diagnosed, with the effect potentially magnified by as much as 30 percent if all states expanded their Medicaid programs. The researchers recommend state leaders consider ways to expand insurance coverage to those who remain uninsured.

The authors point to evidence that gaining health insurance can improve testing rates, and that more generous Medicaid benefits can increase the use of treatment by HIV-positive individuals, both important contributors to prevention efforts.

Additional papers in Health Affairs examine jails and health, and reflect ongoing concerns about how to manage the health needs of a population with higher rates of communicable diseases, mental illness, substance abuse and many chronic conditions — and what the return of “jail-involved” individuals to communities will bring as Medicaid expands in many states and the ACA provision ensuring care to them becomes a reality.

Support for the HIV/AIDS articles included grants from Precision Health Economics and the USC Schaeffer Center for Health Policy and Economics.

For more information or to arrange an interview with a researcher, contact Kim Rymsha at (202) 745-5054 or krymsha@gymr.com.

About the USC Schaeffer Center for Health Policy and Economics: The mission of the Leonard D. Schaeffer Center for Health Policy and Economics is to conduct rigorous research, develop health policy leaders, and broadly communicate solutions to promote health, well-being, and value in healthcare delivery. With its extraordinary breadth and depth of expertise, the Schaeffer Center will have a vital impact on the transformation of healthcare.

The Schaeffer Center is the result of a unique collaboration between the USC Price School of Public Policy and the USC School of Pharmacy. The Center brings together health policy experts from the Price School, a seasoned pharmacoeconomics team from the School of Pharmacy, and other affiliated faculty and scholars from across USC and other distinguished universities.
A briefing about the March issue of Health Affairs and these findings will take place at the National Press Club on Tuesday, March 11, from 9 a.m. to 11:45
Meat and cheese may be as bad for you as smoking
A high-protein diet during middle age makes you nearly twice as likely to die and four times more likely to die of cancer, but moderate protein intake is good for you after 65

you four times more likely to die of cancer than someone with a low-protein diet — a mortality risk factor comparable to smoking.

“There’s a misconception that because we all eat, understanding nutrition is simple. But the question is not whether a certain diet allows you to do well for three days, but can it help you survive to be 100?” said corresponding author Valter Longo, the Edna M. Jones Professor of Biogerontology at the USC Davis School of Gerontology and director of the USC Longevity Institute.

Not only is excessive protein consumption linked to a dramatic rise in cancer mortality, but middle-aged people who eat lots of proteins from animal sources — including meat, milk and cheese — are also more susceptible to early death in general, reveals the study to be published March 4 in Cell Metabolism. Protein-lovers were 74 percent more likely to die of any cause within the study period than their more low-protein counterparts. They were also several times more likely to die of diabetes.

But how much protein we should eat has long been a controversial topic – muddled by the popularity of protein-heavy diets such as Paleo and Atkins. Before this study, researchers had never shown a definitive correlation between high protein consumption and mortality risk.

Rather than look at adulthood as one monolithic phase of life, as other researchers have done, the latest study considers how biology changes as we age, and how decisions in middle life may play out across the human lifespan.

In other words, what’s good for you at one age may be damaging at another. Protein controls the growth hormone IGF-I, which helps our bodies grow but has been linked to cancer susceptibility. Levels of IGF-I drop off dramatically after age 65, leading to potential frailty and muscle loss. The study shows that while high protein intake during middle age is very harmful, it is protective for older adults: those over 65 who ate a moderate- or high-protein diet were less susceptible to disease.

The latest paper draws from Longo’s past research on IGF-I, including on an Ecuadorian cohort that seemed to have little cancer or diabetes susceptibility because of a genetic mutation that lowered levels of IGF-I; the members of the cohort were all less than five-feet tall.

“The research shows that a low-protein diet in middle age is useful for preventing cancer and overall mortality, through a process that involves regulating IGF-I and possibly insulin levels,” said co-author Eileen Crimmins, the AARP Chair in Gerontology at USC. “However, we also propose that at older ages, it may be important to avoid a low-protein diet to allow the maintenance of healthy weight and protection from frailty.”

Crucially, the researchers found that plant-based proteins, such as those from beans, did not seem to have the same mortality effects as animal proteins. Rates of cancer and death also did not seem to be affected by controlling for carbohydrate or fat consumption, suggesting that animal protein is the main culprit.

“The majority of Americans are eating about twice as much proteins as they should, and it seems that the best change would be to lower the daily intake of all proteins but especially animal-derived proteins,” Longo said. “But don’t get extreme in cutting out protein; you can go from protected to malnourished very quickly.”

Longo's findings support recommendations from several leading health agencies to consume about 0.8 grams of protein per kilogram of body weight every day in middle age. For example, a 130-pound person should eat about 45-50 grams of protein a day, with preference for those derived from plants such as legumes, Longo explains.

The researchers define a “high-protein” diet as deriving at least 20 percent of calories from protein, including both plant-based and animal-based protein. A “moderate” protein diet includes 10-19 percent of calories from protein, and a “low-protein” diet includes less than 10 percent protein.

Even moderate amounts of protein had detrimental effects during middle age, the researchers found. Across all 6,318 adults over the age of 50 in the study, average protein intake was about 16 percent of total daily calories with about two-thirds from animal protein — corresponding to data about national protein consumption. The study sample was representative across ethnicity, education and health background.

People who ate a moderate amount of protein were still three times more likely to die of cancer than those who ate a low-protein diet in middle age, the study shows. Overall, even the small change of decreasing protein intake from moderate levels to low levels reduced likelihood of early death by 21 percent.

For a randomly selected smaller portion of the sample – 2,253 people – levels of the growth hormone IGF-I were recorded directly. The results show that for every 10 ng/ml increase in IGF-I, those on a high-protein diet were 9 percent more likely to die from cancer than those on a low-protein diet, in line with past research associating IGF-I levels to cancer risk.

The researchers also extended their findings about high-protein diets and mortality risk, looking at causality in mice and cellular models. In a study of tumor rates and progression among mice, the researchers show lower cancer incidence and 45 percent smaller average tumor size among mice on a low-protein diet than those on a high-protein diet by the end of the two-month experiment.

“Almost everyone is going to have a cancer cell or pre-cancer cell in them at some point. The question is: Does it progress?” Longo said. “Turns out one of the major factors in determining if it does is is protein intake.”

Morgan Levine, Jorge Suarez and Pinchas Cohen of the USC Davis School of Gerontology were co-authors of the study. The research was funded by the National Institute of Aging of the National Institutes of Health (grants: AG20642, AG025135, AG034906, P30AG017265 and T32AG0037) and a USC Norris Cancer Center pilot grant to Valter Longo.
That chicken wing you’re eating could be as deadly as a cigarette. In a new study that tracked a large sample of adults for nearly two decades, researchers have found that eating a diet rich in animal proteins during middle age makes
Keck Medicine of USC among first in U.S. to offer bronchial thermoplasty for long-lasting control of severe asthma in adults

treatment that provides long-lasting control of this chronic disease.

USC was one of 39 participating sites in a landmark clinical trial of the Alair Bronchial Thermoplasty System that showed a 32 percent reduction in asthma attacks after treatment. Approved by the U.S. Food and Drug Administration (FDA) in 2010, the system is the first medical device that uses radiofrequency energy to treat severe and persistent asthma in select patients ages 18 and older.

“Patients who suffer from persistent, uncontrollable asthma have few treatment options to adequately manage their disease,” said pulmonologist Richard Barbers, M.D., professor of clinical medicine at the Keck School of Medicine of USC and principal investigator of the clinical trial at USC. “There is no cure for the disease, but bronchial thermoplasty has been shown to improve a patient’s quality of life by reducing his or her asthma attacks and asthma-related hospitalizations and emergency room visits.”

The airways of people who have asthma can become swollen and narrowed, making breathing difficult. The Alair system, manufactured by Boston Scientific, uses mild heat to reduce the thickness of smooth muscle in the airways, improving a patient’s ability to breathe. It is a minimally invasive procedure that involves insertion of a small tube into the patient’s lungs via the nose or mouth. To benefit, patients will need to undergo three, hour-long sessions over the course of two months to target different areas in the lungs. Each session is done under moderate sedation, and the patient generally returns home the same day.

In the United States, asthma affects 22 million people, accounting for 2 million emergency room visits, 500,000 hospitalizations and 4,000 deaths every year. According to the Asthma and Allergy Foundation of America (AAFA), managing unstable asthma consumes over $18 billion of healthcare resources each year.

“Asthma is a life-long condition that can dramatically affect a person’s quality of life,” said Scott Evans, Pharm.D., M.H.A., CEO of Keck Hospital of USC and USC Norris Cancer Hospital. “At USC, our doctors and staff are committed to finding innovative ways to restore our patients’ health. Bronchial thermoplasty is one example of that commitment, providing an option for people who have so few available to breathe comfortably.”

Bronchial thermoplasty is designed to reduce the number of severe asthma attacks on a long-term basis. The most common side effect is an expected temporary increase in the frequency and worsening of respiratory-related symptoms during treatment. The system is not recommended for asthma patients with a pacemaker, internal defibrillator or other implantable electronic device. Nor is it recommended for patients with known sensitivities to lidocaine, atropine or benzodiazepines. Patients should be stable and suitable to undergo bronchoscopy.

For more information on bronchial thermoplasty at Keck Medicine of USC, call (800) USC-CARE (800-872-2273) or go to http://www.keckmedicine.org/bt/.

ABOUT KECK MEDICINE OF USC: Keck Medicine of USC is the University of Southern California's medical enterprise, one of only two university-owned academic medical centers in the Los Angeles area. Encompassing academic, research and clinical entities, it consists of the Keck School of Medicine of USC, the region’s first medical school; the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established in the United States; the USC Care Medical Group, the medical faculty practice; the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes outpatient facilities in Beverly Hills, downtown Los Angeles, La Cañada Flintridge, Pasadena, and the USC University Park Campus. USC faculty physicians and Keck School of Medicine departments also have practices throughout Los Angeles and Orange counties. The Keck Medicine of USC world-class medical facilities are staffed by nearly 600 physicians who are faculty at the renowned Keck School of Medicine of USC and part of USC Care Medical Group. They are not only clinicians, but cutting-edge researchers, leading professors and active contributors to national and international professional medical societies and associations.
A new procedure at Keck Medicine of USC may give people with severe, uncontrolled asthma a much-needed breath of life. The medical center is among the first in the United States to offer bronchial thermoplasty, an outpatient
Doctors Issue New Treatment Guidelines for Skin Abscesses Caused by MRSA
Antibiotic-resistant infection is most common cause of skin infections in U.S.

grappling with how to diagnose, treat and prevent this virulent form of staph infection, which is immune to many antibiotics.

As MRSA cases have increased dramatically over the decade, so have the number of skin abscesses — generally pus-filled boils or pimples with discharge  — that characterize these infections.  Now, researchers from UCLA have issued updated guidelines outlining the best ways to treat and manage these abscesses.

The first cases of MRSA were relatively mild and primarily affected high-risk patients in hospitals and long-term care facilities. But beginning in the early 2000s, doctors identified a new, highly contagious  and hard-to-treat strain known as "community-acquired" MRSA, which had spread to the general public. This more virulent form of the infection can be dangerous and in severe cases cause necrotizing pneumonia, fasciitis and sepsis.

One of the first reports that MRSA infections would become epidemic was published in the New England Journal of Medicine in 2006 by Dr. Gregory Moran, Dr. David A. Talan and colleagues at Olive View–UCLA Medical Center. Their research showed that community-associated MRSA had become the most common cause of skin infection among patients presenting at emergency rooms and other settings in the United States. 

In a new report published March 13 in the New England Journal of Medicine, Talan and Dr. Adam J. Singer of the emergency medicine department at Stony Brook University in New York present updated "best practice" guidelines for managing the skin abscesses associated with community-acquired MRSA.

"MRSA is not going away, so we need to fine-tune ways to treat it," said Talan, a professor in the division of infectious diseases and chief of the department of emergency medicine at Olive View–UCLA Medical Center. "We hope the information will help guide doctors as to the best ways to address these infection-related skin abscesses."

For the article, Talan and Singer, both of whom are on the front lines of treating MRSA, focused on abscesses that occur on the trunk of the body and the extremities, like the arms and legs, which are often treated by general practitioners or emergency room physicians. An abscess is a collection of pus that has accumulated within tissue because of the inflammatory process in response to infections like MRSA.

The doctors reviewed prior studies and provided their expert opinions. Highlights of their clinical update include an emphasis on new diagnostic techniques such as ultrasound, guidance for doctors on the most effective antibiotics, and an overview of  abscess-draining techniques that are less invasive, painful and disfiguring than conventional methods.

Diagnosing and treating abscesses

While in most cases MRSA diagnosis and abscess drainage is straightforward, the authors note that technologies like ultrasound can enhance diagnostic accuracy for abscesses located deep in the lower levels of the skin. Ultrasound, which is now available in more emergency departments and hospitals, can also help ensure that an abscess has been adequately drained.

Still, most abscesses can be drained with a single small incision, the authors say. In their paper, they discuss techniques for closing drainage incisions and note that the conventional method of packing a wound with sterile gauze to help absorb excess fluid may not always be necessary.

MRSA and the use of antibiotics

Talan and Singer concur with the Infectious Diseases Society of America that when simply draining an abscess is not enough to address a community-acquired MRSA infection, preferred antibiotics include trimethoprim-sulfamethoxazole, doxycycline, minocylcine and clindamycin.

They note that antibiotic treatment is especially helpful for patients who have risk factors like recurrent infection, extensive or systemic disease, rapid disease progression, a suppressed immune system, or who are either very young or very old

But growing antibiotic resistance may also impact treatment, they warn, noting that MRSA has also become resistant to clindamycin and tetracyclines in some communities. The authors encourage doctors to be aware of local susceptibility patterns.

"Even with optimal treatments, there is still a relatively high failure rate in treating these infections, so good patient education on the signs to watch for and availability of close medical follow-up is always recommended," Talan said.

The update also provides doctors with strategies to prevent new infections in some patients who are burdened with frequent recurrences.

Talan and his team are currently working on a large clinical trial that will further investigate optimal antibiotic treatment for MRSA skin infections.

"If you see a skin infection beginning, you should see your doctor right away so that a little problem does not become a bigger one and more difficult to treat," he said.

Preventing MRSA from spreading

Because MRSA and other types of skin infections can be easily transmitted between people, Talan offers the following prevention guidance:

·     People with skin infections should be careful to keep lesions covered with a dressing or band aid and wash their hands thoroughly after changing the bandage. Place bandages in the trash.

·     Avoid sharing personal items like towels, razors or brushes with people who have an active skin infection.

No outside funding was used for the study.

For more news, visit the UCLA Newsroom and follow us on Twitter.
It has been more than 10 years since the clinical battle began with community-acquired methicillin-resistant Staphylococcus aureus (MRSA), and doctors are still
Stem Cells inside Sutures Could Improve Healing in Achilles Tendon Injuries

Achilles tendon injuries are common for professional, collegiate and recreational athletes. These injuries are often treated surgically to reattach or repair the tendon if it has been torn.  Patients have to keep their legs immobilized for a while after surgery before beginning their rehabilitation. Athletes may return to their activities sooner, but risk rerupturing the tendon if it has not healed completely.

Drs. Lew Schon, Samuel Adams, and Elizabeth Allen and Researchers Margaret Thorpe, Brent Parks, and Gary Aghazarian from MedStar Union Memorial Hospital in Baltimore, Maryland, conducted the study. They compared traditional surgery, surgery with stem cells injected in the injury area, and surgery with special sutures embedded with stem cells in rats. The results showed that the group receiving the stem cell sutures healed better.

“The exciting news from this early work is that the stem cells stayed in the tendon, promoting healing right away, during a time when patients are not able to begin aggressive rehabilitation.  When people can’t fully use their leg, the risk is that atrophy sets in and adhesions can develop which can impact how strong and functional the muscle and tendon are after it is reattached,” said Dr. Schon. “Not only did the stem cells encourage better healing at the cellular level, the tendon strength itself was also stronger four weeks following surgery than in the other groups in our study,” he added.

For further information on how to take care of your feet and ankles, or to find a local orthopaedic foot and ankle surgeon, visit the American Orthopaedic Foot & Ankle Society patient website at www.footcaremd.org.  

“Stem Cell-Bearing Suture Improves Achilles Tendon Healing in a Rat Model” by Samuel B. Adams, Jr, MD; Margaret A. Thorpe, BS; Brent G. Parks, MSc; Gary Aghazarian, BS; Elizabeth Allen, MD; and Lew C. Schon, MD in the March 2014 Foot & Ankle International.  To read the full text of the article, free for a limited time, click here. 

The AOFAS promotes quality, ethical and cost-effective patient care through education, research and training of orthopaedic surgeons and other health care providers.  It creates public awareness for the prevention and treatment of foot and ankle disorders, provides leadership, and serves as a resource for government, industry and the national and international health care community.

Orthopaedic Foot and Ankle Surgeons are medical doctors (MD and DO) who specialize in the diagnosis, care, and treatment of patients with disorders of the musculoskeletal system of the foot and ankle.  This includes the bones, joints, ligaments, muscles, tendons, nerves and skin.  Orthopaedic foot and ankle surgeons use medical, physical, and rehabilitative methods as well as surgery to treat patients of all ages.  They perform reconstructive procedures, treat sports injuries, and manage and treat trauma of the foot and ankle.

Orthopaedic foot and ankle surgeons work with physicians of many other specialties, including internal medicine, pediatrics, vascular surgery, endocrinology, radiology, anesthesiology, and others.  Medical school curriculum and post-graduate training proves the solid clinical background necessary to recognize medical problems, admit patients to a hospital when necessary, and contribute significantly to the coordination of care appropriate to each patient.

SAGE is a leading international publisher of journals, books, and electronic media for academic, educational, and professional markets. Since 1965, SAGE has helped inform and educate a global community of scholars, practitioners, researchers, and students spanning a wide range of subject areas including business, humanities, social sciences, and science, technology, and medicine. An independent company, SAGE has principal offices in Los Angeles, London, New Delhi, Singapore and Washington DC. www.sagepublications.com.
Researchers have found that sutures embedded with stem cells led to quicker and stronger healing of Achilles tendon tears than traditional sutures, according to a new study published in the March 2014 issue of Foot & Ankle International (published by SAGE).
Unique Use of Heart-Lung Machine Saves Heart Attack Victim at UCLA Emergency Room
ECMO is normally reserved for transplant recipients, but quick-thinking hospital staff used it on James Manzi, who looks forward to 80th birthday April 6

stabilize him, including shocking his heart 29 times with a defibrillator in an attempt to restore a normal rhythm.  

Often, patients whose heart attacks are as severe as Manzi's don't survive. Only one out of every 10 people who suffer cardiac arrest outside the hospital lives through the ordeal.     

As the team worked, UCLA emergency medicine physician Dr. Eric Savitsky monitored Manzi's diminishing response to their resuscitative efforts using a combination of bedside ultrasound of the heart and clinical indicators. This led to an emergeny request for a rarely used but potentially lifesaving technology known as extracorporeal membrane oxygenation, or ECMO.    

ECMO involves the use of a sophisticated pump that takes over the functions of the heart and lungs, essentially breathing for the patient by pumping oxygenated blood to vital organs so the lungs can rest. This helps reduce stress on the heart. The device is traditionally used to support adults in cardiac failure waiting for a heart transplant and to help protect the delicate respiratory systems of infants born prematurely.     

Fortunately, it worked in Manzi's case too. His heart stabilized, allowing the cardiac team to transport him to the cardiac catheterization lab, where he underwent coronary angioplasty on an artery that was completely blocked. Following the procedure, doctors placed a stent in the artery to keep it open; blood flow was completely restored.

While Manzi's heart function recovered enough that ECMO was removed three days after his heart attack, he had also suffered anoxic brain injury as a result of his brain not getting enough oxygen during the heart attack — a common occurrence after cardiac arrest. After five weeks in the hospital's intensive care unit, he was transferred to UCLA's neuro-rehabilation unit, where he completed his rehabilitation, making a nearly 100 percent recovery. 

At a recent follow-up visit, UCLA cardiologist Dr. William Suh, who performed the cardiac procedures during Manzi's heart attack, confirmed that the patient is doing remarkably well. Manzi is very grateful to the cardiac and emergency teams that went the extra mile to save his life. He's now looking forward to his 80th birthday on April 6.     

"I've always enjoyed my life and now appreciate it even more," said the father of five, who also has six grandchildren. "Just being alive is wonderful." 

Manzi underwent heart bypass surgery 20 years ago and wore a pacemaker to help keep his heart rhythms normal. He had been virtually symptom-free for years. But on Jan. 3, as he was having dinner with his wife and friends, the heart attack hit. He was rushed to UCLA.   

Only hospitals equipped to treat the most advanced cases have the ability to perform ECMO, since the technology requires a multidisciplinary team of specialized physicians, nurses and perfusionists. 

The minimally invasive procedure works by taking deoxygenated blood from a vein in the groin via a catheter, circulating that blood outside the body by means of a tube that passes through an oxygenator, then returning the newly oxygenated blood to body through another catheter into an artery in the groin.    

"We are so pleased that this rare use of ECMO helped save Mr. Manzi's life," said Savitsky, a professor of emergency medicine at the David Geffen School of Medicine at UCLA and Ronald Reagan UCLA Medical Center. "ECMO may be a viable option in very select heart attack patients who come to emergency rooms that are equipped to provide this therapy."  

Barbara Manzi, who has been married to James for 23 years, said that once the doctors and nurses returned her husband to her, she was never going to let him go. She is very grateful to the UCLA team for saving his life and calls the nurses her "angels in green" — a reference to the color of their scrubs.    

"This is an amazing example of a dedicated UCLA team going above and beyond conventional lifesaving measures," said Suh, an assistant clinical professor of medicine and interventional cardiology with Geffen School of Medicine at UCLA and Ronald Reagan UCLA Medical Center. "We are thrilled that Mr. Manzi is doing well."

James and Barbara first met at a bar mitzvah in Texas. James said that it only took one dance and he was smitten. Just a few days later, he sent her three dozen yellow roses commemorating that first meeting in the Lone Star State, and they have been together ever since.     

The UCLA team hopes to help more patients like Manzi.     

The emergency, cardiology and cardiac surgery departments at Ronald Reagan UCLA Medical Center are developing a protocol for the appropriate use of ECMO for select heart attack patients in the emergency room setting. Hopefully, they say, this can lead to better survival in those patients who arrive at the hospital in cardiac arrest.
James Manzi is lucky to be alive. When the 79-year-old arrived at  Ronald Reagan UCLA Medical Center's emergency room in full cardiac arrest, the medical team tried everything to
Stuart Thompson joins California Medical Association Government Relations team

“I’m thrilled to be a part of the CMA team,” said Thompson. “Lobbying for the House of Medicine is something I’m looking forward to, as changing times in the health care delivery system have never been more exciting than now.”

Prior to practicing law, Thompson attended UC Hastings Law School and worked for the Trust for Public Land and at the San Francisco Sheriff’s Department.

“Stuart is going to be a valuable part of the team here at CMA,” said Senior Vice President Janus Norman. “He will cover a wide range of issues as we move forward this year working to advocate on behalf of physicians and the patients they serve.”

Thompson graduated from Brown University with a degree in political science.
Stuart Thompson, J.D., has joined the California Medical Association (CMA) team as the newest member of CMA's Center for Government Relations. An Associate Director, Thompson comes to CMA from the law firm Miller and Owen, where he has been practicing law for the last year and a half.
Technology and entertainment moguls headline most successful fund-raising event for USC center for cancer research -- $9 million raised in one night

the life-saving cancer research of David B. Agus, M.D., professor of Medicine at the Keck School of Medicine of USC and director of the USC Westside Cancer Center and the USC Center for Applied Molecular Medicine (CAMM).  Larry Ellison, CEO and co-founder of Oracle, was honored as the 2014 “Rebel With A Cause” for his long-standing support of Dr. Agus’ research.  At the end of his acceptance speech, Ellison announced his commitment to match the evening’s fund-raising efforts of $4.5 million for a grand total of $9 million.

“Tonight’s announcement from Larry Ellison was a truly moving moment,” said Carmen A. Puliafito, M.D., M.B.A., dean of the Keck School of Medicine and the man instrumental in bringing Dr. Agus to USC.  “Larry believed in Dr. Agus’ work from the beginning when his foundation announced funding for the initiation of our cancer research at the USC Center for Applied Molecular Medicine,” continued Puliafito.  “The generosity of this evening’s guests – the Hollywood A-listers, entertainment and technology industry executives and business leaders – as well as the visionary champions we have in Larry Ellison and Brad Grey will continue to ensure cancer patients today and in the future have hope for better outcomes and improved survival rates at USC.”

The event was co-hosted by Paramount Pictures chairman and CEO Brad Grey and wife, Cassandra, along with Dean Puliafito who joined co-presenting sponsors for the evening, Lynne and Marc Benioff, founder, chairman and CEO of salesforce.com.  Stage 31 at Paramount studios was turned into an exquisite white ballroom for the evening’s event, which was emceed by late night talk show host Jimmy Kimmel.   David Foster served as musical director for Rebels, kicking the evening off with hip-hop R&B singer-songwriter-producer Pharrell Williams’ rousing performance of his Oscar-nominated tune, “Happy.” Grammy, Tony, and Emmy Award winning superstar Barry Manilow had the crowd on their feet with several of his hit songs, including “I Made It Through the Rain,” “Copacabana,” and ending with the event-relevant, “One Voice,” in a stunning performance with 62 members of the USC Thornton School of Music Choir.

Brad Grey, whose fund-raising efforts over the last two years have helped raise significant dollars for USC’s CAMM, welcomed guests including Sacha Baron Cohen and Isla Fisher, John Stamos, Bob Saget, January Jones, Jerry Bruckheimer and Chris Pine. One of the most poignant moments of the evening took place when actors Jonah Hill and Anna Kendrick read aloud from patient letters depicting personal experiences of the life-changing effects of Dr. Agus’ work.

“I first met David Agus through Sumner Redstone, and as I’ve gotten to know David through the years I’ve become a huge admirer,” said Brad Grey.  “It’s extraordinary work he’s doing. Dr. Agus and his team’s tireless and most innovative efforts towards fighting cancer is what propelled us to support this incredibly worthy cause. Like Dr. Agus and Larry Ellison, Cassandra and I are committed to the profound advancements taking place in the fields of genomics, proteomics and gene sequencing.”

“Both Larry and Brad have been champions for the breakthroughs our research is doing to find better ways to manage cancer patient treatments,” said Dr. David Agus. “Philanthropy is allowing us to think outside of the box – to do things differently to fight cancer, to take the risks needed – to treat the millions of people worldwide impacted by cancer.”

Agus believes each cancer patient needs to be treated according to his/her own molecular make-up – there is no “one size fits all” approach to fighting cancer.

“USC is a leader in bringing together different disciplines in research to find cures and solutions quicker – to benefit patients with cancer,” continued Agus. “Our Center brings together a multi-disciplinary team of cancer biologists, molecular biologists, computer scientists, physicists, engineering experts and mathematicians to push the envelope further. We get to continue the fight because of the overwhelming support of visionaries such as Larry and Brad. Without the generosity of those who attended the event, cancer wins, and we can’t let that happen.”

As one of the world’s richest men, Ellison is also one of the most generous philanthropists. He was honored at the event as one of the original champions of Dr. Agus’ research, having provided the initial funding for CAMM in 2009.  Dr. Agus told the audience it was at a time when funding was scarce for medical research and his years of pursuing better treatments for cancer patients through proteomic technology was at risk. Ellison provided the funding Agus needed to keep going as he found a new home at Keck School of Medicine of USC.

“I first met David in 2006 when my dear relative was diagnosed with cancer and given little hope for survival,” Ellison told the crowd as he took the stage to be honored. “I reached out to Dr. Agus and today that close relative is still alive because of the innovative oncology treatment David provided.” Ellison became a believer and has dedicated significant funding since 2009 to continue the pioneering research Dr. Agus is leading at USC.

The Rebels With A Cause event was part of the Keck Medicine Initiative and the Campaign for the University of Southern California. For more information, please visit: keckmedicineofusc.org.

ABOUT THE USC CENTER FOR APPLIED MOLECULAR MEDICINE (CAMM) The USC Center for Applied Molecular Medicine (CAMM) was founded at the Keck School of Medicine in 2009 by David B. Agus, M.D. to develop new cross-disciplinary approaches to treating and preventing cancer. The Center includes teams members with expertise spanning oncology, cancer biology, biochemistry, molecular biology, bioinformatics, computer science, electrical engineering, bioorganic chemistry, physics and applied mathematics. The CAMM program includes the clinical care of cancer patients at the USC Norris Westside Cancer Center in Beverly Hills. For information, visit: camm.usc.edu.

ABOUT KECK MEDICINE OF USC: Keck Medicine of USC is the University of Southern California's medical enterprise, one of only two university-owned academic medical centers in the Los Angeles area. Encompassing academic, research and clinical entities, it consists of the Keck School of Medicine of USC, the region’s first medical school; the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established in the United States; the USC Care Medical Group, the medical faculty practice; the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes outpatient facilities in Beverly Hills, downtown Los Angeles, La Cañada Flintridge, Pasadena, and the USC University Park Campus. USC faculty physicians and Keck School of Medicine departments also have practices throughout Los Angeles and Orange counties. The Keck Medicine of USC world-class medical facilities are staffed by nearly 600 physicians who are faculty at the renowned Keck School of Medicine of USC and part of USC Care Medical Group. For more information, visit: keckmedicine.org/beyond.
More than 500 luminaries in the entertainment, medical science, technology and business sectors gathered for the second annual Rebels With A Cause event last Thursday night, resulting in millions of dollars in contributions for