35 Burst results for "Ucsf"
Scientific Sense
"ucsf" Discussed on Scientific Sense
"Yesterday's robert lustick. Who is professor. Emeritus professor the university of california san francisco and director of assessment for peden child. Health program at ucsf is mostly in book is metabolic. The lower end license process processed food. Nutrition and modern medicine does thorough. Thanks for having me. Thanks for doing this. I know the name metabolic metabolic goal. Because it's a portmanteau of two words metabolic workings of the body and diabolical the workings of a big big pharma and government metabolical. Yeah that's right. Yeah that makes a lot of sense to me. So i wanted to sort of go into the details of the book but before we do that. Do you want to sort of. Lay out teasers Sort of high-level teasers want you pursuing the book the highest level if you will. I'll do it in an analogy. That i use in the in the book is a wasp wasn't around your attic. What do you do kill. The loss were destroy the wasp's nest in order to solve a problem. You have to upstream of the problem. Working downstream of the problem only fixes the result. It doesn't fix the cause and in medicine in order to fix the problem. You have to fix the cause and meta. Modern medicine has basically forgotten and we have focused solely exclusively over the last fifty years on the result and in the process. We've got fatter. Sicker and poor stupider and healthcare's going to helena handbasket because we haven't fixed the bomb yes so In a two of the book you talk lower sort of pleating symptoms valid than the disease. Itself that ran. I spent some time in the film. So the sweet and i know exactly what you mean. There's a lot of money in treating symptoms and symptoms give view pleating symptoms. Give you sort of immediate education. We can measure began. demonstrate began so some associates say right. But it doesn't really mean basaltic robin as right. Give you a false sense of security. They're actually doing something. So i like the analogy. I use is giving an aspirin to a patient with a brain tumor because they have a headache..
The Doctor's Farmacy with Mark Hyman, M.D.
Is Alzheimers Reversible? With Dr. Dale Bredesen
"Our guest is extraordinary. Dr a friend of mine. A pioneer in the field of neurodegeneration. Who's broken ground. That few have treaded on. And it's none other than dr dale bredesen's who you may remember from our previous podcast where we discussed his book. The ending alzheimer's. His latest book is called the end of alzheimer's program which is much more robust programmatic insight into how to actually use the protocol that he uses with patients that i use and how can kill her to anybody at any age in any part of the journey along protecting your brain or fixing your brain. He's been on the faculty of ucsf ucla university of california san diego. He's directed the program on aging at the burnham institute before we coming to the buck institute in one thousand nine hundred eighty eight as its founding president and ceo and he's currently a professor at ucla chief science officer at apollo health which is a great online platform for addressing nerd. Degeneracy so welcome dale. Thanks so much for having me on mark. I really appreciate it okay. So so. let's get into this. Because in almost people worry about heart disease diabetes But it doesn't take away who you are. Alzheimer's takes away who you are. Not gender disease takes away your soul in a sense Your memory which is really what we're made of is memories and and i think that it's a terrifying disease for so many it's it's growing and scope it's affecting millions and millions of american thinking about five million now projected to be about fourteen million and a few years the caregiver burden is enormous. That goes along with this The costs are even more than taking care of a patient with cancer. Heart disease And this is an epidemic really Globally it's you know literally hundred of millions of people are going to be affected by this.
Scientific Sense
"ucsf" Discussed on Scientific Sense
"So Also if you if you proud tight exacts as and prostitute on the y axis prosperity maybe proxy by the ability to learn that that windows that you talked about do sort of a step function. J.j it sounds to. It's not continuously you hit the you time horizon and you basically so is so it closes that window closes. And then there's other forms of plus city but the way you're learning is totally different under way you were learning at that stage. And i think that can be illustrated. Very clearly of how easy is to teach a kid learn english. I mean you can tell that. I'm a foreigner that i've been speaking is very well because i learned english after my critical period but but for one year. Two years. Old is filtered. Naturally they don't have to suffer through these horrible english english classes. They don't learn the grammar onell. Rules just learn it goes. Their circus are by shirring those neuroscience young on are bringing that information so that everything makes sense those closest so one of the amazing findings of these Studies that we've done in collaboration. That you can reopen this windows blasted with transplantation of these local circuiting euros. You can reopen them so so you you. You mentioned introducing new interneuron into the system That's implied that that is sort of an age for the interneuron themselves that they do e what is fascinating. Is that when you transplant these intermurals and induced a second period of plasticity artificially by transplanted cells the timing of the bureau. Classes that you use is very much associated to the h. Of inter neurons when the those interneuron heat a certain age van they use it plus facility unless they mature on the plus. The city also closes yes so just like a latronic equipment. Just like a computer chip Overtime that some eleven of Electrochemical magnetic process so then some veteran of loss of sensitivity and shows sort of each for the weather. Does it process that. We don't understand older night Doug would be something. I would love to study in the lab. What is controlling timing in sale. We know that there's Clocks that run through the organism minority pretty much in every cell. It must be that some of these a time. Controlling mechanisms are operating within neurons. Are telling them went to certain things on went. Do not still. There's another group that also Creek of purusing harbor and they have found that. Actually some of the mutation seem this clogs actually can also alter the ability of the animal going to this critical periods. these hinch in in in harvard. Who was also a a student here. Ucsf with michael.
Scientific Sense
"ucsf" Discussed on Scientific Sense
"Do we have to do that. There are people that are looking into this For a variety of measures of there do seem to be different Chemicals that are more or less safe so one of the more interesting Drugs that we have. Now it's a drug called buprenorphine. And it acts a receptor. It has some other actions that other receptors. A but it's what's called a partial agonised which turns out to make a safer opioid so for example for any degree of pain relief with buprenorphine. Let's say compared to morphine. It produces less respiratory depression and it's respiratory. Depression is what makes. Opiates like morphine. Like sentinel like oxycodones roxy oxycontin heroin. That's what makes them dangerous. It's the respiratory depression. So it's suggests that there may be a way to develop at new compounds that caused less respiratory depression now in terms of whether there's a difference in how rewarding a drug is brandy degree of pain relief. That's a more difficult challenge. There are drugs. That are not opioids. The most common of course is aspirin. Or ibuprofen right which you know. Some people call advil or you know whatever and they if if you don't have pain they're not rewarding right to nobody takes you aspirin to get high but you could have very bad headache in an aspirin will relieve that headache completely. So under certain circumstances you have these drugs so what that says it is at least in theory. You can dissociate pain. Relief from addiction can be can be addiction as lead to do this prediction. The debris has so so if you sort of do this over time you. Conditioning is the brain predicts and effect. It doesn't quite get it And so he wants more. That is what's going on. It's not really satisfied sex yellow. there's actually there two parts to it and this gets in tim. How do you learn for example to associate things in the environment with either reward or pain right the way the way that happens. Is you do something and if you feel good after you've done it then you're going to do it again if you feel bad after you've done it you're less likely to do it again. So that would be a version right. So we know that if you say inject an opioid it's gonna make you feel good. It's gonna make you wanna do it again right so over time with repeated self administration of a drug you learn you know that you go into the dealer buying the drug getting the hypodermic injecting yourself. Go through all.
Scientific Sense
"ucsf" Discussed on Scientific Sense
"To. What are they gonna clinical research organizations. Cro's right and and that's what they do rate so we have templates and and at this time for trial also quite require more patient so it has an impact on the cost demand. Well i would argue no right. Not necessarily i mean if if you say that what you're doing is reducing the variability and you wouldn't need a big cohort. You could reduce variability with the same number of patience and you could pull your results from the two groups that is true. Yeah and and i said it could also make some trials turn out to be positive. That is marginal today on. It might actually actually show effect and it also it also could be. So here's here's another thing to consider. Is that for those people who are expecting to have a drug effect. Their central nervous systems could be operating differently from those who think that they're getting the placebo right. And if you're saying well i've got a drug. That's acting on the nervous system. The effect of the drug may depend on the state of the nervous system. When the drug enters the brain right so you could say you know in the clinical situation. In general a doctor comes in you know the got great hair or wearing white coats of have a nice voice. You know they're friendly. They've taken their time in to give you a thorough examination. They say he looked in a. Here's this new drug had a lot of good responses to it. I think this is really going to help you. And then you give the drug. And i'm saying that in the clinical situation you're going to have a big drug effect and that's why you need the you know. Show that expectation has this big effect and then the other thing that i always tell all my all my friends who are taking care of paint patients is you need to actually ask. People what they expect is going to happen. You know from your treatment. Right is a lot of times. People will say. Look doc. i've tried everything in. Oh nothing's worked right. They're they're coming to this referral center. And i and i'll say well. Do you think i can help you. They'll say will. I hope so. Now i said do you think can help you said well. I don't think so. And then i wire you hear well 'cause you know my uncle told me i absolutely had to come to ucsf. Ah that that is what i bic. Worry that going back to the clinical trial design. There could be some personality and behaviour vices into a spark. There have to be you know.
Scientific Sense
"ucsf" Discussed on Scientific Sense
"Stimulus let's say a noxious stimulus that would generally provoke the sensation of pain. It's you have to remember that it isn't just a neutral stimulus lake say Seeing an apple or or you know an apple pie. This is a stimulus that carries with it the prediction that if you don't respond to it you're gonna dammit. You're gonna suffer some damage there's gonna be a cost to you thing did is important to remember about painful stimuli in particular. Is there not just about what's happening there prediction about what's gonna happen right. What's happening is you know you're near a red hot. You know iron the prediction is did you You're going to get a burn. You're gonna get tissue damage and it's not gonna be good right so Knowing that you wanna get you wanna escape as quickly as possible. And you activate your motor system in addition a because it's predictive. There's a what we call a top down modular 'tory pathway recall it the pain modulating system and this runs from the cortex through the brain stem back down to the spinal cord and it controls the volume on the pain intensity scale. The point of that in it is that you know. Generally there's gonna be a time course for the pain intensity and this is a really important point seventy to go over slowly if the pain if let's use a temperature because it's the simplest to understand if you put your hand on something. The temperature's rising the predictions can be if you leave your hand there over the next center to get worse so you wanna pull your hand away. But let's say that it's mildly painful but instead of the temperature rising it's falling right at that point. You think oh well. I don't need to worry the temperatures going down so i don't need to respond to it now. We have evidence that this top down system can control sensation. Bi directionally if stimulus intensity is rising. It amplifies the signal so it feels worse at any given temperature than it would if it was a steady state temperature stimulus on the other hand. If the temperatures falling at any given temperature it's felt as less intense than a steady temperature so M we have evidence from a functional imaging and people that this rising this falling temperature engages this top down inhibitory system it can also engage a tap down excited to resist. The top bound system is bidirectional one group of cells. Amplifies the pain. We call those pills. There's another group of cells. In the brain stem that inhibit pain. And we call those off cells. The off cells are activated by analgesic. Medications like morphine can be activated. By dodges opioids call endorphins and they can produce actual.
Scientific Sense
"ucsf" Discussed on Scientific Sense
"To help you survive. You have to have behavioral repertoire that allows you to react in a meaningful way to the particular stimulus. The particular change in your environment and so the system formed as you say For either to counteract threat or against some sort of reward lights correct and it is it is it is sort of instinctual soviet baby touch something heart Been deposed that hand The is the brain doing it. Consciously or something instinctually. Something is a different process on us. I would say that We if it's what we call a reflex a reflex as a motor response that's triggered on by particular sensory input so you don't need to be awake to pull your hand away from the hot save pan. You don't need to be conscious of it. In fact probably most people have had the experience of touching something hot pulling their hand away and then only after they pulled their hanaway. You know feeling the burn. So i think if you have to wait till you actually have the subjective experience to react to it it would be too slow to protect your hand from burn. You have to be able to do it quickly. Intermissions doesn't need the even need to get to your brain just needs to get to your spinal cord. Yes let's announcement at so somebody that call. Mom would do that too. Yes it yes Most people in a coma will respond to pain in a you can be at least slightly anesthetized instill have a pain response when an anesthesiologist is trying to gauge your depth of anesthesia. What they do is they raise the concentration of the anesthetic to the point where you just stop responding to pain. I'm so since a you talked about the circuit that gets information to the brain terrace. I think that is something else that sort of inhibits that. So that's that's a very important point That it's in the paper that we're talking about the motivation decision model so it turns out that the.
Scientific Sense
"ucsf" Discussed on Scientific Sense
"Chemical pulses in the neurons that they use to communicate with other neurons. How does that activity translate into a subjective experience. That's completely mysterious and anti suggestion. Expedience is different for different people. That makes it a more complicated right. I don't know if i agree with that. it's it's hard to know what somebody else's subjective experiences so would re difficult to compare it in different people. That said what i do agree with is if you apply a given painful stimulus to different people they will report. Different levels of pain perhaps different qualities of paint. So it's true that there's a highly variable relationships between the tissue damaging stimulus and what different people report. That's for sure troop. Maybe that's what you were driving. Yeah that's what. I was driving outside a number this longtime ago Slicer company was something medications and obviously one of the difficulties in clinical trials in pain is to get a consistent with sponsors consistent said over sponsors from from the correct and this august measurement problem. That's obvious speed it difficult part right. Well you can you can constrain The situation individuals and they can be trained to give very reliable reports. And if you're using a thermal stimulus so you can accurately control the temperature. There's a fear elite reproducible relationship between the intensity of the stimulus and the numerical rating scale. So that you would use something like a zero to ten scale. Where zero is no pain. Ten is the worst pain you've ever seen. Few wrath forty forty three forty four degrees. Most people say yes. That's moderately painful. I'd give a five as you go up higher and higher however you know in the real world. It's very variable. You never predict what somebody's gonna tell you. say after. They've in like sprained ankle. Or even a broken bone The clinical situation is incredibly variable. So i want to go back to the mechanism And so You hit your leg against something Some sort of tissue damage happens on site and From dat site Information is sent to the frame right that that is the mechanism by which we know something bad as direct and at that point the brains converting that information into some. What exactly happens great. Yeah that's a good question. Well we know we know the physics and chemistry of it. We know how nerve cells work. We even know how they talk to each other right so every nerve cell pretty much is the same in the sense that it has what we call an action potential in action. Potential is a rapid in other words anywhere from.
Scientific Sense
"ucsf" Discussed on Scientific Sense
"Welcome to the site of accents. Podcast where we.
The Blog of Author Tim Ferriss
"ucsf" Discussed on The Blog of Author Tim Ferriss
"More of everything so there may be listeners that have experienced with the perspective that i just shared in terms of the experiential the set and setting. They might have it from personal experience. They might have it as a practitioner or as a scientist from any viewpoint. I wanna hear about it. We want to be informed. And as we talked about tim not just based upon literature but based upon all of this real world data that has accumulated over time and so that that is one need right there. Just educate us. How would you like to hear about. It is hitting you on twitter. Is there an email that is not going to bury you forever. Gazali dot com is a contact site. And that would be a great way. And i'll share with my team and so yeah so we want to be educated and one of my sort of tenants is not to just think that we know everything and and in this case none of us to know one and so the contact information on there and the and the way to offer that perspective to us is open. We probably won't be able to reply to everyone but you'll be heard and and that information will be shared and it could. It could help inspire research and and our own perspectives. So website gazali as e. a. l. e. y. dot com. 'cause the next is is financial support. We have done well. We have over six million dollars in funding. Which is enough to get robin here in supported and to build out i said of studies into higher some great post. Docs bring on some junior faculty. but it doesn't go that far when you're talking about the type of division that i just described to you and and the the research objectives we have so there's lots of opportunity we want to build a new cutting edge facility at noor escape with multiple laboratory so that we can do more research more rapidly and so philanthropic support is always welcome at any level and again you could contact me through their this. Also contact netscape site if if that's more palatable to you whatever whatever way you want to reach out and let us know if you would like to be. Part of the funding of this endeavor would be incredibly appreciated. Do you have a target. Raise amount that you're able to disclose or would you prefer not to have any specific number as a target when i first formulated this and then put the team together and we brainstormed about what we wanted to accomplish over the next five years in terms of building the team in terms of having the research tools that we need in terms of building the facilities because we have space to actually create some new labs very cutting edge. Labs that bring this type of technology but not in an intrusive way to maintain the natural and the warmth that's tricky so this design challenges in order to accomplish that our goal was twenty million dollars. So we we have a ways to go now. Adding ten million dollars right now would allow us to actually build a facility that will unlock a massive amount. So that's sort of what. I've been keeping in my mind when i look towards what i hope that will accomplish over the course of this year. Wonderful and nut to act as the pro bono development officer. Here you have capable folks at ucsf for that. But i will just say for folks who who may be wondering. I have some skin in the game here. I i'm a big believer huge believer in you. Adam and netscape and have been for very long time so i i am also through my foundation. Contributing some capital and then that people can donate appreciated securities. I e stocks and possibly other things. Do you know if ucsf is to receive cryptocurrencies of any type It's a great question. Is a good time to investigate that rate gray question and i will find out later today. Wonderful and i know that you and i have the mutual acquaintance of rick. Dobelin maps has in the past figuring out ways to accept cryptocurrency and in fact some of their largest donations have come from mr apple. Maybe mr pineapple as as he is known through believes bitcoin but through cryptocurrency. So and just a be. Good to investigate. And if you are able to do that or if there's an approach to that we can put in the show notes tha plug slash podcast for people who may be interested. This just in breaking news yes. Ucsf ken now. Accept crypto currencies for noor escape and the work that atom will be doing. I believe this could be a first for a major universities. A very big deal. And i'm supporting his work. If you would like to support his work through crypto currency. You can do that and all you need to do is email neuro scape at ucsf dot edu. That's an e u. r. o. s. c. a. p. e. at ucsf dot edu and they can provide you with instructions for how to do and now back to our conversation adam. I'm excited for you. I'm excited for the future of this field. I'm excited for your team. Excited for robin and the people not yet determined who may contribute or join the team in some fashion and i really appreciate you taking the time to on the phone especially looking like old man. Timea of you've made a big beard right now. Which suits you. i like it. I like it and for those who are wondering about the visual is adam has been. I don't know how long you've been the silver fox and you have since since college. I mean you look like. I mean not exactly but like storm from the x. Men you have perfectly white hair luscious locks white hair and now you have full head coverage with accessible beard. It's a great look alike eggs. Ten thin tim. I just wanted to say before we jump off. Thank you so much for your inspiration and now your support in this your support over the years. I'm not just financially. But in every way you've been you've been aggrieved friend and a great colleague to have on this journey and it's just a buzzing right now at how how much fun i had is going down memory lane and then looking to the future so just i know your your listeners. Already appreciate what you bring. And i have. My own perspective is being a longtime friend. And i just want to thank you for always giving all of my ideas and outlet and your attention and then helping to share it with your listeners. Thank you so much thanks. Adam love you and your family very much. I can't wait to give you a proper hug in meat space. This virtual shit is for the birds. I'm jess we'll. We'll get there eventually and hopefully hopefully in a few months in fact and can't wait until we can actually break bread and have a drink together so thanks again for taking the time and to everybody listening. This is exciting stuff. Check adam out. Gazali dot com as mentioned jay z. A. l. e. y. dot com neuro escape. Which honestly even if you have zero interest in psychedelics. Just for the other work that they've done netscape dot. Ucsf dot edu is wall. We're checking out. It is a glimpse of the future. As far as i'm concerned you can find him on. Twitter at adam gaz jazy which is also the handle on instagram and facebook. We will have shown notes for everything including hopefully an update on whether or not n- and adam. Ken except cryptocurrencies. Because adam.
The Blog of Author Tim Ferriss
"ucsf" Discussed on The Blog of Author Tim Ferriss
"Was always a dream to come out here to california and work at this institution. A lot of people don't know. Ucsf university of california san francisco like they might familiar. Names like stanford harvard mit largely. Because a ucsf is only a medical and health center. We do not have an undergraduate. Campus is not just engineering department. Everything's bio bio engineering biochemistry. But it is one of the world's premier medical centers pretty much across every domain early in neuroscience neurology neurosurgery psychiatry in those areas in the brainers is ucs four tade for many perspectives and so it's always ranked as one of the top in the country and even at world measures when it's put to the test or different evaluations and from my perspective of being a faculty member here for now fifteen years. It's amazing. I mean every every other faculty member i would meet without knowing anything about them. I'm excited because there's something about them why they're here at ucsf. That i just want to find out and then of course from the from just a clinical perspective. I would send anyone in my family without hesitation and it. Yeah it's just a a wonderful wonderful place to be scientists just a quick thanks to one of our sponsors and we'll be right back to the show. This episode is brought to you by wealth front. Did you know if you missed ten of the best performing days after the two thousand eight crisis you would have missed out on fifty percent five zero percent of your returns. Don't miss out on the best days in the market stay. Invested in a long-term automated investment portfolio wealth front pioneered the automated investing movement sometimes referred to as roma advising and the currently oversee twenty billion dollars of assets for their clients while front can help you diversify your portfolio minimize fees and lower. Your taxes takes about three minutes to sign up and then wealth front will build you. A globally diversified portfolio of etf based on your risk appetite and manage it for you at an incredibly low cost while front suffer constantly monitored your portfolio day in and day out. So you don't have to. They look for opportunities to rebalance and tax loss harvest to lower the amount of taxes. You pay on your investment gains. Their newest services called autopilot and it can monitor any checking account for excess cash to move into savings or investment account. They've really thought of a ton they've checked. A lot of smart investing should not feel like a roller coaster. Ride let the professionals do the work for you. Go wealth front. Dot com slash. Tim and opening wealth front investment account. Today and you'll get your first five thousand dollars. Managed for free for life that's wealth front dot com slash him while front will automate your investments for the long term. And you can get started today at wealthed. Front dot com slash. Tim i wanna come back to the risk taking the concept of risk-taking for a second and then we're gonna talk about new chapters. We're gonna talk out new new areas. When i hear you talk about risk taking and translating science into the world for impact it strikes me that on on one level. You could look at some of the projects and things that you've done as risky in the sense that there's a possibility that they do not work there in many senses not incremental here not just adding an extra five percent on top of something that's already been demonstrated at the same time when i look at how well you've been able to recruit and how well you've been able to retain and how effectively you've been able to build and grow. This is leading question. Obviously but would you agree that that ambition and the willingness to take things that one might consider risky on as projects is a critical ingredient. In all of those things. I just. I feel like to to foster an environment where you can do. All of those things where people will put in lots of hours and effort over long sustained period of time like you mentioned the years required for some of these breakthroughs. Did that risk taking us seems to be a critical ingredient. Almost a prerequisite for that type of enthusiasm that's at least my perception. But what are your thoughts agree with you. I think that is. That's part of it. And when you create an entity. I think you know at the time that we last talked. It was my lab. Who's gazali la. That's pretty classic. Way of how labs named after the pi and since then my lab is exploded and now it's not a lab anymore. it's a center where there are multiple faculty. We have not seven faculty members. And i think the reason that that has happened is because of the type of risk taking that i am willing to do but also how we build we. My whole team builds a system of security in that risk-taking because it is a long time to go without a publication. When you start one of these types of studies. I mean it could be five years before you're even writing up a paper and therefore in order to jump off that you know that bridge with your bungee on you haas to have security in the bridge and in the bungee and in the end the instructors and the person that ties it on and so it's a whole community effort to create the platform that allows risk to be taken in an appropriate way right because if we were just reckless. Who would join that. And where would be the means to assemble an all star team of staff and post docs and students and faculty they just. They wouldn't gather so. I agree with you. I think that that's all tied together of what it means to take a risk to do something bold but to do it in a way. That's thoughtful and not reckless and you used the term just for people who may not recognize it you said. Pi that is not magnum pi. Investigators principal investigator. If i'm getting it right targeted correct. Yeah which refers to the the lead researcher for grant project. How many folks do you have within the near-escape endeavor on that team. Netscape's the center We caught narrow escape. And we have over forty people on payroll now and we also work with a lot of contractors and volunteers in that numbers while over sixty. So it's a big group and it's been a quite a change for me as a pi as principal investigator to become a director and to really help other scientists upcoming in their careers to spread their wings and to really take those calculated risks as well under this community of neuro. Skip that we created. It's a wild atom. I just have to say to you. Think back to when we first started spending time together looking at the evolution of the bio reading from august. Just the change since two thousand and fifteen and seeing how much you have done since i took also my first my first step into the world of scientific research from the standpoint of funding with that very first very first check whenever two thousand and twelve two thousand and twelve something along those lines for gazali love and it just makes.
Scientific Sense
"ucsf" Discussed on Scientific Sense
"Out to info. At scientific sense dot com. So you're back scarred. We've been talking about epilepsy. Disease that is reasonably prevalent. Fifty million people around the world suffer from it and your lab at ucsf is taking video interesting approach to it using a mortar from a superfish base moral and doing some genetic manipulation of superfish to to to show a lipsey like Light disease And using actually approved drugs underplay testified can actually sees the The issue and seems like you'd have had some successes in that area. You have another paper that just came out last week. Inca nearer origins in the embryonic Legal gang leoni imminence so before we get into this so you say inter neurons contribute to the complexity of twenty neural circuits and maintenance of normal brain function what what exactly are into neurons so interence are one of two major classes of neurons that we have in our brain Eighty percent of our neurons are considered excited jewelry. Neurons that Have a nerd transmitter called glutamate and they regulate Most of our normal functions and the tuning of these cells and the precise timing of when they fire when they work is controlled by the other twenty percent of neurons or brain called insurance and so basically they make synapses at various points this circuit to control the flow of information To simply and they do this by releasing gabba which is an inhibitory transmitter that hyper polarizing are brings it further away from its firing potential. The interesting thing about insurance even though they only make up twenty percent of the neurons.
Scientific Sense
"ucsf" Discussed on Scientific Sense
"Models that would allow us to do addition rounds of drug therapy or other types of development as well and so each of these represents specific human condition. Some are rare. Some are very rare but the approach can be. Broadly used for at least in the epilepsy field. And we're hoping for other types of genetic disorders that are present in pediatric population. Keeping by larvae are only a few days old and so don't really represent the adult nervous system that well and are more attuned to a developing nervous system but autism spectrum disorder which has an overlap with epilepsy about thirty percent of those single gene. Mutations those patients also have epilepsy. We're hoping to develop. That line of research is well. Of course we have to come up with an essay convinced us the fish were exhibiting some form of autistic behavior. But you can imagine. This is possible for autism. Epilepsy and an epilepsy jeans and a wide variety of genetic diseases that you might see in the pediatric population. So so what do you say this case called. Clearly the superfish model is more predictive Of what could happen. The human convict less mice model as could this be the case for other other diseases. Duke could be receiver fish s a model for other other diseases completely. Different of diseases Yeah to foltz so our mouths to fish comparison So far has focused on driven syndrome. There are mice. There are fish at our conclusion. Like like you stated. Was that if you look at the pharmacology in the drugs at the mouse models predict. They're not very accurate. That is they don't. They don't actually predict drugs. That patients with Interim patients have whereas zebra fish do and so the predictability of fish bottles was a little bit better for that particular readout. We believe that might be the case for a lot of The epilepsy rare epilepsy models. That we have largely because there in many cases there are not that many mice now models and also because to do what we do to fish in a mouse model could take money more years..
Scientific Sense
"ucsf" Discussed on Scientific Sense
"Fenfluramine was actually recently approved as one of the first drugs by the fda for driving syndrome and clemson all the other drugs that we've developed are currently in clinical trials. Could you seem stem is on iran for a long time. Could you just do some sort of a bridging study and now we we were hoping that um and that was kind of the intention when we discovered it but it turned out the company that that manufacturer clemens all in the fifties no longer existent that the fda approval of drugs the nineteen fifties was not as strict as it is now so there wasn't actually a lot of safety data that the fda looks for at and more important that no one in the world has manufacturing clinton's all anymore so we had to actually spin out company Epigenetics therapeutics to kind of address. All those those needs to bring to the market so basically formulate the drug Go to the fda get all the approvals do all the preclinical and clinical safety data and then move forward with clinical trials. yes so Can you go back and and perhaps even improve the molecule eve since you know the mechanism. Now you could. You could presumably getting better a great question. And that's exactly what we set out to do. An paper we published a few years ago in a brain communications. I think or frontiers. I forget what journal. Sorry i'm where we worked with. Medicinal chemists here. Ucsf and we manufactured twenty eight derivatives of clemens all and then rescreen them and we actually developed. Three drugs are out of that called novel. chemical entities that are potentially better than clemens all so though that kind development to just take a side drug development works for a novel camp chemical entity which entity which might be a better drug than the original. Like you said the issue is that it has to go through all the initial screening and and safety steps That that would exist by the fda which which has never undergone some repairs drug has some of that data but for an nc. It's a it's a longer path. So we're in the process of getting that data ready for the fda so we can approach the Them later to clinical trials. But it's it's usually a couple of years behind a repurpose drug and it's fascinating approach. You have another people of which just came out or just coming out here. It's about lipsey superfish project as you say we used for to generate forty single gene mutants superfish lines representing catastrophic time. What i was wondering scott as if this is sort of a a platform technology. Could you develop Thanks for other at these things meeting other seabra fish morals that you could attend along the same rather seen as diseases. Yeah we think so. So the epilepsy refresh project which is about to be published was taking this approach and advances in crisper technology which are which are well known which are very efficient for making single gene mutations and our essays for finding fish that have seizures and doing a large scale. So you're correct took forty known human epilepsy. Jeans made zebra fish line for all forty of those screaming. Larbi screen one hundred larvae per line. with our electrophysiology recording so looking for spontaneous seizures screened over four thousand zebra fish from that and came up with now eight eight or nine new.
Scientific Sense
"ucsf" Discussed on Scientific Sense
"My laboratory was already interested in and these patients at the time we started had no available treatments that were approved for driven and so we developed a zebra fish model that had the same exact genetic mutation and we found using techniques developed over the years to record both behaviors an electrical events in larval zebra fish. That had spontaneous seizure so unprovoked spontaneous seizures otherwise known as defined as epilepsy. Once we had that fish in hand or that model hand and those assets in hand we developed a series of high throughput phenotype base screening essays. So most drug discovery is based on thinking of a rational kind of design. Of what channel or receptor you might want to modify. And we and then trying to modify android that modifies that that kind of channel which took the opposite approach which is called phenotype base creating basically. The animal has a seizure and we wanna find a drug that stops it from seasoning at. It's completely unbiased at an agnostic mechanism and the way it's set up is we're able to then screen commercially available libraries blindly and just look for drugs at work and then once we find those drugs that work we can backtrack and figure out what they are and figure out mechanism from that screening effort. Which now we've done for about six or seven years now and screened over thirty five hundred drugs. We actually found her reap what we call a repurpose drug. So an fda approved drug. That was that was already in the market for some other indication and now worked on in our larval zebra fish model of race syndrome and the drug was called clemens. All clemens. all was a first generation. Antihistamine used the nineteen fifties and then discontinued as other drugs. Drugs became available but it turned out. Clem izzo was a very effective suppressor of spontaneous seizures and are driven remodel. We subsequently got on to find similar. Find out the mechanism of action for clemens. All which turned out had nothing to do with antihistamines but had to do with serotonin receptors and have come up with six more drugs. A few repurposing a few novel compounds that do the same. Thank luckily because we were looking at repurpose drugs. Were able to get compassionate. Use data to similar to this. Eli story in patients with the syndrome who agreed to take one of the drugs. We've found in zebra fish five five children who had driven syndrome and remarkably. They also showed the same suppression of their spontaneous seizures. Then so this is the first of its kind basically aquarium to bedside approach where we we. Didn't we never did an experiment on mice. We'd never did an experiment and human stem cells or anything else. We found the drugs in zebra fish. The drugs are safe because they had already approved them in that we showed that it worked in people with epilepsy. Yeah it sounds like a very interesting approach so is again grip negate issue. More of you can try. But right. you've already approved drugs indications. That if you if you get something then he can go back and look for a loop for the mechanism. It seems like you've found a mechanism right. That's exactly correct. So once we had the drug. We're able to kinda back. You know back engineering. Reverse engineer it and figure out what the drug bound and then screen for more drugs that has similar mechanisms of action and then recheck. What those drugs bound to and narrowed it down to a serotonin to be r- To be receptor Which seemed to be the common mechanism for all the drugs that we found as well as a to an emerging treatment that came out around the same call fenfluramine which we had. We had discovered z. Refresh and independently was commercially being developed. as a serotonin reuptake blocker says increasing serotonin signaling and they all seem to work through a to b receptor..
Scientific Sense
"ucsf" Discussed on Scientific Sense
"My guest conferences scott data ban. Who's proficient share nuclear science loose research. Ucsf one of his frightened eliciting near system causes. Include epilepsy Scott thanks thanks for having me go. Thanks for doing this type of april is. I know that you have done. A lot of work in the This paper persistent seizure control in epileptic mice transplanted with gaba up. Progenitor years You say significant proportion of the more than fifty million people worldwide columnist With lexi author assistant do anti epileptic drugs. Add's as an alternative tweety Therapies facial cell plans for an opportunity for long-lasting modification of circuit fifty million. So is a large number. I was later A incident sweet is that high and so in this paper. So you have a mice experiment in this paper correct So the first part is actually a good point that you raise Many times people don't know epilepsies actually more prevalent than alzheimer's parkinson's other neurologic autism combined. It's one to three percent of the worldwide population of those patients. The unmet need is that thirty to forty percent of them have remained uncontrolled by available medications or surgeries for well over forty years and that's despite the existence of of some very good searchable reception techniques as well as over twenty eight. Fda approved anti epileptic drugs. So one of the things. We've tried to do our research program both with mouse models and also zebra fish models. That we can talk about later is to kind of address that unmet need and one of those week we determined longtime ago. And we're not the only ones who think this are that the inhibitory of of cells inhibitory neurons in our brain which is about twenty to thirty percent of all neurons at an produce. A lot of different kind of modulation of network activity those types of inhibitory neurons which express gabba which was entitled paper primary neurotransmitter. They kind of tamped down on seizure activity naturally and so a lot of epilepsy. cases or conditions. you have dysfunction of those into neurons and so we reason years ago that it made sense if there was a way to put back in those into neurons and they can integrate in the circuit. That that would be therapeutic in a way. That drugs couldn't be by modifying the circuit and so that's the premise of that cell. Therapy approach initiated. Almost fifteen twenty years ago with two of my colleagues here at ucsf robbers. Who's an expert. In kind of neurogenesis and cell transplantation take ten transplantation and john rubinstein. And think you've already met with one of his colleagues word for shell. The two of them are pioneers in identifying where these inhibitory cells come from and so they had come up with a way in late. Nineteen ninety s early. Two thousand to harvest these cells as progenitor cells from embryos sue basically taking embryonic mice or fetal tissue dissecting region called the medial game on eminence which we referred to as mg..
Medical Device Success - Your Success is Our Mission!
"ucsf" Discussed on Medical Device Success - Your Success is Our Mission!
"They were deemed they tech transfer and investors and accelerators and big corporates and really just people Interested in innovation. I had health policy expert in it and Lots of ucsf faculty and faculty from around the world. Frankly from japan from europe. Ben from west virginia and texas in every place so This is some of the feedback. That i got and i don't know. Let me move your little picture there so this is vice chief of emergency medicine at one of our hospitals in. She said the courses inspiring. I've learned so much from the speakers. Fear forums in people's stories. Note that how many degrees she has. She actually has an mba as well as her md ph so someone who's highly educated in fans so much value in different than what she learned. This man is in hong kong. He runs in accelerator. There in said it soon spiring. Thank you for inviting the speakers loved. The classes couldn't come very often because the time zone difference but he watched all the recorded lectures and was a participant that way. This is a entrepreneur and in silicon valley. He was a founder of a company called coded health and said i wish this class have been available before joined a startup so i would have known what to look for and So that was valuable feedback. Then this mirko is a phd candidate from pasteur institute in paris. And he's thinking he's been leave academia and go do something in the commercial world. The course gave me the essentials for my future career outside academia so lots of different people with different interests and some of the reasons people are taking this class of. They knew they wanted to do a startup. Or maybe they thought it would be interesting someday and wanted to learn more about it. Some people had an idea that they were wondering what to do with a startup or license it or sell it or do nothing others wanted to understand our startup scene. Now say not just us but silicon valley to. They wanted a network for entrepreneurship. If you're out there and not in a hub. Like i am not so easy to find people who love the idea of doing startup or currently entrepreneurs some people wanted to access to silicon valley or they wanted to benchmark reviews things here and this gave them that assurance and then just generally tapping into innovation thinking. So you asked who should take this class this. He spent who did take the class so entrepreneurs academics clinicians..
Medical Device Success - Your Success is Our Mission!
"ucsf" Discussed on Medical Device Success - Your Success is Our Mission!
"Stephanie it is really terrific to have you on the program today. Thank you for taking the time. This is a really great addition to what. I am. Calling my in the c. suite series. Because you're dealing with it. Dan and day out with startups. So thanks for being here. Of course it's good to be here with you. Ted so i've got a bunch of questions we're going to ask you today as we talk about. what you do what your role is and the listeners of always already been introduced to you in a in a couple of different ways but you do really have a terrific background and career history Just give us a brief introduction of yourself and the description of what. Your role is at this Ucsf innovation ventures. Sure happy to do that. So probably i should tell people who. Ucsf is in case there listeners. Some viewers who aren't too sure It's the university of california san francisco. So we're one of ten campuses that part of the university of california ar- campuses quite unique because we are only graduate institution and we only deal with science and medicine as so. Do scientific research allow nobel laureates. We have top tier. Us hospitals medical school and really great special teas in great clinicians. And that's my world so So what do i do. We in that world i i. I'm very different on the business person who teaches all these scientists and clinicians have to set up a business around their innovative ideas. So these are people who were on the line at actually doing the work and they come up with ideas for instance on the clinical side. They might see a better way to do a procedure if they only had a certain tula medical device or on the diagnostic side. They might see a better way to diagnose a disease state and then from those ideas some of them a small number but some of them are interested in starting a commercial venture around them and bringing that information in that that idea out eliza product so my world is to try to help people at ucsf and more broadly in the ecosystem that i participated in which is silicon valley Them start new companies that can bring science technology out to the world..
Talking Biotech Podcast
Gene Editing and Recovery from Radiation
"Welcome to the talking biotech podcast. Weekly podcast about agriculture medicine with an emphasis on biotechnology and the good things we can do for people and the planet names kevin volta. I'm a professor and a podcast host. Who cares about science communication mostly around the area of biotechnology. So today we wanted to talk about something interesting. Radiation and radiation has many places in biology. Of course our resistance to it. The problems that can be caused from it as well as its use as a therapeutic agent used to induce genetic variability when we do plant breeding but has some deleterious downsides and they've represented barriers both for remediation of radioactive. Waste as well as if there's issues with the side effects of radiation therapies for cancer. So i was excited to learn about some work. That's happening. The innovative genomics institute out at the university of california berkeley. There's work that's gone. Underway under darpa funding to attempt to use gene editing to solve some of the problems associated with radiation exposure. Mostly in acute radiation sickness. and so. today we're going to talk to dr feodor urnov. He's a professor in molecular and cell biology department at the university of california berkeley as well as the director for translation technology at the innovative genomics institute associated with berkeley. So welcome to the podcast. Dr urnov thank you for having. This is really a pleasure. I was really excited to read about this. Because it seems like such a cool project that's long overdue and i can certainly understand arpaio's interest in this. I tried to frame a little bit of the problem ahead of time. But could you give me a better explanation of. What is the problem with acute radiation sickness. And where do we see it across. The bay from the berkeley campus is one of the best if not the best teaching hospital in america. Ucsf in the chair of radiation oncology. Dr mary fung has told me how frustrating it is to have. Her patients succumb to cancer of the abdomen and of the pelvis. Oh things like pancreatic liver you. Try a variant. Despite the fact that she has a powerful weapon to pure those cure is a big word and the weapon is radiation as you pointed out as all technologies radiation has had a positive side in the negative side the negative side. Of course we think about weapons. We think about radiation disasters such as mobile in in the ussr. Where i went grow was born and raised three mile island Shema but then on the positive side radiation is used to determine how our teeth are doing or our lungs are doing which is particularly timely given. What's happening right now. In our nation and has also a really really powerful medicine to cure cancer. The reason it's not more widely available is what's technically known as dose limiting city and in english. That means you cannot give enough of the cure before it side effects overpower its benefits. So in dr funk's practice the physician. So i'm regurgitating. What i learned from her and other had the honor to collaborate with. She has a patient with a with a major cancer of the abdomen. Or or the pelvic area she can irradiate the tumor and eradicated. The patients do not recover because tissues that are inevitably also effective so the gut and the bone. Marrow where are aquatic stem cells live are irreversibly damaged by the radiation itself. So the patients Die off either lethal diarrhea which cannot be stopped using anything
Tom Sullivan
UCSF scientists develop nasal spray to fight COVID-19
"At the University of California, San Francisco, say they've come up with a nasal spray to combat Corona virus. While not a cure. The spray is an antiviral that would help Ward off Cove in 19 UCSF researchers are now working with the business community to try to bring the nasal spray to stores at an affordable price.
The Afternoon News with Kitty O'Neal
Los Angeles - UC Davis Medical Center ninth on U.S. News’ best California hospitals list
"Well these northern Californians and have a lot to worry about these days when it comes to public health, but we can rest easy now. One of our local hospitals is one of the best in this state, according to the U. S News. Best hospital rating rankings. U. C. Davis Medical Center is ranked number one in Sacramento and number nine in all of this state. Other newer Cal hospitals ranked high on the national list, with UCSF Medical Center, coming in eighth overall.
The 3:59
How NBA players are using the Oura smart ring to warn of coronavirus
"What exactly does the Smart Ring Do, and and let's start with what its original purpose is, and what it was marketed for initially sure, so the has been around for two years and never got to review. It was one of these things I meant to, but it is a it is. A fitness rang health ring much. Much like the ring made by motive years ago, it checks heart rate it contract sleep it contract motion and activity, but it also tracks temperature. The temperature sensor is the interesting part because there aren't any other wearables that do that, but it's not necessarily the temperature sensing. You think it can't give you like an actual body. Reading of like you know what hundred point seven or whatever? It's a relative temperature that's. Night to show temperature fluctuations plus or minus degrees Fahrenheit. That's mentioned. Just show your changes in your baseline, so to speak, and so how is it being used as a early warning system for covid nineteen? Now been working with a couple of research teams UCSF has a study that you can opt into in the APP. That's been going on for a while. That's asking people to log You know their own moods and symptoms to try to study correlations. That's similar to what other companies are doing trying to see. If there could a way could help connect to symptoms and krona virus, but those researchers are seeing that you can with with the temperature capabilities see signs of illness symptoms a couple of days in advance of when you would normally perceive them. That could line up with the couple of day. Lead time that people believe might might be you know a symptomatic spread period now I'm not a another doctor. My research scientist from talking to researchers working with this and I've been I've been really curious about what that could actually mean. Another research team at Rockford Neuroscience Institute West Virginia University. Has Been Looking at trying to create a health forecasting APP that they have in place that they're using with with frontline workers and seeing if you could provide you know a couple of day pre forecast of whether you're likely to be getting sick. And built on a similar idea of using temperature mainly as a way to pick up ways that you're you're readings are hinting towards the sign of sickness, but not necessarily a sign of coronavirus, just a sign of sickness general from what they perceive. They claim it's like eighty nine percent. Accurate in predicting so far signs of upcoming sickness that will be when you get a coronavirus. You know that's when you get tested. That's when you would maybe. Go into work in some future world where we go back to work, and you know the reason why folks might be more familiar, we're now is because NBA players are supposed to be wearing them as they. Get set to kick off their their special. BUBBLE SEASON DOWN IN FLORIDA. Yes so NBA players have been wearing this of chosen this this wearable. OPT in program and. Coaches that that can look at the stats get kind of a distilled subset of the stats that aware of the ring, now like the consumer version would get so I see all these different pieces of information. There is a respiration. There's heart rate variability temperature these are estimated again. A couple of those key factors of four of them were pulled out and turn into a risk score. That idea is that if you seem like you're, you're scoring significantly high on that, you would Pull yourself out. Get Kobe test, and that type of thing. But you. You get something like that on the on the order APP itself. There's a score, the kind of shows like a whole bunch of factors and talks about like you know Harry feeling today. It sometimes it correlates with our. I feel sometimes a dozen so. Same thing asleep scores but it will let me remind me of like how I'm sleeping. And how much I'm you know? Both bedtime in some element of restiveness, how much I can do about that is is the other thing, but that the NBA is using again is kind of a pre screening tool for those who were bubbling Brian. So you're obviously not an NBA player, Sarah Scott, but how how are you using this? And how does that differ from what they're using this for? As as Early Warning System, yeah, so again as curious and I've not been doing any of those those things and I'm not using any advance APPS. I'm just using the consumer version and seeing what it's like so I just live with it. I've been wearing three months since late April. All the time and what have been noticing is that a lot of ways I don't notice anything because I. Just live my life, and then I check the APP in Awhile, and it says okay. This is sleeping and I tried to make myself sleep better, but like a lot of sleep tracking things. I don't act on those things as well. They should still go to bed super late, even knowing do. But the temperature thing is mostly been fluctuating around the same thing, a little down a little, if I who knows I, haven't knock on wood. I haven't gotten sick over this period. If I had actually gotten sick or perceived something that might be kind of interesting so hard to tell in that vacuum, but. I just wear. It will give some testing with it and I'm curious. I don't think it's it wouldn't replace a fitness watch because it's not as detailed as that and the one thing that the ring is, it's totally invisible with how it shows stuff. It's this nettle ring with no readouts doesn't buzz no buttons and you'd have to check the APP and also if you don't know if it's running out of batteries on the seven day battery life. Until you check the APP where you get a notification from your phone, so there's times where just went dead, and then I had like five days of no readings because I forgot to charge it, which is not ideal if you want a wearable, that's going to help provide early detection for people in a future workplace so that that's one challenge with it. The other thing is talking to the researchers and thinking about what would we all be doing with this? The NBA is bubbling now in a world where you go back to work and have some sort of you know wearable screening tool, which is what people are imagining. Its Eye, contact tracing unit everyone to opt in. And that means rock varner sciences. He was also trying to build towards. Maybe eventually a ways like at that would show ideally like where signs of potential illness popping up through crowdsourcing, but much contact tracing that requires people to participate and right now you still have questions. People are still refusing to wear masks so I mean. The. The degree to which you get people to all agree to wear wearable. Seems extremely optimistic and then when you deal with things like public. It adds all sorts of other complications so an office. Could all agree to do it? But how do you? What do you do in the larger world? I think those are questions. It still hadn't been worked out because the systems are only as good as everyone else's reporting, and just to be clear that this is not a cheap option. This is not cheap solution. Right? Like how much does this thing go for? And how easy is it the by one? The pretty easy to buy, and they're not that cheap there four hundred dollars so. Yeah the falls line with with. Your standard good smartwatch or Apple Watch or thing like that, but you know it's made like titanium plastic on the interior and It's it feels nice, but that's a lot of money, and I think some people will really like it because it's convenient. Enter praying and not a watch Some of the researchers also pointed out that a doctor's and frontline workers don't like wearing rings because they're not good that the germs could get in there. LEXIE! Shoes she's wearing. It didn't like it because of swelling and for exercise, the ring didn't feel ideal was uncomfortable for her and you have to get fitted. You have to get a particular size on the ring. They send you a sizing kit, so if your size changes, that's not great. A watch is adjustable, so there's a lot of things that are weird about it, but I think. It opens interesting questions about what temperature could possibly do. On, wearables in I'm really curious, what will pops up after this? It seemed like from your experience that made you call it somewhat invisible and the data I mean how ultimately how useful is this data? Have you used it to change your life for because you sort of hinted that that you looked at the data? then. It hasn't really changed anything, but like ultimately is this useful? In terms of changing my life. No, because you're right. You know this reminds me of like the talk. I had with with Kevin Lynch on Apple. Watch and apple could be making a lot of decisions on this to why they're only doing. Certain elements of sleep tracking. You know they're just doing the bedtime. Wake up is they claim that the rest is not actionable? Now they call so it could be that apple isn't fully develop the rest of the tools to their liking. But I think that's true in terms of when you get sleep scores like on this. What do I really do with like that? I didn't rest well enough you. There's really not much you can. Do you try to get to bed earlier? Maybe try to take it easy. Me could try to like take on yourself, and that's what the APP recommends like. You know you're reading the scores. Great. Go do it today, or it's not great. Take care a little bit today and I think that's interesting. So in that sense did change the way I would perceive some days I go. Hey, I'm not a great readiness score. just be a little easy on myself. What I know that just waking up and just feeling like crap. Probably you know I think some of these things correlate with how you would normally feel. Feel anyhow, if you're a self aware, but I think the getting back to work thing, the bigger question which is like you know I hate to even leave with that in the story, but it's what people think about about the possible Kobe awareness. I can't yeah for me I'm I you know I? Pi- blood pressure. I'm not going to put myself at risk going out. Out in the world, even if there's a sliver of it and then if I don't know that the APP, the rest of the world is behaving in a responsible way. Then I don't want to put myself there and that doesn't have to do other a wearing ring. It's like so the hard part. There was a halo over everyone's head. That said you know yes I. I am using the device I. Am I am part of your network? Then that's bubbling I. think that would be. That might be a different story, but again. None of these data things that these research programmes are absolute yet. These are all experiments, and all the researchers things a tip of the iceberg, so look how long people have been researching sleep and possible signs of. OF APNEA. or All. These research programmes with wearables they can go on for years and the NBA is very much an experiment. We don't know at all how that's going to turn out
This Week in Machine Learning & AI
A Critical Inflection Point for Responsible AI
"Remond, welcome to the twin Wa podcast. Thank you for having me Sam, then a few years in the making and I'm glad we're able to do this. You know what it only takes a global pandemic to make this conversation happen. These are the best conversations I think when I'm finally able to connect with with friends and you know folks I know from industry, and you and I in particular I. Think I've been trying to make this conversation happen for as you said a few years and it's always. I'm going to be in Asia. I'm not in the bay area and. been able to to make it happen so super, super, super excited. Get this going. Let's start out as we usually do here on the show and have you share a little bit about your background? You work in ethical and responsible How did you come into into that field? In the answer, that is a lot of meandering. By background data scientists in a social scientist. I would officially say me Quantitative Social Scientists I have degrees in political science management economics. Bastions quantitative methods one degree or like five or six. I know folks like you. But I moved to Silicon Valley in twenty thirteen to receive a job in this weird little fields called details, science which I had heard about anecdotally while Mike Kishi procurement ucse everybody's crazy. Nobody understood while leaving a political science teach de Haram to do some weird tech job on Humira seventy years later. with Dina Science in anything related to data signs in. Being the only thing people talk about so after my stint as a data scientist action, teaching data science at bootcamp, cold medicine, and that's when. I was doing talks on polling, the elections and in the sense of how numbers and statistics can be misleading, because I woke background and things design only and quantity of human behavior analysis and you know extension was three years ago. Looking for someone to lead this weird thing is sponsored. And that's how that's how! That's how I got this job. And so you've been at accenture. How long now three years actually hit the three year mark in early, February wow nice, nice, which sponsor air world makes the ancient. Absolutely. And you're based in San Francisco. How have things been going for you with? Shelter in place and covert, and all that kind of stuff, yeah I mean fortunately San Francisco had a really good response and people stayed at home than they more or less have been listening. I think everyone just getting antsy, so I see more and more people although people whistle being careful. Fortunately, it's been pretty quiet. Ellen Mission Bay, which is near the UCSF hospitals. and. It hasn't been that bad I fortunately. I live in a really walkable neighborhood is parks here by CETERA, so it hasn't been over the fuzzy I just think this is also the shortest as I've a longest amount of time. I have ever spent not flying somewhere in the last few years, so it's been nice yeah. I've commented to to fight back just earlier today. Like by this time a normal year I'd have been probably to half a dozen at least conference. Is You know not? That's not a dozen. It's probably would have been around the world a couple times, but I mean it's funny because I have all these place holders on my calendar when by one they all truck, but you know. By now I would have been in London what Vice. India and the Nordic sexually this supposed to be doing it for different Nordic countries to visit different accenture offices, client partners, and then in a month those supposed to be in Atlanta. still have this thing in Singapore. That apparently is still on the calendar for August, but I think they're being ambitious at this point. But you know. It's nice to be home. It's nice to be around by my pets. Organize my apartment Buehler's things that come to do.
Environment: NPR
'Why We Swim' Looks For Answers In People And Places Across The Globe
"And humans came from. Dust says ECCLESIASTES DIS but Bonnie Sui us that humankind also wants sprang from end still seeks. Water why we swim is her latest book which Texas from Ponds Pools to surfers racers and a few who have survived icy currents Bonnie Soy who writes frequently for the New York Times in California Sunday magazine. Join just for more home in Berkeley California. Thanks so much for being with us. Thanks so much for having me Scott. You begin with an amazing story about a man whose name I will not chance to even try and say March Eleven nineteen eighty-four what happened on this planet. Good Liquor Thorson. He's an Icelandic fishermen and fishing trawler with his crew. It's calm waters it's cold it's forty one degrees and the boat overturns with forty one degree water within twenty to thirty minutes we die from hypothermia but he did not everyone else did and he ended up swimming six hours and when he finally got to the hospital the doctors weren't able to discern his heartbeat or read his temperature on the thermometer but he didn't show any signs of hypothermia and he was only a little bit dehydrated. He was a strong swimmer certainly but was he also saved by his own biology. He was like the story very much. Because it is this the distillation of what makes swimming so special for humans. We have to learn how to swim. we're not born knowing how to do it instinctively and yet there are sort of traces of that evolutionary past still within us that our evolutionary past that came from the sea and so with good liquor for. Thorson turns out that his body fat was two to three times normal human thickness and more solid and so he resembled a Marine Mammal. More than terrestrial mammal. And that saved him. Did you grow up feeling? Pull into the even. If it was only Jones Beach in New York I did. I mean my family origin story is at my parents met no swimming pool in Hong Kong. We grew up with swimming family and so we grew up at Jones beach in the pool. Lifeguards swim team. I just always remember feeling more comfortable and happy in the water actually than on land. I mean there's just a sense of magic that you get from being in the water and buoyancy that you just don't have on land you in this book talk to swimmers all over the world right nearby you though you you swim San Francisco Bay without a wet suit and there are people including I gather you who believe that's actually good for you in all ways it can be. I mean I have also talked to scientists and researchers who say cardiovascular risk. Don't go into sudden shock cold water because it could stop your heart that aside a wr decided there are benefits to cold water immersion. And there's been quite a bit of research in recent years where your dopamine levels go up in your over time that your cardiovascular system is strengthened and you know there are people there are things that we knew from across cultures around the world that there was a water cure there. Was you know jumping in cold? Water was good for you and jumping in hot water and then jumping into cold water and so we didn't know why exactly in the science kinda starting to catch up. What is this Brown fat you talk about in this book. Well this was really interesting. I did not know about Brown fat until I started swimming with a Dolphin Club swimmers in San Francisco Bay and so I went to ucsf to talk to the foremost researchers in Brown fat and it turns out that mammals are born with two kinds of white fat which we all know about the energy stores of our bodies and Brown fat which actually Burns and produces heat energy. We kind of start to lose it as we get older but there are ways to do what's called the Browning of white fat which is to kind of turn it into energy burning tissue. That fat is called Beige Fat. And so what? Kind of encourages. The development of beige fat is cold water exposure and exercise among other things. But those have been proven to be causing this change in our bodies. Wonder if you have any words for people who aren't able to swim these days you know. The water is a draw for us no matter what and so even if you can't get in the water if you can walk near it can look at. It can see it can You know have some what a wall Nichols calls domestic waters in your house and you know. Take about the shower. Just look at imagery watches surf movie. I mean those things. Make a difference for our souls and our the way our bodies and brains work. Click we respond to those set points in the environment and even if we can't get in the waters right now you know the ocean will be waiting for us. The pools we waiting for us on the other side of this Bonnie Choi. Her book why we swim she in the Water
Pacifica Evening News
San Francisco ramping up effort to track every COVID-19 case and contact
"San Francisco city officials are taking measures to repair this city for a win coronavirus restrictions are lifted including a new program for testing and contact tracking but the city is also facing criticism for their handling of the homeless population during the crisis K. because the woman is reports city officials in the new program for contact tracing will identify people who might have come into contact with an infected person the program is a partnership between the department of public health UCSF and the software company DiMaggio director of the department of public health grant Colfax is this program will be essential when the ultimately left the shelter in place orders and moved to a new phase of fighting the pandemic San Francisco's innovative new program will engage with individuals who test positive for covered nineteen to identify their recent close contacts specially trained outreach workers will then follow up remotely by phone or text with any individuals who may have been in contact with the covert positive patient these conversations will be voluntary confidential and culturally and linguistically appropriate city officials also gave an update on plans for housing vulnerable homeless people in hotel rooms the city is focusing on those who are coping nineteen positive or under investigation for having the virus those over sixty and we have underlying health conditions they now have placed a hundred and seventy four individuals in hotel rooms for homeless individuals that don't belong in these categories they plan to continue to reinforce social distancing and hygiene protocols in homeless shelters but San Francisco supervisors disagree with the city's response the unanimously approved an ordinance on Tuesday directing the mayor to procure eight thousand two hundred and fifty hotel rooms for homeless people and first responders night April twenty sixth the move follows a corona virus outbreak at a shelter the infected ninety two homeless people intend shelter staff in what's being called the largest homeless corona virus outbreak in the country supervisors say they've been warning for weeks that shelters would be a breeding ground for cove in nineteen and the mayor's office was moving too slowly making an outbreak unavoidable your supervisor Hillary Ronen saving lives matters more we can rebuild our economy over time but stating lives means more we have simply not done that pretty and house population we have not gone all out we have not used those rooms than there has not used her power to commandeer which is now a public memo from the city attorney's office giving her that power we have not needed a fiscal priority that we want to save those lives just as much as we want to save our own and it's time to make that clear statement not with the resolution like we did last week but with the binding law Maryland every double down her response arguing it is not that easy to put that many homeless individuals and hotel rooms giving that many deal with mental illness and substance issues and needs for cevik resources it's not easy and if it were that easy we would have done it a long time ago and other major cities in this country would have done the same thing we are we have moved faster and further along than almost any other major city in the country as a relates to housing are on house population over seven hundred people have been house out of our shelters and counting so I'm really proud of the work that they continue to do what I like to do more yes I'd like to do more what I like to open up eight thousand nine thousand ten thousand hotel rooms of course who wouldn't but that is not the reality of what we as a city can do the mayor's administration have been working to obtain a total of seven thousand hotel rooms the ordinance ups the ante it says seven thousand rooms should be allocated for homeless people five hundred rooms for discharged hospital patients who have no place else to quarantine and seven hundred and fifty for frontline workers who can't commute large distances or who fear infecting their
On The Media
Calling Trump: When connections help steer virus supplies
"President trump who's told states to fend for themselves has had female blocking orders for vital equipment secured by governors some of them anyway so the government can buy them instead this week FEMA see is that in order for five hundred ventilators from a private company obtained by democratic Colorado governor Jared Paul is only to have trump give back a hundred of them at what he called the request of the state's endangered Republican senator Cory Gardner Thursday's Denver post editorial declared trump is playing a disgusting political game with our lives but the trump administration says it's got a plan and that it's working White House adviser Peter Navarro April second these guys up here doing a heck of a job organizing the supply chain well I think that's news to a lot of medical providers no I'm levy is a national health care reporter for the LA times trying to follow the cultic nineteen supply chain I can't say I've talked to many hospitals or doctors offices or clinics around the country who feel that the supply chain is being managed in anything close to a rational way that's for sure and we can't seem to get answers from FEMA or the White House about what system if any is being used to balance the needs a couple weeks ago I was speaking with the head of the Texas academy of family physicians who working with the golfing buddy of his managed to in about a half million masks over the border from Mexico and then spent about seventy two hours getting them to rural hospitals and doctors offices around Texas because the state of Texas didn't have anything to distribute so you've got the system in which everybody's running around trying to get masks and ventilators and everything else and then on top of that is a totally opaque system of what appears to be haphazard intervention by the federal government on some supplies but not all of them everyone is completely perplexed we hear that trump is having no problem directing to Florida whatever Florida seems to need so zero which is the agency that is allegedly responsible for distributing supplies from the strategic national stockpile has claimed that they have some formula for distributing medical supplies that reflects states in large metro areas relative populations and the relative severity of corona virus outbreaks they are actually shipping things across the country however it's impossible to find out what that formula is whether or not allowances are being made in one way or another four criteria that have not been identified president trump hasn't been shy about claiming that he's willing to reward its friends and punish his enemies the conspiracy minded person might think well is there some nefarious methods to how these supplies are getting distributed or not we just don't know what difference does it really make if we know or we don't know what the formula is for distributing this stuff this is taxpayer money that we're talking about private actors in the market of course don't have an obligation to be transparent about what they're doing because there's no expectation under normal circumstances that they're acting in the public interest we hope that the government is acting in the public interest but without transparency who knows who's accountable for this who's in charge is it rear admiral John Paul love check who's at the head of FEMA's coronavirus supply chain task force is it FEMA director Peter Gaynor is it Peter Navarro who is reportedly coordinating private and public sector communication maybe it's the Jared Kushner or the invisible hand isn't really fundamentally the president and no one else you know without clear lines of authority things are not getting done as far as we know in a particularly efficient way nor do we know that however they're being done is being done in a lawful way frankly if for example the president's son in law is dialing up private companies and asking them to give support in one way or another to the supply chain challenges what assurances are being made to those companies about what they can expect I'm talking about promises that are made the company acts that if they help out that they'll be made whole in the end with they'll be reimbursed at a certain level without a process all of that is open to question is there a way to have an informed data driven approach to this as Jared Kushner said the federal government was engaged in if in fact the federal government isn't engaged in an informed data driven approach can big business small business health officials state officials do this on their own so the facts on the ground suggests that this can't happen on its own no that's not to say that there aren't a lot of efforts by individual actors some of them quite influential to play a constructive role I mean we've seen a number of large companies including apple for example say we are going to use our connections to the supply chain to procurer masks and we're going to distribute them the owner of the New England Patriots flew the patriots plane to China to go pick up a shipment of masks and flew back to Boston the problem is when you have this sort of thousand points of light approach to procuring and distributing needed supplies what ends up happening is that well connected medical centers that have relationships with large companies either because they do business with them or because they're located in their backyards are often times at the top of the list so for example sales force made a donation to the university California San Francisco Medical Center because they have a long standing relationship both being based in San Francisco does UCSF knew that equipment more than a hospital in New York City or New Jersey that's a lot to ask of sales force to try to make that determination they don't have any expertise in
On the Media
Calling Trump: When connections help steer virus supplies
"President trump who's told states to fend for themselves has had female blocking orders for vital equipment secured by governors some of them anyway so the government can buy them instead this week FEMA see is that in order for five hundred ventilators from a private company obtained by democratic Colorado governor Jared Paul is only to have trump give back a hundred of them at what he called the request of the state's endangered Republican senator Cory Gardner Thursday's Denver post editorial declared trump is playing a disgusting political game with our lives but the trump administration says it's got a plan and that it's working White House adviser Peter Navarro April second these guys up here doing a heck of a job organizing the supply chain well I think that's news to a lot of medical providers no I'm levy is a national health care reporter for the LA times trying to follow the cold pick nineteen supply chain I can't say I've talked to many hospitals or doctors offices or clinics around the country who feel that the supply chain is being managed in anything close to a rational way that's for sure and we can't seem to get answers from FEMA or the White House about what system if any is being used to balance the needs a couple weeks ago I was speaking with the head of the Texas academy of family physicians who working with the golfing buddy of his managed to in about a half million masks over the border from Mexico and then spent about seventy two hours getting them to rural hospitals and doctors offices around Texas because the state of Texas didn't have anything to distribute so you've got the system in which everybody's running around trying to get masks and ventilators and everything else and then on top of that is a totally opaque system of what appears to be haphazard intervention by the federal government on some supplies but not all of them everyone is completely perplexed we hear that trump is having no problem directing to Florida whatever Florida seems to need so zero which is the agency that is allegedly responsible for distributing supplies from the strategic national stockpile has claimed that they have some formula for distributing medical supplies that reflects states in large metro areas relative populations and the relative severity of corona virus outbreaks they are actually shipping things across the country however it's impossible to find out what that formula is whether or not allowances are being made in one way or another four criteria that have not been identified president trump hasn't been shy about claiming that he's willing to reward its friends and punish his enemies the conspiracy minded person might think well is there some nefarious method to how these supplies are getting distributed or not we just don't know what difference does it really make if we know or we don't know what the formula is for distributing this stuff this is taxpayer money that we're talking about private actors in the market of course don't have an obligation to be transparent about what they're doing because there's no expectation under normal circumstances that they're acting in the public interest we hope that the government is acting in the public interest but without transparency who knows who's accountable for this who's in charge is it rear admiral John Paul love check who's at the head of FEMA's coronavirus supply chain task force is it FEMA director Peter Gaynor is it Peter Navarro who is reportedly coordinating private and public sector communication maybe it's the Jared Kushner or the invisible hand is it really fundamentally the president and no one else you know without clear lines of authority things are not getting done as far as we know in a particularly efficient way nor do we know that however they're being done is being done in a lawful way frankly if for example the president's son in law is dialing up private companies and asking them to give support in one way or another to the supply chain challenges what assurances are being made to those companies about what they can expect I'm talking about promises that are made the company acts that if they help out that they'll be made whole in the end with they'll be reimbursed at a certain level without a process all of that is open to question is there a way to have an informed data driven approach to this as Jared Kushner said the federal government was engaged in if in fact the federal government isn't engaged in an informed data driven approach can big business small business health officials state officials do this on their own so the facts on the ground suggests that this can't happen on its own no that's not to say that there aren't a lot of efforts by individual actors some of them quite influential to play a constructive role I mean we've seen a number of large companies including apple for example say we are going to use our connections to the supply chain to procurer masks and we're going to distribute them the owner of the New England Patriots flew the patriots plane to China to go pick up a shipment of masks and flew back to Boston the problem is when you have this sort of thousand points of light approach to procuring and distributing needed supplies what ends up happening is that well connected medical centers that have relationships with large companies either because they do business with them or because they're located in their backyards are often times at the top of the list so for example sales force made a donation to the university California San Francisco Medical Center because they have a long standing relationship both being based in San Francisco does UCSF knew that equipment more than a hospital in New York City or New Jersey that's a lot to ask of sales force to try to make that determination they don't have any expertise in
Real Talk with Dana | Nutrition, Health
Codependency and the Nervous System, and Managing Stress in a Pandemic with Victoria Albina
"Love to get started by talking about your story. So you talk about how you coach. Women raised by people who are codependent or alcoholic or both to stop being anxious exhausted and overwhelmed so you can cultivate better relationships with yourselves with other people and then also you have this other like cool section of your work. Were this intersection of like you. Also help people here. They're adrenals and justify issues with functional medicine. So how did you get to that place? Yeah so my story starts like so many of the stories of the folks who do the work. We do With a lot of sickness so I grew up with wake. Bowel Syndrome heartburn. So bad I couldn't sleep lying down for years and I really. I was very very sick. All of that led to my adrenals. Doing what adrenals should do when you're so sick which is just kind of giving up the ghost a little bit you know and it was really really really challenging to find help. I went to a hundred thousand different. Doctors had every test imaginable including like swallowing radioactive liquids. And getting all these extra. It was bananas and the Best Advice I ever got was good luck right like pretty much. There's nothing we can do for you in Western medicine and you're on your own Kitto and that didn't Jive for my super science-based nerdy self right. I knew that another way was possible and I realized I had to find it on my own so I started started studying herbs. I started studying supplements holistic medicine. Public Health I eventually went to. Ucsf the University of California San Francisco and became a nurse Practitioner I really wanted to understand the science behind it all and why couldn't stop having these terrible symptoms and through that work. I started practicing medicine. I worked in primary care for years and I realized that again the drug based one pill one ill western system couldn't help with the deeper underlying stuff and so my science brain said well more advanced. Testing is the way to go so. I trained in that I stayed with Chris Presser. I learned how to do all the advanced functional medicine route. 'cause work all of that helped me and helped my patients to heal things like small intestine. Bacterial overgrowth CBO library. Which is the same thing in the large intestine and I would get better and it symptoms would relapse and then I'd get better and I'd take a fistful more supplements and symptoms would relapse and what I came to understand. Over the last decade was that while the physiology is incredibly important. Right I had parasites. I beg overgrowth. They needed to be dealt with appropriately. Murdered I couldn't get back into real health really feeling well until I learned to attend my nervous system. Because the autonomic nervous system is the thing that rules Gosh everything are digestion are thyroid. Our Dreams are hormone balance and by not looking at my trauma my own co-dependency my own struggles with self doubt perfectionism et CETERA. I was in fact keeping myself ill without realizing it right because I was stuck in all these coping strategies which were gifts when I was a kid but as an adult no longer served me so I recognize that I needed to bring all this work deeply into my practice. I trained as a life coach with a life coach school I trained in somatic modalities and here. I am helping. Women folks assigned female at birth when folks who identify as women to shake free from codependency and all those old patterns that keep our physiology stock so we can heal in deep ways. It's so amazing. And so interesting too. Because I feel there aren't enough. People that are talking about the interconnectedness between between our psychology and physiology right and especially in the nutrition and the functional medicine world. We tend to blame everything on food or we tend to say unfortunately a lot of what's tended to happen not necessarily by experienced practitioners. But let's say influencers out there is like oh you have this condition like let's slap this food on it or like let's slap this supplement on it and then it'll fix everything just remove this one food and then it'll fix everything and like you mentioned you can do all the testing you can do all the elimination diets. You can do all the work and stuff that you would assume but then your symptoms kept coming back and it was because of this psychological side that you finally realize absolutely yeah and the deep ways like you said that psyche and Soma are one your mind and body are one and your spirit is a huge part of this as well spirit soul whatever word you use your vital life force energy needs to be. Gosh in your consciousness right. Yeah and I think. We're getting a big wakeup call right now to attend to ourselves in all of these ways. Yeah definitely and we so. If you're listening to this now we're going to be talking about the how to manage the stress response that we're all experiencing due to. Cova a little bit later. But first I want to talk about a word that you had mentioned and I had mentioned but I haven't actually dove into on the podcast yet so I'd love if you could talk a little bit more about codependency and what that is. Yeah so codependency is when you chronically. Put yourself last in order to gain the love. Validation Acceptance Care approve all of other people so any put other people's thoughts feelings actions wellness ahead of your own because somewhere deep inside. You believe that this will make you worthy of love. It will make you a valid person and usually one has been doing this since childhood and so it becomes a part of your identity right. Oh I'm just a caretaker. Oh I just I love doing things for others which to be clear. There's nothing wrong with taking care of other people. I just want to support folks in taking care of themselves. I I believe in the power of collective healing I believe in the power of Inter dependence. But that doesn't mean putting yourself last.
Weekend Edition Saturday
Coronavirus and homeless senior citizens: Why they're especially at risk
"Are concerns that the new coronavirus could sweep through homeless communities and experts are worried about one of the fastest growing segments of the community senior citizens K. two D. Sir Husseini reports about half of those on the streets are fifty or older Dr Margot Kushel conducted landmark research on the group at UCSF she says most are prematurely sick and frail we often say that we should think of them more like people in their seventies or eighties because of their underlying health concerns and this is exactly the group of people who we really worry about with corona virus covert nineteen hasn't swept through homeless communities but experts like shell are bracing for that possibility I mean in some ways we have two intersecting crises the ongoing humanitarian crisis of homelessness intersecting with this new coronavirus shell says while affordable housing is a big part of the solution emergency measures like hand washing stations and temporary shelter for homeless folks who must warn teen help for now
All Things Considered
Trump briefs the nation on how his administration is tackling the threat of a coronavirus outbreak in the U.S. but health care workers don't feel prepared
"Tonight president trump briefed the nation on how his administration is tackling the threat of a corona virus outbreak with screening people we have been at a very high level screening people coming into the country from infected areas we have been quarantined those infected and those at risk now the centers for disease control and prevention says there are now sixty cases of the corona virus in the U. S. and the US healthcare system is bracing for more but some health care workers here say they don't feel prepared NPR's Yuki Noguchi reports so far coronavirus cases in this country have been isolated but this week the center for disease control warned communities to prepare for an outbreak that worries marine Dugan she's a veteran nurse at the university of California San Francisco Medical Center this month to corona virus patients were transferred there UCSF is one of the premier hospitals in the country but do can says her frustrations are mounting because she says her employer offered little notice or training to those caring for the infected patients you want to do that we work extremely hard to do the best for our patients so don't so the thought the sale was not only nurses if all the other staff it's a nursing assistant it's transport every staff member is worried coronavirus has yet to sink in American health care workers as it has in China the deaths of hospital workers there have heightened scrutiny of the US healthcare system's ability to protect people on the front line do then says the medical community it wasn't fully prepared for previous viruses like sars and Ebola and she's concerned lessons learned are not being applied today for example the medical where provided she says leave their necks exposed to guarantee or providing are in adequate I'm sorry I get very passionate about this because we work so hard to make sure that our our nurses were protected and therefore they can protect the public in a response UCSF said it's taken multiple extensive safety precautions including isolating sick patients and training for proper use of safety gear it said it brief workers treating the patients but the hospital does not as a matter of course inform general staff of incoming infection cases thus far hospitals in the U. S. have been able to plan for incoming patients that's very different from an outbreak we're sick people come in off the street that is far more dangerous for health care workers and the public they treat mark Robb is chief of infectious disease at the university of Nebraska it's the arm recognize case that comes through your hospital system or your clinics that really pose the greatest risk what sauce that'll is considered a model for managing infections it's pioneering Medical Center is one of the few with experience treating a bola it has an isolation chamber that filters pathogens it practices dry runs making sure respiration masks that workers most critically he says it screens patients at the hospital entrance right at the front door we sequester people away from the rest of the traffic that's one of the biggest hazards he says a coughing patient can quickly infect medical staff and other patients waiting in emergency rooms and doctors offices
The Electorette Podcast
Carole Joffe: Author of "Obstacle Course: The Everyday Struggle to Get an Abortion in America"
"I'm Jim Taylor. Skinner in this is the electorate on this episode. I have a conversation with professor reproductive. Rights Advocate Carol. Joffe about her new book. Obstacle course the everyday struggle to get an abortion in America. We opened our conversation by discussing. How legislation has failed to protect access to abortion because it overlooks the everyday obstacles. That make it nearly impossible from any women to obtain an abortion legislatively. I confess to being very cynical. I seriously I don't think that even I mean. Look the country's deeply deeply divided about abortion those who are pro choice. See these restrictions as inhibiting often in a very cruel way women's ability to get an abortion. Those who are against abortion say. Yeah that's the point. We we are putting these things in precisely so we don't believe in abortion so therefore These restrictions are good because they make it harder to get an abortion. They they make it easier to close down clinics so all is to say that. I'm I mean in terms of the legislative process I don't think that anything we say in our book will sway. Those who who are opposed to abortion could put an antiabortion restrictions. What my co author David Cone and I are hoping is that those who are pro-choice but do not do abortion work or study or advocacy twenty four seven like many of the People. We discuss in our book. will come to understand how onerous restrictions are and hopefully will will move to remove those legislators out of office so who who are doing this as people who are pro choice when. I look for someone to vote into office right just to put. It simply feels like this people when they speak to us and you know. They're saying vote for me when they talk about abortion they talk about Roe v Wade and it doesn't spread from there they don't really talk about all of the little restrictions that have gone into place which makes exercising your right to an abortion nearly impossible for a lot of women. I mean legislatively one of the things that you point out in the book is that you know Central v Wade past have been about what to- hundred restrictions by now probably probably more like thirteen hundred? Yeah I feel like none of our politicians are really focusing on those. Are you know they have a blind spot? They're only looking at Roe v Wade. We have the protective weighed. Yes no if certainly make sense and and You know what I would say in response to that is of course. It's important to protect Roe. V Wade and there's a lot to be very nervous about at this very moment about row but what researching and writing this book show to me. Is that many women already live in post real world. In other words if roe is overturned what presumably will happen is it will be turned back to the states. That means they'll be a lot of traveling from what we now. Call hostile states to quote haven states. But that's already happening. I mean one thing that really surprised me and I've studied abortion more than thirty five years. one thing. That really surprised me was just extent of the travel of efforts at took to just get to a clinic for so many women. The really important thing about your book when I was reading it. You outline the stories of a lot of women. I think the first person you highlight is a fifteen year old teenager right and her parents were kind of in and out of the picture. And when you think about the fact that in some states you have to have parental consent right and you think about the thousands of dollars at it takes to get an abortion and this particular person ended up in one of those e call fake clinic. What do they call them? A clinic crisis pregnancy center. You just talk us through that scenario of what that might have been like for her fifteen year old teenager while she was a extrordinary. We did not interview her personally. We we found her story she had written it up So I can't speak to her personally but she. She had extraordinary. Extraordinarily determination was like for her to go to the center. She lives in the state where she had to make a separate trip to the clinic. Twenty four hours before the abortion. She got to the clinic. She realized something was wrong. It was a fake clinic. These crisis pregnancy centers and there's thousands of them there. There are more crisis. Pregnancy centers in the United States. Now than there are abortion providing facilities and in a number of states. They get they get public funding. You know one of the most of the many things in this world to be enraged about one of the most enraging things is for example in the state of Texas. Money is taken away from family planning centres not even abortion. I mean you may be sure does not give money to abortion clinics but to family planning programs contraceptive programs and gives them to these religiously sponsored crisis pregnancy centers that outright. Lie To women they either tell them they're ultrasound is so far along that Can't pass get an abortion? Or sometimes they tell them they're ultrasound shows actually earlier stage in pregnancy than they actually are so these women won't rush and by the time they get to a clinic They'll be too late. Another feature of them is that they have been very aggressive about buying property. Is nearest possible to legitimate abortion facilities and it's often very very confusing to patients. I mean this this case that we talked about in the book we call her Collier. It's very common especially for example in in a case that we do discuss the park crisis. Pregnancy center had a parking lot right next to a clinic. People from the fake clinic would stand outside would wave women in who of course stopped that they were being waived into the real clinic. So yeah this is one of many many problems that women face when they try to get an abortion. When I read this story I I. It was just incredible to me. I was so angry. And just the Paul the links go to to to to lie to women and you know into teenagers who are going through something. That's really really hard. So and in that case with Talia this clinic you can remind me or tell me if I'm correct or not. This clinic was right next door very close to it and it looked very much like the real clinic and the name was very similar. That's right and when you go into these places they're they're you know they're wearing lab coats and make you think that their doctors that's right and just it's just unfathomable to me the link to go through none of the I think you hit the right word on the head. It's unfathomable that these fake clinics Goto but it also Jennifer I would also say it's unfathomable the lengths women not just teenagers but women in general have to go through to get their abortions and they do. Yeah they do right. That gets to one of my next questions do we do. We have any data on. The percentage is the percentage of cases where obstacles collectively were. They've been successful right in a woman knocking abortion we done. That's a great question. We don't have good data on specifically women who were dissuaded or allied to at a crisis pregnancy center. My colleagues here at UCSF in the answer program have come up with a estimate that about four thousand women a year Who Show up at clinics are turned away because they arrived too late in in just station. Your listeners should understand that all abortion facilities are not uniform some go only through the first trimester of pregnancy some go to eighteen weeks Some states a number of states have banned abortions after twenty weeks there's only three or four clinics and the United States that will perform abortions after twenty four weeks and that's usually for Fetal anomalies or the woman herself is is very ill. I mean those are not the only people who get abortions there. But that's the bulk of the cases so It's a very cruel vicious cycle Europe. Poor woman you find out you're pregnant you try you look around you. Try to find a clinic. You make an appointment you try to find someone who will drive you there. You try to arrange childcare for your children. Sixty percent of abortion patients are our parents You arrange to take time off from work so all you have to put all these things into place. What we found out is simply getting a getting a reliable ride to a clinic if you don't have your own car or even if you do some clinics a use sedation which means you are not able to drive yourself home afterwards. Anyway but the time you get all these pieces in place and you show up to the clinic you may be past that clinics limit
The Voice of Healthcare
How Teladoc Health Approaches Clinical Quality, Meets Hospital Virtual Care Needs
"So recently I came across an article On Talladega with the title. What's not to love about being in virtual healthcare? Maybe you can comment a little bit about the experience that you hope to create for patients as well as what safety and quality measurements. Do you as a clinician hoped to focus on through tele doc solution so I do believe that just like ten or twenty years ago when folks began exploring what it meant to be Devoting one's career to hospital medicine and we had that growing growing definition of the hospitalised. Actually the physician that coined that phrase Dr Bob Wachter WHO's the current chair? Uh of the Department of Medicine that. UCSF recently joined our medical advisory board. But I do believe that There will be in the years ahead. A growing field of medicine known as virtual care and that we will have virtual lists and virtual lists will have outstanding upstanding website manner if you will that ability to connect with patients and a highly personal way and then be able to offer that that individual a whole range of services. meaning that if that person for instance needs an expert medical opinion that virtuous can achieve that or if they need a type of referral to some type of specific expertise again the virtuous can care for that individual increasingly from our clients were getting Strong interest in virtual primary care. You're so this is an area that we believe is very ripe for development right now So no longer. Does it mean that your interaction with your virtual doctor is that episodic interaction but increasingly I do believe that there's a number of individuals who have a variety of chronic conditions diabetes hypercholesterolemia hypertension that really lend themselves into a longitudinal relationship with a clinical care team. And all of this can be done. Virtually what about quality and safety. What are you looking for? What are you tracking with these teams until talk solution so we believe that At the end of the day clinical quality is really what differentiates health In the market today and so we take clinical quality. Quite quite seriously actually Dr Bill Frist is On our board of directors electors and he tears up our quality and safety subcommittee and I would say that my job is a pretty easy job because when coming to that committee and having various ideas in terms of how we can move the quality needle I feel as though the quality and safety committee at CAL is a highly receptive audience for initiatives in these areas. So what are the some of these initiatives one. Our current General Medicine Program does see a tremendous amount of individuals who are suffering from upper respiratory illnesses. As you know there's a ramp's over prescribing of antibiotics And one initiative that. We've been very very focused on is antibiotic antibiotic stewardship. We're very happy to report that. We're currently working on a ARC grant With some researchers from the University of southern in California. Just around antibiotic stewardship. We do believe that we're currently tracking a bit better than brick and mortar in terms of Not Not over prescribing antibiotics. And yet we also feel so there's always room to grow We also feel as though there's ED overuse of steroids Being utilized for individuals who have a variety of upper respiratory complaints so using I using steroids indiscriminately is obviously not good for the patient. So this is another parameter that we're very carefully monitoring and then as you might imagine we look very carefully at our providers NPS scores that member satisfaction. We look at complaint rates. We look at visit time. We look at visit volume And ultimately what we have created for. Our clinicians is a dashboard. Because we do believe getting feedback on how you doing and how you're doing relative to your peers is a very important way that we can dr clinical quality On our expert medical services. We have a whole host of parameters that were routinely ainley tracking changes in diagnosis changes in treatment again. The member satisfaction being the hallmark of We're really trying to deliver care that is meaningful to the individual at the time that they're reaching out for care from Talbot Health. I Love Love The web side Care and As you as you mentioned when you were speaking about the virtual health care physician and I've never heard that before. I believe a lot of our listeners. When they hear virtual healthcare they are going to think that? There's this additional technologies in play other than what is at the normal Brick and mortar clinicians office. If you will could you discuss with us a little little bit about the technology you all are using that help. Sure so I I. I'd say that at its simplest. We really really feel as though we want technology to be deployed in a way that enhances coulda call quality so We do have the capabilities to integrate With Taito care for instance which is a way that one can Listen to someone's chest and look at their ear But we don't want these to be GATING obstacles So if the issue of the individual can be resolved with a simple phone call. Aw We will do that If the individual requires a video consultation. Of course we do that. With a high degree of frequency We also are always looking for digital therapeutics and other ways as in which we can deploy technology to enhance clinical quality. But it's not the other way around so we're not looking to just put if if you will sizzle into our program through integrating devices and technologies. That at the in the end result are not meaningful meaningful in terms of driving meaningful clinical outcomes. That's great so we're we're not adding tech just to have more technology and play. I I think I think we can all appreciate that. You mentioned that one of the largest growing areas is primary care and chronic diseases which is so important A lot of times a diabetic doesn't necessarily need to go in to see the clinician in person every week or every month month. So when I if I'm a diabetic do I have the same doctor each time or do I simply have tele doc health physician each time when I reach out to them. Right so Again we are just beginning to dip our toe if you will into the waters of virtual primary care but I think it is all centered around an individual's care team so it would be a physician. It would be some type of advanced practice. Clinicians being a nurse practitioner or physician assistant would be a medical assistant. And this would be the care team team that would be connected with the individual Seeking care. But it wouldn't be the general network work of general medicine providers. We really feel as though that personal care team will be key In terms of the success of the program. Yeah Lou I think That's a great point. I I like to highlight care team management and personalized. Care as much as I can. I think I think The clinicians that I've worked with over the years in the literature allstate that the healing process and maintaining wellness health. I come from a community so creating that upfront. And being part of the plan is huge no matter how high tech the solution might be a little bit of if you can you had. Yeah right I mean obviously I don't think either one of you on this call would disagree with that. I'm pretty sure our listeners would applaud that as well Not I tonight one point that I did want to make. Is that what we're trying to create in terms of our virtual primary care offering is much more than Instead of seeing me in the office on Brooklyn Avenue we can have a skype call and We can resolve your issue without you needing to come in and park and go through all that inconvenience. I do believe leave. That virtual primary care can achieve a higher level of clinical outcome through the successful deployment of Data analytics so that this program can be specifically targeted to individuals that we know we'll take full advantage digital therapeutics remote patient monitoring a I a lot of other resources that that frankly are not available to the general internist practicing in the office setting so that if one can if you will not only be prescribing medications but also be prescribing digital tools. That will help drive the the individual to a greater state of wellness. I think you can begin to see. How virtual care can in some instances exceed what is traditionally unle available through your routine? Hi Mary Care in a brick and mortar setting.
Forum
Who are the coronavirus victims? What to know about the fatalities as the pneumonia-like illness spreads
"Org this new strain of coronavirus has killed dozens in China and spread to as far as the US from Wuhan where the onus is believed to have originated in originated with animals so listen the clerk you were at SFO earlier this week and talking with passengers as you mentioned and what is what is the effectiveness of airport screenings for an illness that may not show symptoms initially as people are coming in and you know it's kind of after the fact at this point the two cases that we did have in the U. S. are of people who were not at who came through the airports before the screening process took place but but they have been caught if they had come in you know it's it's an open question yeah I think you know the CDC is obviously putting a lot of resources on the ground to do this and would argue that this is an important precautionary measure to try to stop cation cases but as you know the CDC representative that I talked to did say you know not no measure is going to be full proof for sure they may or may not there are definitely some critique critical voices against or not against but but critical of that airport screening is actually going to do much of for example the World Health Organization does not recommend that countries around the world do airport screening because it's not it hasn't been shown to really justify the amount of resources that are necessary to do it and for example these both of these cases maybe at the airport screening was taking place they would have been caught but they might not have been if they you know they might not have been showing symptoms yet so at the airport I think it's important to know they're taking your temperature and they're asking you to fill out a health questionnaire are you coughing do you have fever you know are you having trouble breathing so if you don't if you're feeling fine still but you might be infected but you're just not showing symptoms you could you know potentially get through that screening and in fact people here in another place so I would say you know it depends on who you ask but there's definitely some criticism that it's we're putting too much effort into it we're joined now by Charles Chu is a professor of medicine at UCLA at UCSF he specializes in infectious diseases thanks for joining us on form thank you so let's just get down to basics here what is a coronavirus my understanding is it's the same virus as the common cold it is so curry viruses are a family it's of a family of viruses and they they do belong to a group of viruses that cause the common cold other viruses in this group include rhinoviruses an adenovirus and current viruses are simply a fat family of respiratory viruses that cause respiratory infections what what makes this a little different is our that certain kind of viruses have recently trance have recently crossover jumped over from animals to humans what we call zoonotic transmissions and so some examples would be in two thousand two we had sars coronavirus which was a a species job as well as members kind of virus and and I believe around around twenty eight to twenty eleven of which came from camels and so this is another corona virus it it appears to cause respiratory disease along with other Quinn viruses and but we don't we just don't know where it came from end how dangerous is this virus I mean the number of cases and deaths grow daily is this because it's spreading so rapidly or because existing cases are finally being diagnosed in the numbers updated trust you yeah we we we actually do not know at at this point exactly how dangerous or deadly the virus may be I think it's a bit and part of the reason is that it's still very very early in the course of the outbreak and there has been there have been hundreds of cases yes and and several fatalities based on the early data it does suggest that this does not appear to be as deadly as for instance sars coronavirus or even murders kind of ours and I I believe there as of as of today they're probably took twenty one fatalities and more than six hundred cases I saw that side of Italians meaning patients who are developed the disease and die from it so it does not appear to be as dangerous as prior coronaviruses but it's still very early days actually the numbers that I was seeing were more than eight hundred and twenty six outs at this yes again it just continues to grow so then we were talking with less in the clerk about how they're doing screenings at the airport but what symptom should people be on the lookout for especially if they've traveled to China or other regions in Asia that ours reporting cases yes it's a current affairs infections because a respiratory illness and it's it's just as in any viral flu like illness patients or Invid individuals were infected can demonstrate fever cough nasal congestion in this in a subset of patients in a purple small proportion of patients they may then develop more severe disease chest pain chest tightness and shortness of breath I can develop into a life threatening pneumonia a but it presents initially as any other common cold or viral like flu like illness at less cynical you wanted to jump in I just jump in in the sense that and nationally it looked like it was mostly older people with pre existing conditions who were dying from this this virus and just recently they announced that the a man thirty six years old in Shanghai has has died so it does look like it might be affecting and he was perfectly healthy he died of cardiac arrest a couple hours before the diagnosis so is that increasing the concerned doctor chew in terms of you know how this virus infects people and can affect people who did not have pre existing conditions who were apparently young and healthy I I think it is concerning but and and that was actually the case with for for instance some some other viruses that we scenes for instance the two thousand nine H. one and one pandemic influenza virus where it appeared to disproportionately because perhaps severe disease in in younger people so it's I I I do want to stress so that really is early days and we can't really really can make conclusions about how deadly the viruses I think probably much more concerning to me is the fact that this virus clearly is able to be transmitted from person to person for human to human transmission does that mean it can mutate essentially two or the L. yet this last week regardless of whether or not the the that that the the virus can mutate the greater concern is that the capacity for human to human transmission what that means is if it translates very efficiently it's very it would be very difficult to stop this outbreak it's very difficult to curb the spread of the outbreak or so I I I'm I'm what I'm worried about is that this may be an outbreak that would be very difficult or even impossible to stop and it certainly has that potential if it has really at if it really transmits officially from person to person so even if you have of say a virus that's not that deadly or perhaps only causes severe disease a small fraction of patients if you have millions of people infected it's still results in a large number of deaths from the virus so then do you agree with the world health organization's assessment at this point that this is not a global emergency they have not been willing to declare it so at this point I believe that the World Health Organization is being cautious at this point we we we see the evidence of transmissibility from person to person I believe what the world health organization's looking for those at this of sustained transmission what we describe as ongoing transmission passes initial introduction to a country if there's evidence of sustained transmission I do to believe that will help her position will be will likely to declare this an emergency well Emily I'm not yet yes is there any reason to avoid traveling to Chicago we have plans to travel there next week that's where the latest case has been confirmed in the U. S. should this person avoid that doctor to I I don't think there's any particular reason to avoid travel to to Chicago it's it's it's probably it's it's simply by chance at that we're doing and screening at major airports and and really across the United States that's the CDC is conducting surveillance for the virus I suspect that we will likely have additional cases and they will but they'll tend to pop up where where surveillance is being done and and I know that we we previously had the discussion about whether or not you know airport base surveillance is going to be effective I I do agree with my what what with I do agree with the other speaker in that I believe that it's it may be perhaps too little too late and perhaps not effective but it definitely is an attempt to prevent to prevent a transmission into this country what do you think is the likelihood that this illness will come to California to the bay area if it hasn't already we do have I mean server disco bitter national airport was one of the first airports to have screenings put in place because of direct flights from Wuhan in so there's a lot of questions especially among our listeners about the likelihood that it will be here in the bay area and what can be done for prevention I I think it's it's likely that we may eventually see cases have simply because based on the data from China based on information that's coming from China this does appear to be a relatively contagious virus it is and there have been several examples for instance of what we call hospital choir transmission where infected patients in China transmitted to multiple health care workers we've also seen some exam examples of sustained cycles of transmission in China meaning that someone's infected but then in fact somebody else and in turn affects somebody else so I I I believe that it's only a matter of time before we'll start to see additional cases well is eager asks I was surprised at the coverage on the Seattle individual didn't include information on the airports he visited or even confirmation Hughes the Seattle airport there also wasn't an acknowledgement of this information is being withheld is this normal is this advisable it's interesting lesson the clerk because I understand that one of the things that they were looking at was whether the Washington case that the man had even travel through SFO as on a connecting flight potentially so do we have any more insight into where you know I'm not exactly sure I don't have more insight on exactly where he flew in I think to address both that listeners concerns and the woman who who is traveling to Chicago those people who have come across in who are infected the CDC is monitoring anyone that they have come in close contact with since they have arrived in so they are trying to make sure anyone that that person you know had dinner with their talk to or whatever in the man in Chicago and Seattle apparently had not been contacted very many people and in both of them had live alone except dresser there was a fair amount of kit you know which I say so the service so their surveillance around those people who who have come across to make sure that they're not spreading it some took to relay their concerns must be king also a Charles true about information being withheld there were concerns that the Chinese government is not being as transparent as they should be maybe not sharing information as readily as they could be because of concerns about the previous you know sars epidemic when the Beijing government with held a lot of information initially about it do you think that this time around the government is sharing enough information about the case I do think that things are different with regards to disclosure of verses the what happened in two thousand two with the sars outbreak for instance are in two thousand two there was a lot of information that was that was simply not available for several weeks it but here
The Takeaway
Protein tangles in Alzheimer's patients could help predict brain shrinkage
"A small study just out from UCSF demonstrates how a specific protein in the brain can predict the progression of Alzheimer's disease KQED science reporter at Leslie McClurg explains scientists followed about three dozen patients with Alzheimer's to see how their brain atrophied over fifteen months images revealed the areas covered in a protein called how shrunk the most knowing which brain regions are likely to decline will help doctors forecast what kind of cognitive loss is coming are we speaking a language problem next I respecting eagles diesel problems this we hope is something that we're going to be able to address in the next years we know the joy is a UCSF expert on neuro imaging and lead author of the study the data adds to a growing body of research suggesting that tile maybe a more significant player and Alzheimer's disease than amyloid plaque unless limit cleared KQED
1A with Joshua Johnson
A new blood test could indicate multiple conditions with one sample
"A new blood test could predict multiple diseases with a single sample KQED science reporter Leslie in the clerk says UCSF positions publish their research today the new test which doctors are dubbing a liquid health check can measure five thousand different proteins in one blood sample Dr Peter Ganz is a cardiologists at UCSF patterns of proteins inform us about the risk of diseases such as risk of heart attack or stroke risk of developing diabetes or it can inform us about your current state of health like your physical fitness or the amount of fat in your