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THE CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE AT UCSF AND THE DEPARTMENT OF MEDICINE by Jack Whiteford, RSA for AIDS/ID The Clinical and Translational Science Institute (CTSI) at the University of California, San Francisco (UCSF) is a result of the recent Clinical and Translational Science Award presented by the National Institutes of Health (NIH). As of September 30, 2006, the CTSI replaced a T32 training program, two K award programs, and several clinical research centers with 13 consolidated and new programs and over $100 million in funding over the next 5 years. The CTSI’s mission is to create a comprehensive, integrated academic home that promotes research and education in clinical and translational science at UCSF, at affiliated institutions, and in participating communities. As the RSA for Dr. Joel Palefsky, Associate Dean for Clinical and Translational Research, I was asked to describe the CTSI for you and how it might impact the Department of Medicine (DOM). To begin, a clear understanding of translational science is necessary. The CTSI is a response to ongoing frustration with the rate at which research findings from basic and clinical science studies and clinical trials are translated to improvements in bedside and community health practices. It is hoped that the CTSI will foster a cultural change that will value this kind of research focus. The award is one of 12 Clinical and Translational Science Awards made by the NIH. If our program is successful, it is expected that the NIH will continue to expand

the model for funding these programs on a national level. The CTSI has several programs that are managed by various UCSF departments. For the period of transition to the CTSI, it was believed best in some cases to have those departments continue to manage the programs. Others are being managed through central CTSI administration. It is likely that the administration of the CTSI will evolve in order to achieve the success desired. This may result in major changes in how things are done at UCSF, and, in particular, within the DOM. Since we have the largest research portfolio of any UCSF department, we stand to be the most affected by these changes, the extent of which are yet to be seen. The CTSI has several new programs to support research initiatives of the DOM and UCSF investigators. One program is the Strategic Opportunity Support (SOS) Center, which sustains clinical and translational research conducted at UCSF and with its community-based research partners. The SOS Center is a new funding opportunity with a substantive affect on the research and careers of clinical and translational scientists at UCSF, particularly among those in an early stage in their careers. The CTSI Clinical Research Center (CCRC) will be a key resource for CTSI investigators to perform their patient-oriented studies. It will combine and integrate the three existing NIH-funded UCSF Clinical Research Centers. In addition, new CCRC units have been added to provide new research opportunities at the San Francisco Veterans Administration

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Medical Center and at Kaiser Permanente. The existing Pediatric Clinical Research Center satellite unit at Children’s Hospital of Oakland Research Institute will expand to include adults. The Biomedical Informatics Program is a campus-wide resource for planning and conducting informatics in all clinical and translational research, providing UCSF with world-class data management and analysis services, as well as offering relevant training in informatics research. The program will expand existing services. The CTSI Virtual Home will build on the current standard tools used for community building (e.g., seminars, journal clubs, and newsletters), and will facilitate these important interactions through an innovative online information and communications service. This web-based knowledge management system will provide CTSI community members with specialized collaboration tools and will include directories of clinical and translational research facilities and services and resources; faculty information; specialized databases; software resources; research administration services; training resources; links to laboratory web sites; news and current information about CTSI activities; announcements of seminars, regulatory updates, and funding opportunities; as well as other information of potential interest to CTSI investigators. For more information on the CTSI, please see the website: http://ctsi.ucsf.edu

POLICY/PROGRAM UPDATES by Joseph Wilson, Assistant Director Stipend Levels NIH has released the stipend levels for the government FY 2007 National Research Service Awards. The stipend levels for FY 2007 will remain the same as those for FY 2006. The announcement also summarizes the new policy and benefit levels for "Training Related Expenses" for trainees and the "Institutional Allowance" for fellows. http://grants2.nih.gov/grants/guide/notice-files/NOT-OD-07-052.html FY 2007 Funding on Non-Competing Awards NIH has announced that non-competing research awards made with FY 2007 funding will be awarded at 97.1% of the FY 2007 committed level. Future year commitments will also be adjusted accordingly. However, institutes and centers "will maintain the flexibility to supplement such non-competing awards on a case-by-case basis according to scientific and programmatic imperatives." Non-competing awards previously issued in FY 2007 at reduced levels will be revised to restore funds to the level indicated above. NIH has stated that this policy does not apply to Career Awards, SBIR/STTRs, and the Ruth L. Kirschstein-National Research Service Award (NRSA) Fellowship Grants—these mechanisms will be funded at the committed level. http://grants2.nih.gov/grants/guide/notice-files/NOT-OD-07-049.html

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FY 2007 Salary Cap Guidance Final guidance on the FY 2007 NIH salary cap rate of $186,600 has been announced. Departments can find instructions for implementation of the salary cap at UCSF on the Contracts and Grants (C&G) webpage at: http://www.research.ucsf.edu/cg/memo/cgSalarycap.asp NOTE: If you are submitting a proposal to NIH with a categorized budget, application of the federal salary cap should be noted on budget justification page in the justification section for the individual using the capped rate. http://grants2.nih.gov/grants/guide/notice-files/NOT-OD-07-051.html C&G 4-Day Deadline for NIH Electronic Proposals It is critical that fully completed electronic applications to NIH be received at C&G by 9AM 4 days prior to the deadline. Proposals with incomplete sections that are received at C&G with a note attached or with a subsequent phone call to "hold for changes to the technical or other sections" will not be considered as meeting the C&G deadline and will be logged in as late. It is important to understand that there is a possibility a proposal might be rejected upon first submission to either Grants.gov or to the NIH Commons and may need to be resubmitted through Grants.gov after corrections are made. Therefore, in order to avoid missing the agency deadline due to system rejections, it is essential that proposals are received at the UCSF C&G Office as early as possible.

MEET LAN PHAM Division Administrator, Infectious Diseases by Deborah Airo, Principal Editor

DA: What new projects or developments are coming up for your division? LP: Infectious Diseases does not have a major presence in Transplant and Immuno-compromised ID; therefore, we are in the process of developing a second clinical ID consult service at Moffitt that will specialize in infectious diseases in transplant and immunocompromised patients. This new service will also help the ID consult service when it is overburdened. We are also anticipating the move into our new office space on the third floor of the Medical Science building in November 2007. DA: What is it like being a Division Administrator for ID? LP: I think ID is a great place to build a foundation and to grow one’s career because

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the faculty are very supportive and en-couraging of personal and career develop-ment. I am grateful to make my contribution in a setting where Principal Investigators are working hard to help lessen infectious diseases. DA: How has the Research Administration Unit been most helpful to your work? LP: Although our clinical services generate revenues, the majority of our funding is research related. We have many grants from both private and government sources, which makes services provided by DOM’s Research Administration Unit very important to our operations. DA: What are the qualities of the best RSA? LP: The best RSA understands the balance between pre- and post-award activities and is very knowledgeable about University, Depart-ment, and funding agency policies and guidelines. Great RSAs are people who, because they work closely with the PIs, have strong communication skills and the ability to provide accurate budget status reports. They are able to handle last minute requests and follow through on proposals. DA: What are the qualities of the best Division Administrator? LP: As Division Administrators, we interact with people from many offices, both internal and external, at all levels and on different issues. We need always to be mindful that we are representing the University, so what we do and how we handle situations is very important. I believe the best DA should have strong interpersonal and communication skills, be tactful, and respect people regardless of their professional level. The best DA is not

afraid to take on a challenge and make decisions in a time of crisis. DA: What is your background? What is your history at UCSF? LP: I will have been at UCSF for 6 years in December 2007. I started working as a part-time swimming instructor and lifeguard at the Millberry Fitness and Recreation Center after graduating from high school and during college. After earning my BS in Marketing, I worked as an administrative assistant at the UCSF Public Affairs office and found that the work was not what I wanted to do at the time. I became a flight attendant, and after 6 months I realized that this too was not what I wanted to do for the rest of my life. I then worked as a sales and consulting service administrator for over 2 years and became an executive assistant for the President and CEO of Vitasoy, until I was laid off a year later because the company relocated to Massachusetts. I had to start my career search all over again! In July 2002, I was hired as an AAII in ID and was promoted to AA III in October 2003, then to Analyst I-Supervisor in April 2004. After the previous DA from ID left, I was promoted to that position. Had it not been for the layoff from Vitasoy, I would not be where I am today. DA: Why be a Division Administrator? How did you grow into the position? LP: As a child, I always dreamed of managing a business one day and when the DA opportunity came along, I just could not sit back and let it pass. Being a DA is similar to managing a business because you have to deal with finance, HR, and making sure the operation runs smoothly. Through the years, while I was working in different positions in ID, I came to realize that this is

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where I want to start my management experience. The faculty and staff here are very supportive, and I feel a sense of belonging. Taking the position was a huge leap for me because back then I did not have management, financial, and other skills that are crucial for this work. My first year was very challenging because we were short of staff and I was filling both my previous position and my new role while we were recruiting for my replacement. However, I was able to get through it without the Division falling apart because of my prior work in ID and the close working relationship that I have with my RSA. DA: What do you like most about your work? What are the most challenging aspects? LP: I enjoy that there are a variety of tasks and that every day is different. I constantly learn new things and expand my knowledge in finance, human resource management, clinical operations, and research. I also find working with the faculty, fellows, postdocs, and staff to be very enjoyable, and the guidance and mentoring that I receive from the Chief and Martha Hooven is invaluable. I am fortunate to be a part of UCSF where I am able to contribute to the improvement of patient care. The most challenging aspect of my job is hiring effective and efficient staff and retaining the best people, as ID has had numerous turnovers in staff. The other challenging aspects are managing Division funds and expenditures to ensure that we are spending within budget. DA: Tell us something about your life outside of the job. LP: I am married with a 3½-year-old son, Ryan. In my spare time, I enjoy getting

together with family, going on cruises with my son, teaching swimming, and reading. DA: What is something you would most like to do in the next few years? LP: I hope to grow further in my career in the years ahead and to take on more challenges. I also would like to fulfill my dream of getting an MBA in business management and maybe have another child. My philosophy in life is to always demand the best of oneself, live with honor, and devote one's talents and gifts to the benefit of others. MEET MATT LEWIN, MD, PhD Asst. Adjunct Professor, Division of Emergency Medicine by Sarika Parekh, RSA for Emergency Medicine

Matt Lewin visits one of his favorite patients, a 12-year-old girl, in Ica, Peru.

SP: Why did you choose Emergency Medicine as your specialty? ML: Emergency Medicine was ideal for me because I love variety, team sports and

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research. Unlike many specialties, Emergency Medicine has very well-defined work hours. I never have to worry that I am going to have to drop what I am doing in either arena. Finally, I love the fact that the skill-set is portable. You can go anywhere on Earth and use your skills to help people. I always wanted to see the world and have a portable skill--this is it for me. SP: What are the most rewarding parts of your job? ML: The team spirit is great, especially when there is a true, life-threatening emergency. After several years working with the same nurses and PCTs, we can run a resuscitation quietly and calmly. Everyone chips in and can air suggestions. If the patient does well, that is our best reward. I feel good for the patient and the family and about the bond with my colleagues and students. SP: Why did you choose carbon dioxide as your research subject? ML: I am always looking for ways to improve patient care. The physiology of CO2 and respiration has been studied for more than 100 years. Many people are prejudiced against CO2 in such a way that it has not often been considered as a therapeutic agent more than a sign of trouble. We believe that CO2 may have great therapeutic utility in the ED setting and are looking for ways to exploit its potentially beneficial properties. If our data pan out, hopefully we can make CO2 sexy like many NFL players have done for light beer. SP: How important is research in our division of emergency medicine? ML: Important! Not taking advantage of the many opportunities to answer fundamental

questions relevant to EM would be a shame. We have a fantastic research environment. No shift goes by without some question popping into my head. I'm 39, so I figure my life is about half over. Not enough time to do everything. SP: Tell me more about your Mongolia and Peru expeditions? ML: As I mentioned, I love to have a portable skill and I love research. It has been my good fortune to be able to find ways to travel while doing research. The Gobi and Peru expeditions have been a great vehicle for studying the challenges and hazards of travel in extremely arid environments. The Gobi Desert is more volatile than the Atacama Desert . . . but the Atacama is so hot it makes the Gobi feel like summer in San Francisco. Between researching the medical challenges of desert travel, I've been lucky to participate in palaeontological research on the evolution of dinosaurs (Mongolia) and Cetaceans (Peru). On several occasions, members of the scientific crews have fallen ill or local people have come by our camp ill or injured. It is always a pleasure to help out. Sometimes it is complicated and stressful. Nevertheless, it is always memorable! SP: Can you tell me something about Operation Rainbow and your association with the project? ML: My involvement with Operation Rainbow was most rewarding in 2006 when we went to Ica, Peru to perform club foot repairs on impoverished children from the region. Some families traveled more than a week to get to the hospital. We performed more than 50 procedures. My job was

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helping with sedation and airway management of the kids. It was interesting, challenging, satisfying, and educational. I hope to return soon. BEST IN RESEARCH ADMINISTRATION OF GRANTS (BRAG) AWARD

The Research Administration Unit is proud to announce that Linda Lew is the April 2007 BRAG Awardee. Linda is the Research Services Analyst for the Divisions of Allergy and Pulmonary. She has been with these divisions since September 2005, when she started out as an Administrative Assistant III. She quickly demonstrated her capabilities and was promoted to Analyst in February 2006. Linda has received the BRAG Award because she submitted the highest percentage of grants on time with the fewest mistakes during the pre-award process. AFTER THE FACT PROPOSALS by Joseph Wilson, Assistant Director After the Fact (ATF) proposals are defined as those directly submitted to a funding agency by a

Principal Investigator (PI). These proposals have not gone through a formal review process and have not been signed by an Institutional Official in the Sponsored Research Office. Proposals submitted without going through the Sponsored Research Office are discouraged on all occasions. Submission of a proposal without the concurrence of the Institutional Official is against University compliance rules. Before an award resulting from an ATF proposal can be accepted and administered by the University, the proposal must be reviewed and approved in accordance with the policies and procedures required for formal proposals. The University retains the right to accept or reject such awards. The Department of Medicine discourages the submission of ATF proposals. Types of errors which have occurred in the past include inaccuracies in indirect rates, salaries, and benefit rates. There can also be issues of PI status and space. PIs should never sign in the place of an “Institutional Official” on any document, as a PI is not authorized to legally obligate the University. STAFF UPDATES Michele Carter joined Central Admin as an Administrative Assistant in February 2007. Among other duties, she will log all incoming proposals requiring internal review. Before joining UCSF, Michele worked for a skincare and cosmetics retailer

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where she gained experience in management, events planning, inventory and purchasing, PR, vendor coordination, and customer service. She also worked as a makeup artist. Carol Yarbrough has been providing support to the Division of Cardiology as an interim RSA since February 2007. She has been with the Division for 9 months and was originally recruited as the Billing and Revenue Analyst. She has an extensive background in legal support services, as well as technology vendor contracts. Prior to joining UCSF, Carol worked as a transaction support analyst at a marketing firm and as a contracts specialist at an on-line brokerage and spent many years working for various law firms in San Francisco. She currently holds an MBA in Technology Management, a Certified Coding Associate certificate, and a Certified Professional Coder-Apprentice certificate. Michelle Chang joined the Geriatrics Division as an Analyst I in November 2006. Prior to coming to UCSF, she worked as an accounts manager in a local law office and also served an internship at SFGH as a Medical Social Worker. She recently graduated from UC Riverside with a BA in Sociology. In November 2006, Jennifer Kellen joined the Hem/Onc Division as an Analyst III for Dr. Small. Previously, she worked for 8 years in several positions at the UCSD Moores Cancer Center. She started with opening the DNA Sequencing Shared Resource in 1998 and grew the unit into one of the most well respected resource facilities in the U.S. She also supervised the relocation of the Cancer Center into its new building, successfully incorporating both clinic and basic research

components. Finally, as financial manager for all 13 shared resources for the last 2 years, she coordinated and supported the shared resource portion of the grant application and site visit.