Competências científico- tecnológicas e cooperação universidade-empresa na saúde / Health-related scientific and technological capabilities and university-industry research collaboration / Competencias científico-tecnológicas y cooperación Universidad-Empresa en la salud

OBJETIVO: Analisar a evolução recente das competências científicas na área de saúde, o efeito das linhas de fomento na redução dos desequilíbrios científicos regionais e a interação universidade-empresas entre os grupos de pesquisa em saúde no Brasil. MÉTODOS: As informações utilizadas foram provenientes das bases de dados do Conselho Nacional de Desenvolvimento Científico e Tecnológico, referentes aos anos de 2000 a 2010. Foram calculados indicadores relativos à mobilização de recursos, à estruturação de grupos de pesquisa e à realização de esforços para transferência de conhecimentos entre a esfera científica e o setor empresarial. RESULTADOS: Com base no mapa da distribuição regional das competências técnico-científicas na área de saúde, foram identificados possíveis padrões de especialização científica e os padrões de interação entre a comunidade científica e o setor empresarial. Houve relativa desconcentração espacial dos grupos de pesquisa em saúde e seis áreas de conhecimento eram responsáveis por mais de 6% dos grupos de pesquisa em saúde, pela ordem: Medicina, Saúde Coletiva, Odontologia, Medicina Veterinária, Ecologia e Educação Física. Os incentivos representados pelas linhas de fomento no período 2000-2009 contribuíram para reduzir os desequilíbrios científicos regionais, induzindo o aprofundamento de competências pré-existentes ou, alternativamente, estimulando a descentralização espacial dessas competências. CONCLUSÕES: Ainda persiste uma concentração espacial elevada das competências técnico-científicas em saúde e os incentivos de política têm contribuído apenas parcialmente para reduzir esses desequilíbrios.

OBJECTIVE: To examine recent developments in health-related scientific capabilities, the impact of lines of incentives on reducing regional scientific imbalances, and university-industry research collaboration in Brazil. METHODS: Data were obtained from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (Brazilian National Council for Scientific and Technological Development) databases for the years 2000 to 2010. There were assessed indicators of resource mobilization, research network structuring, and knowledge transfer between science and industry initiatives. RESULTS: Based on the regional distribution map of health-related scientific and technological capabilities there were identified patterns of scientific capabilities and science-industry collaboration. There was relative spatial deconcentration of health research groups and more than 6% of them worked in six areas of knowledge areas: medicine, collective health, dentistry, veterinary medicine, ecology and physical education. Lines of incentives that were adopted from 2000 to 2009 contributed to reducing regional scientific imbalances and improving preexisting capabilities or, alternatively, encouraging spatial decentralization of these capabilities. CONCLUSIONS: Health-related scientific and technological capabilities remain highly spatially concentrated in Brazil and incentive policies have contributed to reduce to some extent these imbalances.

OBJETIVO: Analizar la evolución reciente de las competencias científicas en el área de la salud, el efecto de las líneas de fomento en la reducción de los desequilibrios científicos regionales y la interacción universidad-empresas entre los grupos de investigación en salud en Brasil. MÉTODOS: Las informaciones utilizadas fueron tomadas de las bases de datos del Consejo Nacional de Desarrollo Científico y Tecnológico de Brasil, referentes a los años 2000 y 2010. Se calcularon indicadores relativos a la movilización de recursos, a la estructuración de grupos de investigación y a la realización de esfuerzos para transferencia de conocimientos entre la esfera científica y el sector empresarial. RESULTADOS: Con base en el mapa de la distribución regional de las competencias técnico-científicas en el área de salud, se identificaron posibles patrones de especialización científica y los patrones de interacción entre la comunidad científica y el sector empresarial. Hubo relativa desconcentración espacial de los grupos de investigación en salud y seis áreas de conocimiento eran responsables por más de 6% de los grupos de investigación en salud, por el orden: Medicina, Salud Colectiva, Odontología, Medicina Veterinaria, Ecología y Educación Física. Los incentivos representados por las líneas de fomento en el período 2000-2009 contribuyeron para reducir los desequilibrios científicos regionales, induciendo la profundización en competencias pre-existentes o, alternativamente, estimulando la descentralización espacial de tales competencias. CONCLUSIONES: Aún persiste una concentración espacial elevada de las competencias técnico-científicas en salud y los incentivos de política han contribuido sólo parcialmente en la reducción de estos desequilibrios.

Commercializing biomedical research through securitization techniques.

Biomedical innovation has become riskier, more expensive and more difficult to finance with traditional sources such as private and public equity. Here we propose a financial structure in which a large number of biomedical programs at various stages of development are funded by a single entity to substantially reduce the portfolio's risk. The portfolio entity can finance its activities by issuing debt, a critical advantage because a much larger pool of capital is available for investment in debt versus equity. By employing financial engineering techniques such as securitization, it can raise even greater amounts of more-patient capital. In a simulation using historical data for new molecular entities in oncology from 1990 to 2011, we find that megafunds of $5­15 billion may yield average investment returns of 8.9­11.4% for equity holders and 5­8% for 'research-backed obligation' holders, which are lower than typical venture-capital hurdle rates but attractive to pension funds, insurance companies and other large institutional investors.

Why technology matters as much as science in improving healthcare.

BACKGROUND: More than half a million new items of biomedical research are generated every year and added to Medline. How successful are we at applying this steady accumulation of scientific knowledge and so improving the practice of medicine in the USA? DISCUSSION: The conventional wisdom is that the US healthcare system is plagued by serious cost, access, safety and quality weaknesses. A comprehensive solution must involve the better translation of an abundance of clinical research into improved clinical practice.Yet the application of knowledge (i.e. technology) remains far less well funded and less visible than the generation, synthesis and accumulation of knowledge (i.e. science), and the two are only weakly integrated. Worse, technology is often seen merely as an adjunct to practice, e.g. electronic health records.Several key changes are in order. A helpful first step lies in better understanding the distinction between science and technology, and their complementary strengths and limitations. The absolute level of funding for technology development must be increased as well as being more integrated with traditional science-based clinical research. In such a mission-oriented federal funding strategy, the ties between basic science research and applied research would be better emphasized and strengthened. SUMMARY: It bears repeating that only by applying the wealth of existing and future scientific knowledge can healthcare delivery and patient care ever show significant improvement.

Structures promoting research, training, and technology transfer in mobility: lessons learned from a visit to European centers.

The purpose of this paper is to describe the education, research, technology transfer, and cooperative models that appear to have the greatest likelihood of successfully tackling the issue of technology to improve mobility. Ideally better models in each of these areas will lead to an increased number of researchers who are more productive. There will be increased international collaboration that will allow for better research with small and/or disadvantaged populations, and the research completed will lead to changes in clinical care that positively impact individuals with impair mobility.

First Universities Allied for Essential Medicines (UAEM) Neglected Diseases and Innovation Symposium.

Universities Allied for Essential Medicines organized its first Neglected Diseases and Innovation Symposium to address expanding roles of public sector research institutions in innovation in research and development of biomedical technologies for treatment of diseases, particularly neglected tropical diseases. Universities and other public research institutions are increasingly integrated into the pharmaceutical innovation system. Academic entities now routinely undertake robust high-throughput screening and medicinal chemistry research programs to identify lead compounds for small molecule drugs and novel drug targets. Furthermore, product development partnerships are emerging between academic institutions, non-profit entities, and biotechnology and pharmaceutical companies to create diagnostics, therapies, and vaccines for diseases of the poor. With not for profit mission statements, open access publishing standards, open source platforms for data sharing and collaboration, and a shift in focus to more translational research, universities and other public research institutions are well-placed to accelerate development of medical technologies, particularly for neglected tropical diseases.

[Health-related scientific and technological capabilities and university-industry research collaboration]. / Competências científico-tecnológicas e cooperação universidade-empresa na saúde.

OBJECTIVE: To examine recent developments in health-related scientific capabilities, the impact of lines of incentives on reducing regional scientific imbalances, and university-industry research collaboration in Brazil. METHODS: Data were obtained from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (Brazilian National Council for Scientific and Technological Development) databases for the years 2000 to 2010. There were assessed indicators of resource mobilization, research network structuring, and knowledge transfer between science and industry initiatives. RESULTS: Based on the regional distribution map of health-related scientific and technological capabilities there were identified patterns of scientific capabilities and science-industry collaboration. There was relative spatial deconcentration of health research groups and more than 6% of them worked in six areas of knowledge areas: medicine, collective health, dentistry, veterinary medicine, ecology and physical education. Lines of incentives that were adopted from 2000 to 2009 contributed to reducing regional scientific imbalances and improving preexisting capabilities or, alternatively, encouraging spatial decentralization of these capabilities. CONCLUSIONS: Health-related scientific and technological capabilities remain highly spatially concentrated in Brazil and incentive policies have contributed to reduce to some extent these imbalances.

Reducing systems biology to practice in pharmaceutical company research; selected case studies.

Reviews of the productivity of the pharmaceutical industry have concluded that the current business model is unsustainable. Various remedies for this have been proposed, however, arguably these do not directly address the fundamental issue; namely, that it is the knowledge required to enable good decisions in the process of delivering a drug that is largely absent; in turn, this leads to a disconnect between our intuition of what the right drug target is and the reality of pharmacological intervention in a system such as a human disease state. As this system is highly complex, modelling will be required to elucidate emergent properties together with the data necessary to construct such models. Currently, however, both the models and data available are limited. The ultimate solution to the problem of pharmaceutical productivity may be the virtual human, however, it is likely to be many years, if at all, before this goal is realised. The current challenge is, therefore, whether systems modelling can contribute to improving productivity in the pharmaceutical industry in the interim and help to guide the optimal route to the virtual human. In this context, this chapter discusses the emergence of systems pharmacology in drug discovery from the interface of pharmacokinetic-pharmacodynamic modelling and systems biology. Examples of applications to the identification of optimal drug targets in given pathways, selecting drug modalities and defining biomarkers are discussed, together with future directions.

Commentary: A delicate balance: weighing the effects of conflict-of-interest rules on intramural research at the National Institutes of Health.

In 2005, in response to increasing public concerns about potential conflicts of interest in biomedical research, the Department of Health and Human Services (DHHS) tightened its ethics rules to prohibit National Institutes of Health (NIH) employees from receiving consulting fees from "significantly affected organizations." In response, NIH took steps to implement these regulations and ensure that relationships between intramural NIH researchers and industry could proceed without threatening the integrity of federally funded research. Examples of these steps include creating an ethics advisory committee to review outside activities of NIH scientists and subjecting its researchers to special scrutiny to eliminate any perception of personal profit or conflict of interest. In the authors' experiences, interactions between NIH scientists and industry have continued relatively unaffected by these regulations. The continuing success of the technology transfer program at NIH and the number and types of cooperative research and development agreements with industry are good measures of the extent of productive interactions with industry since the implementation of the 2005 ethics rules. Although recruitment of outstanding scientists to the intramural program has continued, these regulations also have challenged NIH's ability to attract and retain some of the most qualified scientists, who fear they may miss certain opportunities because of the tighter regulations. As DHHS revises the regulations governing oversight of financial conflicts of interest in the extramural community, the authors recognize that the NIH intramural experience may provide valuable lessons about developing and implementing the next generation of financial conflict-of-interest rules.

Tightening conflict-of-interest policies: the impact of 2005 ethics rules at the NIH.

PURPOSE: To determine both the intended and unintended effects of the National Institutes of Health (NIH) 2005 ethics rules by examining changes in publishing rates and the frequency of external relationships among NIH scientists. METHOD: After identifying eligible intramural scientists and administrators from institutes' Web pages and central directories, a mailed survey was administered to 900 NIH research faculty between October 2008 and January 2009 (response rate 70.1%). RESULTS: Eighty percent of respondents believed the NIH ethics rules were too restrictive. Whereas 45% of respondents believed the rules positively impacted the public's trust in the NIH, 77% believed the rules hindered the NIH's ability to complete its mission. Implementation of the ethics rules significantly decreased self-reported government-industry relationships among NIH faculty (from 51.8% to 33.2%, P < .01), including significant drops in consulting (33.1% to 7.8%, P < .01) and scientific advisory board membership (31.5% to 16.0%, P < .01), both of which may be allowed under the new regulations in restricted situations with increased oversight. The policy had limited impact on NIH faculty participation in nonindustrial professional service roles and had no detectable change in publishing behavior (5.29 articles per researcher per year from 2002-2005 versus 5.26 from 2005-2008, P = .88). CONCLUSIONS: The NIH ethics rules accomplished much of what they were intended to do, limiting relationships with industry while maintaining NIH researchers' association with external scientific and professional organizations. However, the rules negatively affected personnel morale and the perceived progress of research.

The eICU research institute - a collaboration between industry, health-care providers, and academia.

As the volume of data that is electronically available promliferates, the health-care industry is identifying better ways to use this data for patient care. Ideally, these data are collected in real time, can support point-of-care clinical decisions, and, by providing instantaneous quality metrics, can create the opportunities to improve clinical practice as the patient is being cared for. The business-world technology supporting these activities is referred to as business intelligence, which offers competitive advantage, increased quality, and operational efficiencies. The health-care industry is plagued by many challenges that have made it a latecomer to business intelligence and data-mining technology, including delayed adoption of electronic medical records, poor integration between information systems, a lack of uniform technical standards, poor interoperability between complex devices, and the mandate to rigorously protect patient privacy. Efforts at developing a health care equivalent of business intelligence (which we will refer to as clinical intelligence) remains in its infancy. Until basic technology infrastructure and mature clinical applications are developed and implemented throughout the health-care system, data aggregation and interpretation cannot effectively progress. The need for this approach in health care is undisputed. As regional and national health information networks emerge, we need to develop cost-effective systems that reduce time and effort spent documenting health-care data while increasing the application of knowledge derived from that data.

Global microbial commons: institutional challenges for the global exchange and distribution of microorganisms in the life sciences.

Exchanges of microorganisms between culture collections, laboratories and researchers worldwide have historically occurred in an informal way. These informal exchanges have facilitated research activities, and, as a consequence, our knowledge and exploitation of microbial resources have advanced rapidly. During the last decades of the twentieth century, the increasing economic importance of biotechnology and the introduction of new legislation concerning the use of and access to biological resources has subjected exchanges of genetic resources to greater controls. Their access and distribution are more strictly regulated and, therefore, exchanges are becoming more and more formalized. This paper analyzes one of the main drivers of the movement toward more formal worldwide exchange regimes, which is increasing global interdependency of access to genetic resources. Its main finding is that formalization of exchange practices as such is not necessarily leading to more restrictive licensing conditions. The goal of further formalization and harmonization of institutional frameworks should therefore be to provide the broadest possible access to essential research materials (within the constraints set by biosecurity and quality management requirements), while maximizing the reciprocity benefits of access and exchange (which motivate the exchange practices to start with).

Current trends in antimicrobial agent research: chemo- and bioinformatics approaches.

Databases and chemo- and bioinformatics tools that contain genomic, proteomic and functional information have become indispensable for antimicrobial drug research. The combination of chemoinformatics tools, bioinformatics tools and relational databases provides means of analyzing, linking and comparing online search results. The development of computational tools feeds on a diversity of disciplines, including mathematics, statistics, computer science, information technology and molecular biology. The computational approach to antimicrobial agent discovery and design encompasses genomics, molecular simulation and dynamics, molecular docking, structural and/or functional class prediction, and quantitative structure-activity relationships. This article reviews progress in the development of computational methods, tools and databases used for organizing and extracting biological meaning from antimicrobial research.

The role of public biological resource centers in providing a basic infrastructure for microbial research.

Public collections of microorganisms have been established since the late 19th century, and currently 573 service collections are registered at the World Data Center for Microorganisms (www.wdcm.org). All together, they hold more than 1.5 million microorganisms. By implementing guidelines compiled by the Organisation for Economic Co-operation and Development (OECD), many public service collections evolve into professional ex situ repositories of biodiversity and distribution nodes for known, validated and precisely identified microbial resources and associated information to legitimate end-users. These Biological Resource Centers (BRCs) may be the preferred mechanism for the appropriate exploitation of microbial resources by offering the guarantee of accessibility and of transparency of supply, taking into account all relevant regulations and stakeholders' rights, as required by the Convention on Biological Diversity (CBD). Scientists are encouraged to deposit researched microbial material at public BRCs to contribute to the Science (semi-) Commons and maximize the impact of prior knowledge. BRCs are essential infrastructures supporting the future of life sciences and biotechnology.

Supporting the academic mission.

The mission of an academic radiology department includes not only high-quality patient care, but also the educating of a broad variety of health care professionals, the conducting of research to advance the field, and volunteering service to the medical center and our professional societies. While funding is available for the research and educational aspects, it is insufficient to cover the actual costs. Furthermore, it is becoming increasingly difficult to make up the deficit by using a portion of the clinical revenues. Development and revenues derived from intellectual property are becoming essential to support the academic mission.

Evaluating the informatics for integrating biology and the bedside system for clinical research.

BACKGROUND: Selecting patient cohorts is a critical, iterative, and often time-consuming aspect of studies involving human subjects; informatics tools for helping streamline the process have been identified as important infrastructure components for enabling clinical and translational research. We describe the evaluation of a free and open source cohort selection tool from the Informatics for Integrating Biology and the Bedside (i2b2) group: the i2b2 hive. METHODS: Our evaluation included the usability and functionality of the i2b2 hive using several real world examples of research data requests received electronically at the University of Utah Health Sciences Center between 2006 - 2008. The hive server component and the visual query tool application were evaluated for their suitability as a cohort selection tool on the basis of the types of data elements requested, as well as the effort required to fulfill each research data request using the i2b2 hive alone. RESULTS: We found the i2b2 hive to be suitable for obtaining estimates of cohort sizes and generating research cohorts based on simple inclusion/exclusion criteria, which consisted of about 44% of the clinical research data requests sampled at our institution. Data requests that relied on post-coordinated clinical concepts, aggregate values of clinical findings, or temporal conditions in their inclusion/exclusion criteria could not be fulfilled using the i2b2 hive alone, and required one or more intermediate data steps in the form of pre- or post-processing, modifications to the hive metadata, etc. CONCLUSION: The i2b2 hive was found to be a useful cohort-selection tool for fulfilling common types of requests for research data, and especially in the estimation of initial cohort sizes. For another institution that might want to use the i2b2 hive for clinical research, we recommend that the institution would need to have structured, coded clinical data and metadata available that can be transformed to fit the logical data models of the i2b2 hive, strategies for extracting relevant clinical data from source systems, and the ability to perform substantial pre- and post-processing of these data.

Translating health care-associated urinary tract infection prevention research into practice via the bladder bundle.

BACKGROUND: Catheter-associated urinary tract infection (CAUTI), a frequent health care-associated infection (HAI), is a costly and common condition resulting in patient discomfort, activity restriction, and hospital discharge delays. The Centers for Medicare & Medicaid Services (CMS) no longer reimburses hospitals for the extra cost of caring for patients who develop CAUTI. The Michigan Health and Hospital Association (MHA) Keystone Center for Patient Safety & Quality has initiated a statewide initiative, MHA Keystone HAI, to help ameliorate the burden of disease associated with indwelling catheterization. In addition, a long-term research project is being conducted to evaluate the current initiative and to identify practical strategies to ensure the effective use of proven infection prevention and patient safety practices. OVERVIEW OF THE BLADDER BUNDLE INITIATIVE IN MICHIGAN: The bladder bundle as conceived by MHA Keystone HAI focuses on preventing CAUTI by optimizing the use of urinary catheters with a specific emphasis on continual assessment and catheter removal as soon as possible, especially for patients without a clear indication. COLLABORATION BETWEEN RESEARChERS AND STATE WIDE PATIENT SAFETY ORGANIZATIONS: A synergistic collaboration between patient safety researchers and a statewide patient safety organization is aimed at identifying effective strategies to move evidence from peer-reviewed literature to the bedside. Practical strategies that facilitate implementation of the bundle will be developed and tested using mixed quantitative and qualitative methods. DISCUSSION: Simply disseminating scientific evidence is often ineffective in changing clinical practice. Therefore, learning how to implement these findings is critically important to promoting high-quality care and a safe health care environment.

Integrating research into clinical practice: development of an echocardiography research unit.

Introducing a research program into an echocardiography clinical practice can pose many challenges. Some initial factors to consider are the possible effects on the current clinical schedule and the equipment and personnel resources required to support the research projects. More importantly, how can an organization successfully complete reliable and accurate research projects? Here, we describe our experience with establishing an echocardiography research center within our clinical echocardiography practice. In addition, we identify key staff roles, highlight our current research practice methods, and suggest essential components that may prove advantageous when incorporating echocardiography research into a clinical practice.