Translation research aims to bridge the gap between basic science and clinical applications by developing new medical treatments and ensuring they reach patients. It has two parts: T1 translates new knowledge from basic research into clinical tests and applications; T2 translates clinical findings into practice. Successful translation requires multidisciplinary teams with expertise in both basic and clinical research. Challenges include coordinating large research efforts and overcoming barriers to implementing new practices. National research institutions have established translation centers and programs to facilitate collaboration between scientists and speed the delivery of new treatments to improve human health.
Genetic polymorphism in drug transport and drug targets.pavithra vinayak
Genetic polymorphism in drug transport and targets.--pharmacogenetics
DRUG TRANSPORTER
Two types of transporter :
•ATP binding Cassette (ABC) – Found in ABCB, ABCD and ABCG family. Associated with multidrug resistance (MDR) of tumor cells causing treatment failure in cancer.
•Solute Carrier (SLC) – Transport varieties of solute include both charged or uncharged
P-glycoprotein
• ATP binding cassette subfamily B member- 1 (ABCB 1)
• Multidrug resistance protein 1 (MDR1)
• Transport various molecules, including xenobiotic, across cell membrane
• Extensively distributed and expressed throughout the body
Mechanism of Pglycoprotein
Substrate bind to P-gp form the inner leaflet of the membrane
ATP binds at the inner side of the protein
ATP is hydrolyzed to produce ADP and energy
An Introductory Presentation to Clinical Research. A go through from this presentation will give you a brief and clear introduction about Clinical Research.
Genetic polymorphism in drug transport and drug targets.pavithra vinayak
Genetic polymorphism in drug transport and targets.--pharmacogenetics
DRUG TRANSPORTER
Two types of transporter :
•ATP binding Cassette (ABC) – Found in ABCB, ABCD and ABCG family. Associated with multidrug resistance (MDR) of tumor cells causing treatment failure in cancer.
•Solute Carrier (SLC) – Transport varieties of solute include both charged or uncharged
P-glycoprotein
• ATP binding cassette subfamily B member- 1 (ABCB 1)
• Multidrug resistance protein 1 (MDR1)
• Transport various molecules, including xenobiotic, across cell membrane
• Extensively distributed and expressed throughout the body
Mechanism of Pglycoprotein
Substrate bind to P-gp form the inner leaflet of the membrane
ATP binds at the inner side of the protein
ATP is hydrolyzed to produce ADP and energy
An Introductory Presentation to Clinical Research. A go through from this presentation will give you a brief and clear introduction about Clinical Research.
MAPK Signaling pathway (Mitogen-activated protein kinase), how the pathway helps in regulation of mitosis, It's activation and inactivation inside the cell, roles of MAPK pathway in cancerous cell, different classes of MAP kinase in human
Biomarkers have a diversified role in diagnosis, prognostication and risk stratification. This presentation aims to compile the basic information and new literature on various biomarkers pertaining to cancer care.
Final presentation for BIOL405, NSC, Spring 2014. Presented by Kevin Hugins and Duy-Khiem Chanh Pham. This presentation addressed the use of Chimeric Antigen Receptors for gene therapy for cancer. Gene therapy was first conceptualized to alter debilitating fates of genetic diseases. Gene therapy technology can help introduce new functional DNA to replace mutated genes. The idea first arose in 1972 when Friedmann and Roblin authored a paper, “Gene therapy for human genetic disease?”, demonstrating that exogenous DNA can be taken up by mammalian cells (1). They proposed that the same procedure could be done on humans to correct genetic defects by introducing therapeutic DNA. Currently, genetic modification of T lymphocytes has been the major area of research for treating malignant tumors. This technique seeks to create chimeric antigen receptor (CAR) in T cells by genetically modifying them in vitro and reintroduce them back into blood circulation. The T cells are unique to every patient and the chimeric antigen receptors are unique to the tumor that it is targeting.
chimeric antigen receptor, its structure and role in killing tumor cells,mechanism of antitumor killing, car's in clinic,evolution of cars and new chimeric antigen models
MAPK Signaling pathway (Mitogen-activated protein kinase), how the pathway helps in regulation of mitosis, It's activation and inactivation inside the cell, roles of MAPK pathway in cancerous cell, different classes of MAP kinase in human
Biomarkers have a diversified role in diagnosis, prognostication and risk stratification. This presentation aims to compile the basic information and new literature on various biomarkers pertaining to cancer care.
Final presentation for BIOL405, NSC, Spring 2014. Presented by Kevin Hugins and Duy-Khiem Chanh Pham. This presentation addressed the use of Chimeric Antigen Receptors for gene therapy for cancer. Gene therapy was first conceptualized to alter debilitating fates of genetic diseases. Gene therapy technology can help introduce new functional DNA to replace mutated genes. The idea first arose in 1972 when Friedmann and Roblin authored a paper, “Gene therapy for human genetic disease?”, demonstrating that exogenous DNA can be taken up by mammalian cells (1). They proposed that the same procedure could be done on humans to correct genetic defects by introducing therapeutic DNA. Currently, genetic modification of T lymphocytes has been the major area of research for treating malignant tumors. This technique seeks to create chimeric antigen receptor (CAR) in T cells by genetically modifying them in vitro and reintroduce them back into blood circulation. The T cells are unique to every patient and the chimeric antigen receptors are unique to the tumor that it is targeting.
chimeric antigen receptor, its structure and role in killing tumor cells,mechanism of antitumor killing, car's in clinic,evolution of cars and new chimeric antigen models
English-Spanish translation of the chapter Analyzing Business Goals and Const...Enrique Zurita-Guitar
Abstract
"Translation is that which transforms everything so that nothing changes." - Grass Günter. Doing that requires a high skills and it might be hard but not impossible. A translation is the reflection of its author, it shows the knowledge and background of the translator. This work aims to offer the reader a trustworthy translation of the text “Analysing Business Goals and Constraints” which shows us how to use a systematic, top-down process when designing computer networks. The main purpose for this monographic study is to be analysed using the techniques proposed by Molina and Hurtado Albir as well as reading material for Network Design students.
Software Project Proposal: Bengali Braille to Text TranslationMinhas Kamal
Software Project Proposal- Bengali Braille to Text Translation
Presented in 4th year of Bachelor of Science in Software Engineering (BSSE) course at Institute of Information Technology, University of Dhaka (IIT, DU).
EVB-Evidence Based Practice- principles,purposes,valuechristenashantaram
This brief out the principles,purposes,value involved in EVB-Evidence Based Practice and helps health, scoial care practisioner to know more about the EVB-Evidence Based Practicein health and scocial care international base.
The Philippine Council for Health Research and Development.docxJamaicaSalvador
The Philippine Council for Health Research and Development (PCHRD)
- is one of the three sectoral councils of the Department of Science and Technology (DOST).
- It is a forward-looking, partnership-based national body responsible for coordinating and monitoring research activities in the country.
- was created on March 17, 1982 through Executive order No. 784. In 1987, Executive Order No. 128 reaffirmed its existence and relevance. This directive reorganized the National Science and Technology Authority into what is now the Department of Science and Technology.
European Pharmaceutical Review: Trials and Errors in NeuroscienceKCR
With many shifts in legislature, and advances in science and technology affecting clinical development in neurology and its clinical studies, it has never been more important to stay up to date with the latest regulations and trends
EVIDENCE –BASED PRACTICES 1
Evidence-Based Practices
Stephanie Petit-homme
Miami Regional University
Professor: Garcia Mercedes
07/05/2021
Evidence-Based Practices to Guide Clinical Practices
In other terms recognized as evidence-based medication, evidence-based scientific practice is elucidated as the careful, obvious, and judicious use of the best indication in creating results for the outstanding care of separate patients. It helps those who brand the choices to device best healthcare practices while drawing the roadmaps for the health system. In clinical trials, the integration of the EBCP entails clinical respiratory medicine considers two fundamental principles. For example, the principle is the hierarchy of the evidence and the art of clinical decision-making.
The interrelationship between the theory, research, and EBP
The relationship between the theory, research, and the EBP supports the three recognition programs. They still relate in terms of the magnet model component of modern knowledge, innovation, and advancement. They describe in a way in which they lead to the promotion of quality in a setting that makes supports professional practices. Second, there is the identification of excellence in giving nursing services to sick people or the people who stay around. For instance, the model, which is other terms the magnet theory, has got five components ( Reddy, 2018).
The first constituent includes transformational management; the additional is structural authorization. The third one is archetypal specialized practices, new information, invention, and upgrading. Lastly, in the model, there are the empirical quality outcomes. For the achievement of the aims of the goals that have been set, there is a need to make sure that the theory, current knowledge innovation, and the improvements and the components that are found in view all the nurses who are located in the levels of the healthcare company need to get involved.
The research has its primary purpose for the help of coming up with knowledge or the validation done for the knowledge that has always been there from before based on the theory. There is systematic, scientific questioning in the research to give the answers to some of the specific questions. It can use the test hypotheses and the rigorous method, the primary purpose of the study being for investigation knowing of the new things and the exploration. There is a need to understand the philosophy of science.
Second, on the EBP, there is no development of the new knowledge or even the learning being validated. The primary purpose of the EBP is to translate the evidence and then apply it to medical executive. It uses the indication available to brand patient-care choices. The EBP goes yonder the exploration as fine as the persevering penchants and ideals. The EBP retains into deliberation that the best indication is for the opinion leaders and the experts. Even though there is the existence of definitiv ...
The Clinical and Translational Science Awards (CTSA) Program: What can it do ...CTSciNet .org
Meeting: Physician-Scientist Career Development Meeting, New York Academy of Sciences, November 3-5, 2010
Panel: Successful Strategies for the Physician-Scientist
Presentation: The Clinical and Translational Science Awards (CTSA) Program: What can it do for you?
Speaker: Lisa Guay-Woodford, M.D., Professor and Vice Chair of Genetics, CTSA director, University of Alabama, Birmingham
View online with audio at http://community.sciencecareers.org/ctscinet/groups/sessions/2010/12/the-ctsa-program.php
Evidence based nursing practice is one of most important for perfect and accurate in terms of saving a life.this presentation covers almost all aspect of EBD
evidence based practice is best for the people working with patients
ebp should be used by the heath care provider.
ebp based upon clinical experties
best research evidence
patient preference and values
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
2. Before knowing what translation Research is, it is
necessary to provide definition of other biomedical
research sections so as to later demonstrate how
they’re all linked to Translation Research.
2
3. Definitions:
What is biomedical (medical) research?
This is a broad area of science that:
- Seeks to find ways of preventing, diagnosing and treating
diseases that cause ill - health in humans and animals.
- It is multi-disciplinary in nature and includes, but not
limited to:- Biologists, Chemists, Physician Scientists,
Veterinarians, Bio-engineers, Computer Scientists,
Dentists, Technicians, Public health and health services
researchers.
3
4. They carry out careful:
- Observations,
- Experimentation,
- Analyses,
- Development and evaluation of new medicines,
procedures, medical devices, and tests to diagnose,
prevent, treat and cure diseases.
What are the traditional major divisions of biomedical research?
- Basic (pre-clinical)
- Applied (Clinical)
4
5. BASIC RESEARCH:
- This is concerned with development of fundamental scientific
knowledge;
- It expands our understanding of how cellular and molecular
processes in living organisms develop and function;
- Mechanisms of disease development and progression;
- It is not associated with short-term therapeutic or commercial
benefits.
- It is however associated with knowledge development
breakthroughs that may take decades to achieve; e.g.
- association of cholesterol and formation of arterial
atherosclerosis;
- association of the gene RPA4 with cancer cells.
- decreased levels RPA4 increased likelihood of
development of cancerous cells.
5
6. CLINICAL OR APPLIED RESEARCH:
Definition according to NIH, US:-
It is research conducted with human subjects or materials of human origin -
tissues, specimens and cognitive phenomena for which an investigator or
colleague directly interacts with human subjects.
It includes:
Patient Orientated Research:
Involves a particular person or group of people or materials from humans.
The research involves:
- Mechanisms of human diseases,
- Therapeutic interventions,
- Early clinical trials,
- Development of new technologies.
6
7. Epidemiological and behavioural studies:
These involve:
- Studies to investigate distribution of diseases and their
determinants;
- Factors that affect health and how people make health related
decisions.
Outcomes and health services research:
The studies involve:
Identification of the most effective and efficient interventions or
services.
7
8. What prevents scientists working in the major divisions of research
from working together efficiently?
1. Basic scientists are not generally trained to think of the clinical
applications of their work.
2. The physical and cultural separation of basic and clinical research
departments in research institutes and universities do not
encourage interdisciplinary collaboration among the scientists.
3. Clinicians are not taught how to formulate research studies
from clinical observations.
4. Clinicians training does not make them appreciate the value of
basic sciences in the developments of new interventions - drugs,
medical devices, etc.
5. Public health scientists may not have strong basic or clinical
research backgrounds - but have community knowledge that
the other two groups lack.
8
9. What should be done to improve working relationships
among these groups to provide quality healthcare?
TRANSLATION RESEARCH.
9
10. What is Translation Research?
This is the area of research that harnesses knowledge from basic
sciences to produce new drugs, medical devices and treatment options
for patients and then ensure that these new products actually reach
the patients or populations for whom they’re intended and are given
correctly.
However, this translation is divided into 2 parts:
T1: This is the first translation block which is referred to “Bench-
to-Bedside” research where new knowledge from basic sciences
gained from laboratory experimentations is used to develop new
methods of disease diagnosis, drugs and disease prevention after
having been tested in humans. This is a bi-directional process, since
observations noted during the clinical phase of investigations can be
chanelled back to the laboratory for further research.
10
11. T2: This is the second translation block which refers to translating
research findings into practice - ensuring that new
treatments, diagnostic tools, other research knowledge actually reach
the patients and populations they’re intended for and are
implemented correctly. This is also a bi-directional process since new
findings noted during the implementation among patients or the
community can be reported back to the scientists for further
investigations.
Why has Translation Research come to matter so much in recent
years?
Translation research has always taken place.
However, over the years, there has been a proliferation of basic
research data, but there has been no corresponding development of
clinically useful products being developed for improvement of human
health.
11
12. What have some countries done to solve the problem?
In their effort to translate available basic science discoveries and those
to emerge in the future, National Institutes of Health (NIH) started
translational research centres at its Institutes in 2006 and launched
Clinical and Translational Science Awards (CTSA).
It was expected to have created 60 such Centres by 1212, which they
did - NIH was spending 500,000 US dollars per year.
The UK invested £450 million over 5 year period in Translational
Research Centres.
Translation research took a significant budget of European
Commission’s 6 billion euro budget.
12
13. It is evident that starting Translation Centres is a very expensive
exercise that can be ill-afforded by developing countries which are still
struggling to develop fundamental systems of both basic and clinical
research.
The developing countries will have to devise a different model for
translation research.
Developing new centres within existing research infrastructure is not
realistic and sustainable for these countries. Their options probably lie
with doing translation research within the existing
infrastructure, forming collaborative teams from both basic research
and clinical research.
13
14. What is the composition of Translation Research teams like?
Translating findings from basic sciences to clinical studies to T1 and T1
clinical findings to T2, enhancing the adoption of best practices in
health institutions and the community, are not automatic processes.
T1 and T2 studies only share a common name - Translational Research.
However, their goals, settings, study designs and investigators differ.
However, there has to be unrestricted interactions between the clinical
and basic research scientists to facilitate the conduct of translation
research within research institutes and universities.
Translational Research Team Composition:
Translational research is a collaborative team effort. One individual
cannot succeed in the venture.
14
15. T1 Research requires:
- Mastery of molecular biology, genetics, basic pharmacology
and other relevant basic sciences, trained clinical scientists,
data documentation specialists, appropriate computer
software for data analysis.
- Evaluating the results in the context of global systematic
reviews.
T2 Research requires:
- Mastery of the implementation science of fielding and
evaluating interventions in the community.
- Disciplines that inform the design of such interventions -
clinical epidemiology, evidence synthesis, communication
theory, public policy, financing, organisation theory, systems
re-design.
- Data Documentation Specialists - Appropriate data entry
software and search engines to access systematic reviews.
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16. Team Composition:
Multidisciplinary professionals, laboratory based investigators, clinical
investigators, public health specialists, biostatisticians, data
managers, computer specialists.
What are some of the challenges to be expected during Translational
research knowledge - T2?
- Large volumes of research evidence being produced,
- Access to evidence sources,
- Time to read the evidence sources,
- Skills to evaluate and understand research evidence.
However, this challenge can be surmounted by:
- Developing clinical practice guidelines;
- Electronic libraries of health and public access
evidence sources.
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17. - Organizational barriers - lack of facilities and equipment, and
inappropriate skill mix.
- Peer group barriers - e.g. local standard of care not in line with
the desired practice.
Professional-patient interaction (communication).
- Community - socio-cultural barriers
- level of education
- Policy makers:
- Ignorance of the new quality improvement tools.
- Bias towards what is commonly known.
- Pricing of alternative tools.
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18. Does KEMRI engage in Translational Research?
KEMRI does engage in translational research, but not regularly and
consistently.
There are well developed structures to conduct robust translation
research.
There is very little interaction between basic research and clinical
scientists.
Whatever interactions exist are initiated informally by the concerned
scientists and do last for as long as the research that brought the
scientists together.
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19. However, some clinical researchers would occasionally interact with the
Ministry of Health if they’ve what they think can be used to manage or
prevent a certain illness - e.g. PVC10 by the Kilifi group - a vaccine against
pneumococcal lung infection in children.
Resistance of malaria parasites to chloroquin - led to change of policy to SP
(Fansidar).
Resistance to SP - Changed to COARTEM.
In conclusion, a robust platform for T1 and T2 translation research will lead to
the development of new tools to prevent, diagnose and treat illnesses.
It should begin with a few scientists - basic and clinical coming together to
form a research translation team at the Institute and then ensure its
sustainability by putting in place permanent structures for the purpose.
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