Posts Tagged ‘medical innovation’

Isn’t it time we flipped around the old ‘divide and impera’ (‘divide and conquer’) strategy attributed to the Romans and used for centuries to assert dominance? (The correct Latin term for “unite” might be “iungo”, but you get my gist). While the strategy has pretty effectively helped many generals and emperors take over large pieces of our world’s map, I am proposing that it is also the single most important reason for which most major empires have ultimately failed, being reduced to history book chapters or precious relics needing the controlled environment of museums to survive… This should not remain a history book story, but a living lesson for today’s world.

Now, fast forward to what is happening in the pharmaceutical industry today, where several companies that have dominated the world of pharmaceuticals, not unlike the great empires with their own achievements, territorial claims and peculiar corporate cultures are marching toward the “patent cliff”. The causes for what I believe is essentially a pharma innovation problem could fill in many posts. The current pharma model is increasingly more analyzed and scrutinized and thought to be unsustainable. Every day brings new stories that have created for me the vision of  a pharma’s “python phase”. To feed their draining pipelines, many companies ingest and digest consecutive boluses, M&A, expansions and cuts, which constantly inflate and deflate their bodies. What I decided to do here is to simply summarize how observations I made from a completely different situation – to me, a great way to learn! – may hold clues about other powerful strategies to survive life-or-death challenges.

I have recently learned about the practical and harmonious solution to survive the extreme challenge of the frigid waters in the Bay area during my recent visit at the Dolphin Club, a swimming and boating club in San Francisco. I have already raved elsewhere (Sports-inspired life and business lessons) about my admiration for its members who challenge the frigid open waters of the bay. If I had to summarize in only two points what was needed to survive those waters from an individual perspective, it would have to be: 1) cross-training and 2)… being “Zen”! But I also learned fascinating things about the strategy that constitutes the basis of the club and about its inner functioning from Reuben Hechanova, the current boat captain and upcoming 2011 president of the club. Everybody has to share learnings such as hypothermia classes and to regularly work together to maintain the wooden boats, even if they are not rowing them, as one day they may save their life. While touring the club one of the returning rowers reported to Reuben having had a “fantastic” row! “I had the opportunity to save a swimmer who was beginning to experience hypothermia”. These people not only share the waters (politely giving way), but they closely collaborate to successfully conquer them. For instance, I learned that for long swims, the club members move in a well-orchestrated formation, again reminiscent of the Roman’s tactics, with the swimmers in the middle surrounded by small boats, while all being flaked by the bigger wooden boats protecting from them from the potential impact of passing tankers and being ready to take back to safety anyone succumbing to hypothermia. In my many years as a rower, I had never come across such tight symbiotic collaboration between swimmers and boaters. I believe the reason is that I do not know of any other place that chose to deal with such an extreme challenge: normally rowing clubs have rules that require members to stop operating when the water temperature gets too low to be comfortable for swimming (to prevent hypothermia in case the rower accidentally falls into the water). Most outdoor swimming facilities close even earlier in the year! But, what is one to do in San Francisco, where the temperature of the Bay waters is never warm enough for most people to comfortably swim in it? Here, some people choose to jump into frigid waters and seem to love it, but not before having a survival strategy in place that capitalizes on the close, symbiotic, collaboration between rowers and swimmers. Rowers need to be able to withstand swimming if needed, swimmers need to be able to rely on or become rowers should one need to be saved from hypothermia.

Just had a great row... saving a swimmer!

So here are the three main points I derived from my recent visit about how collaborations may work for survival:

1. Goal/Need to conquer the same domain/major challenge, e.g., the frigid open waters.

2. Have complementary strengths: some are experts at moving inside the water, some over it.

3. Should share enough trust, knowledge, and capabilities to be able (and willing) to jump to the rescue or even into the other’s shoes, in this case, at the drop of an oar!

Also based in San Francisco is the UCSF. Last week, a press release announced a major common effort with Pfizer, which is expected to lose exclusivity for world’s largest ever earning drug, Lipitor, in exactly one year from now . The waters below that patent cliff might be very frigid indeed! We applaud this trend, it may produce some of the greatest example of ‘unite and impera’ our common global challenge: developing new therapeutics to address the unmet medical need. Let’s see, do the other, sports-inspired lessons apply? Do the two partners have different strengths? Check: academia excels at the “fuzzy” innovative front end of life science discoveries, while pharma’s strength is the late stage development and commercialization of therapies.

And, how about the third lesson: How much do pharma and academia share in terms of trust, knowledge, and capabilities? More and more facilities that are appropriate for drug development are becoming available, either “for hire”, being used by or built for academia’s and other self starters’ use. Mind you, several have been deserted specifically due to pharma’s budget cuts, including Pfizer’s own site demise in Ann Arbor, Michigan, and many are operated via new government programs. Do I dare say the major lasting dividing problem remains the lack of trust and knowledge sharing, not only of intellectual property (IP) per-se, but even that of common “know how” of drug development. A better shared understanding of “what” and “how” to develop a new medicine will only increase our common ability to conquer diseases. This knowledge, “as good as gold”, could be as enabling as the precious coins made of it, or, if not shared, will remain as elusive as the buried treasures of a lost pharma empire.

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In a recent, widely anticipated decision that pertains to rights to some of what makes us us, a federal judge ruled in favor of patients, medical societies, and researchers, who were suing Myriad and the Utah University research foundation, owners of the patent on the two genes whose mutations had been associated with increased risk for breast and ovarian cancer, BRCA1 and BRCA2. Their ownership had allowed them to retain complete rights for these widely prescribed diagnostic tests, which have remained prohibitively expensive for many patients (currently at more than $3,000).

Interestingly, in taking the decision to invalidate such patents, the Department of Justice differs in its opinion from the US Patent and Trade Marks Office (USPTO). Meanwhile the status quo will be maintained. The Biotechnology Industry Organization (BIO), the organization that lobbies for the pharma and biotech companies, has been arguing since the beginning of the case that preventing patenting of human genes will literally impede life science innovation and had stated after the court’s decision that carrying this one out would: “undermine U.S. global leadership and investment in the life sciences”. A variety of people have spoken for and against the decision. The New York Times just wrote an article citing several of them.

The US government filled a “friend of the court” (or “Amicus curiae”) opinion entitled: ”BRIEF FOR THE UNITED STATES AS AMICUS CURIAE IN SUPPORT OF NEITHER PARTY” (you can read the pdf here ). As expected with these types of opinions (see Wiki)- and indicated by its title – the intent was not to support either of the parties. The last point listed in the government’s opinion constitutes a good summary: “Isolated Genomic DNA Is Not Patent-Eligible Merely Because It Is Useful Or Requires Investment To Identify.”

As someone who has dedicated her life to improving human health: I understand the need to recognize and reward discoveries, so that they may continue to advance the available diagnostic and therapeutic interventions. At the same time, in my opinion, a balance needs to found – or maybe a line needs to be drawn. Otherwise, these innovations will remain out of the reach of many patients who need them. The exact balance may not be easy to figure out or accept by consensus.

To what point should we own things we just happened to be the first to discover/figure out? Should various entities (researchers, universities, companies) own pieces of everybody’s proteins, DNA, or maybe their constituent atoms, electrons or the even more ephemeral particles and their interactions? These are all things that make us us. Or, going in the opposite direction, should each disease/syndrome or epidemic have owners that need to be paid before we could proceed with curing them? Am I right to assume that in such case, arrangements and payments would need to be exchanged between the owner of the gene and the person who had discovered the disease, with corresponding arrangements with those who had patented the smaller molecular or atomic pieces of the puzzle? How are we ever going to navigate such complex territorial and legal claims? Maybe Google could develop maps of the human body charting out the parcels to indicate ownership? I am on the opinion that we should only own things we create ourselves. In relation to this specific discussion, I think it is appropriate to own the rights to a new method to test or to control a gene, or a newly created molecule that could be used for diagnostic or therapeutic effect.

I know patients who were unable to take advantage of the BRCA test because of its prohibitive price and who knows how many more cases we might have failed to diagnose and treat because of these legally imposed economic barriers. Can you imagine that currently the actual cost of performing such a diagnostic test is only a few dollars? Would it be possible to compromise by assessing limits on the profit margin of diagnostic tests? I feel that we need to ensure that the initial intent – or what many say is – of our efforts to improve human health is not compromised.

What is your opinion? Should those sequencing one of the genes we all share – and its mutations – gain the exclusive rights to any diagnostic or therapeutic intervention that is related to that gene? Do you know who owns YOUR genes?

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Great quality life sciences fuel medical innovation, but great science usually requires “happy scientists”. Where are they now, and what can we learn about that makes them happy? Are they different from other people?

From the beginning I need to say that I can’t claim to have the definitive answer to this question. However the subject has been interesting to me as an educator and manager of scientists, and here are some personal comments triggered by looking at the 2009 surveys published by ‘The Scientist’, a magazine specializing in the life sciences, as well as other independent studies I had found on the overall topic of work and personal happiness. In case you can’t tell, these contain information that pertains to the factors that make scientists (and other working people) happy…

In their 2009 annual survey of “Best places to work” in academia, they listed the ‘top ranked 40 places’ in US and the ‘top 10 ranked internationally’ (you can see their surveys and methodology here). As someone with a scientific background would instinctively do, as soon as I saw data, several potential explanations immediately came to my mind (as well as more questions, that generated hypotheses I think would be nice to test…) But let me start with the data collected and made widely available thanks to ‘The Scientist.’

What makes an institution a great place to do science?
Venture some guesses? I will make the assumption that overall the responders’ sense of satisfaction for their place of work is related to its listed strengths. Those most often cited by all top ranked 40 US academic institutions were: ‘Research resources’ and ‘Infrastructure and environment’ (17 times each), also ‘Job satisfaction’ (11 times) and ‘Teaching and mentoring’ (9 times).

At my very first inspection, as one would expect, what caught my eye were places I am very familiar with (two of my previous home institutions). More specifically, Emory University in Atlanta, Georgia made the list within the top 5 (at #5), while Brigham and Women’s Hospital, in Boston, MA came in at #39. The strengths listed for Emory were ‘Peers’ and ‘Job Satisfaction’, while for Brigham and Women’s these were ‘Management and Policies’ and ‘Infrastructure and Environment’.

Interestingly (I think) the ‘Pay’ category is cited as a strength only for 10 out of the top 40 institutions, and only once in the top five (University of Oklahoma Health Sciences Center, Oklahoma City, OK). Furthermore, the specific example that struck me when looking at the other survey about salary levels, was the observation that the average pay in the state of Georgia is lower compared to other US states, with the sole exception of the state of Ohio. Of note, another Georgia institution, the Medical College of Georgia, Augusta, GA also made the top 40 list in 2009, at #14. Again, I’m making the assumption that the “happy customers” of the first survey were the same with those paid less than the average US academic pay (a ‘side thought’ that came to mind was: ‘they might become less happy after seeing this US salary survey!’). Thus, based both on overall weight and the specific case, the pay per se did not seem to dampen scientists’ enthusiasm (at least not for these two GA work places!) One factor that was important was “job satisfaction”, which might be harder to define, yet there is information available on what motivates people and makes them feel they had a “great work day” (including later in this post).

Also, worth noting are the specific reasons for which some institutions are top and/or climbed really fast in the ranking. The institution ranked as #1 in the US, is Princeton, very small with only 203 full-time life scientists, which helps foster – indeed forces! – interdisciplinary collaborations/relationships. Max Planck’s Institute of Molecular Cell Biology and Genetics in Germany which ranked as the top institution internationally, also encourages strong cross-field collaborations and social interactions between scientists, strongly supported by their unusually democratic leadership system. Interestingly a common theme that lifted the University of Oklahoma Health Sciences Center in the US ranking from 30th to the #4 place and brought the University of Groningen (in the Netherlands) directly at #4 in the ‘top 10’ world-wide, was their focus on recruiting and supporting young talent.

Thus, the 2009 survey results seem to be consistent with the fact that scientists are happiest when they are able to do the best possible science. This requires not only passion, curiosity, resilience, dedication, hard work, from the researchers themselves, but also a supportive environment, specifically enabling interdisciplinary collaborations through appropriate institutional policies and infrastructure. Hopefully administrators, regulators, and others with the power to influence the enviroment (of universities and other science-driven institutions) are paying attention to this type of feedback.

Do these findings surprise you in general/ do you work in any of these places? Any additional insights?

What makes people happy with their work in general?
This refers to the ‘job satisfaction’ definition, but also to the question whether things that make scientists happy are any different from those important to other professions?

For instance, the results of these scientists’ surveys seem to challenge the conclusion that ultimately “work IS about money”, as Susan M. Heathfield had drawn from her own research about what motivates people at About.com Guide, yet they likely do not surprise many of us. We all know many great (even if not famous) scientists who think more about giving through their work, rather than obtaining something from it, unless one would say they obtain the satisfaction of being able to figure out things that will ultimately “save the world”? Ms. Heathfiled does indicate – seemingly in an effort to recognize that some people have different motivation that: ’Some people work for love; others work for personal fulfillment. Others like to accomplish goals and feel as if they are contributing to something larger than themselves, something important. Some people have personal missions they accomplish through meaningful work. Others truly love what they do or the clients they serve. Some like the camaraderie and interaction with customers and coworkers. Other people like to fill their time with activity. Some workers like change, challenge, and diverse problems to solve.” Nice summary of why most scientists do their work, don’t you think?

An older theory known as the “Herzberg’s motivation-hygiene theory”(or the “two factor theory,”) suggests that job satisfaction and dissatisfaction are determined by different factors. This already indicated that the salary per se is not a positive motivator, but rather a “hygiene” factor.

  1. Factors that are work ‘motivators’ include challenging work, recognition, responsibility which give positive satisfaction, which arise from intrinsic conditions of the job itself, such as recognition, achievement, or personal growth.
  2. The work ‘hygiene factors’ which Herzberg suggested do not trigger positive satisfaction, are related to the work environment (e.g., company policies, supervisory practices, or wages/salary), and not necessarily related to the work itself, include: status, job security, salary and fringe benefits. However their absence leads to dissatisfaction, hence the name “hygiene” (its absence is hazardous).

What defines a ‘great work day’?
A Harvard Business Review study published in the latest issue (Amabile, T. M., Kramer, S. J “What really motivates workers”, HBR Jan-Feb 2010) concluded that the biggest factors in defining a workday as great was the perception of “making progress” and collaborations.

The authors underline the important role of the manager in making workers feel they had a great day. In the scientific slang, in an academic, as well as biotech/pharma laboratory, this personal might be refered to as the Principal Investigator (PI).

What a leader/manager should do:

  • Clarify goals
  • Use glitches as learning moments
  • Cultivate a culture of helpfulness, including rolling up own sleeves to pitch in
  • Recognize real progress (otherwise praise loses value)

The top three things a manager should avoid doing:

  • Changing goals autocratically
  • Being indecisive
  • Holding up resources

What makes people happy: common denominators and “diversity” in happiness

This is not off the topic, but it’s rather considering the whole person’s “happiness” as a combination of personal and professional aspirations.

In studying how personal/individual factors contribute to the overall human feeling of happiness, another report revealed that in fact both women and men share the two main sources of happiness: achieving professional/financial aspirations and… being married! (Plagnol and Easterlin, the Journal of Happiness Studies). These authors also discovered an inter-relationship between gender and age and happiness. Their conclusion was that… “Women end up less happy than men” because they feel less able to achieve their life goals. Women begin life happier than men but the difference wears off and by 48 yo, men are in average happier that women. Here are some age milestones that stood out from the gender comparison:
o 41: Age at which men’s financial satisfaction exceeds women’s financial satisfaction
o 48: Age at which men’s overall happiness exceeds women’s overall happiness
o 64: Age at which men’s satisfaction with family life exceeds women’s satisfaction

Harvard experts cited by Physics.org suggest the following rounded approach is most likely to create overall (lifelong) happiness:

  • Eat thoughtfully, exercise often, have daily ‘quiet’ time,
  • raise your children well, teach them to be kind!),
  • stash a few bucks away,
  • and ‘stop thinking it’s all about you! ‘ Giving money away creates lasting happiness compared to spending it on oneself which only creates a ‘buzz’, the kind of happiness that wears off quickly

What makes working couples happy?
Sharing responsibilities for paid (professional) and unpaid (house chores) work apparently works well in making working couples happier and more productive. For more insights see “Power couples”, The Scientist 2010, Volume 24 (1): 55.

What makes YOU happy?


• ‘Best Places to Work 2009: Academia’, The Scientist Volume 23 (11) Page 43, 2009-11-01
• Heathfield, Susan M. ‘What motivates people’, About.com http://humanresources.about.com/od/rewardrecognition/a/needs_work.htm
• The ‘two factor theory’ http://en.wikipedia.org/wiki/Motivator-Hygiene_theory
• Plagnol, Anke C. and Richard A. Easterlin, “Aspirations, Attainments, and Satisfaction: Life Cycle Differences Between American Women and Men.” 2008, Journal of Happiness Studies, http://www.springerlink.com/content/4j11681jx415315k/
• Wiens Carl, ‘Power couples’, The Scientist 2010, Volume 1: 55, 2010-01-01

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Oral session at an AHA meeting (AHA picture)

Oral session at an AHA meeting (AHA picture)

This topic popped up as I was working on putting together my itinerary for the upcoming annual meeting of the American Heart Association (AHA). Conferences are especially stimulating for me, as they represent a great intersection of people and ideas. Some may say planning should not be a big deal after years of attending conferences; yet, I can still easily become overwhelmed by rich content gatherings that bring together more than 20,000 people. My zest becomes my biggest problem: it may seem that during any of the long days, I would profit from and enjoy being able to attend more than a half a dozen… simultaneous presentations! So here are some thoughts:

Knowledge/Content: putting together an action plan!

1. Browse topics and speakers ahead of time. I know, I have trouble making proper time for this beforehand, but it always ends up being the best strategy to make the most of my conferences. Postponing until close to departure never works, somehow fires that will need to be put out will always occur just as I am about to take off…

2. Define your strategy, i.e. main goal(s). Ask yourself “what is the most important thing I could bring back after this year’s conference?” Will I want to be able to say: a) “I learned the latest details about a specific project I am working on” b) “I had the opportunity to meet/follow the work of… (specific people/groups)” c) “I was able to check on a specific technology” or d) “I got a good sense of the ‘hot topics’/ future trends?” When in doubt, dig deeper into who/what will be available at this year’s conference, e.g. read abstracts, quickly Google subject/presenters. Learned from experience: frequently the title is more interesting than the content itself! Maybe including in your schedule some of each works best. If on the other hand, the main purpose is to present your own stuff, make sure you alert/invite the people who should hear it. And don’t forget to plan time to check on the room, equipment, or to talk to potentially interested people after the presentation.

3. Use all available scheduling tools to make your life easier (e.g., online planners, personal calendars, alerts, etc.) Prioritize the content, produce a plan/schedule, and find information fast and easily (even when your brain might be half numb).

4. Check on feasibility of reaching presentation locations – can you actually make it from one event to the next on your schedule? If not, have a plan B, could be even just take a quick break and regroup rather than frantically missing half of the next event.

5. Be flexible and nimble, not only in terms of running from one session to another, but if you find that an unexpected topic is capturing your imagination, go for it! You may catch up with the previously planned speaker or topic another time or way.

6. Avoid the “burn!” After a couple of busy conference days, this is to be expected, plan even more purposefully, including breaks. “Spice it up”: mix various formats, contents. Don’t give up easily on your daily exercise routine, unless you really get a lot of mileage walking from session to session. There is also a benefit from using different muscles, maybe use the chance of having a hotel pool to swim instead?

Attendees – interacting with people at meetings is as important as absorbing the content – make time for them! I found that while this is engrained into the business culture (see my previous post on the professional benefits of social interactions at conferences), this may not come naturally to many science or technology-oriented people.

1. Attend interactive sessions, e.g. posters, they usually allow more quality interactions than the plenary sessions. Match your content priority with the format (or… strategy with tactics!), i.e., poster sessions are best for digging into technical details with the presenters, oral/plenary sessions are better to get a bird’s eye view of trends or hear what others might say/ask about a topic .

2. Listen and ask lots of questions, but, please, please, not as a series of excruciatingly detailed questions after an oral presentation… Avoid being one of those people! You will not be making any friends as you will be wasting everybody else’s Q&A great opportunity by insisting on some detail you only are interested in, and you might publicly demonstrate being the last one still in the dark… Asking the presenter technical details after the session always works best.

3. Best opportunity to make contact with people whose work you have followed. One of my greatest thrills when I started going to international conferences was to put a face on a name I only knew from their scientific reports, likely equivalent to that felt by people meeting their Hollywood favorite stars. Schedule time with these people ahead of time (authors’ contact info is mandatory for published reports, or you can Google any academic), or just plan to be where they are likely to be during the meeting to do some “star-gazing.” Take the opportunity to introduce yourself, be very brief, unless invited to elaborate.

4. Re-connect and stay in touch: Use conferences as an opportunity to touch base with previous colleagues, collaborators, mentors, who now work in different locations. Most people feel safer spending the whole time huddling with their current buddies, but you can do that without having to travel. Schedule meetings that do not interfere too much with the “flow”, e.g. go see them by their poster, after their presentation, attend alumni events, or purposefully schedule coffee, lunch, drink, etc. You can use social networks (e.g., LinkedInTwitterMy Lab Your Lab) to signal you will be attending or send invites. Use these after the meeting to re-connect and stay in touch.

5. Network! Go beyond the “known,” make an effort to strike up a conversation with people you don’t know, even if they do not work in an area directly related you current interests. It is often the best opportunity to learn something truly new and come back with great ideas for novel projects. For instance, ask people what are they working on, what is the most exciting angle/topic to them? By doing this, I became aware of a lot of great concepts that I was then able to connect with my own areas of interest and I also identified new collaborators to help me apply them, similarly, a lot of people found me! An easy recipe for innovation. Don’t forget to exchange contact information. You can also “solidify” new connections by inviting people to become part of your professional network.

Did you have some good tips to share with us?

I probably forgot many tips, but a very important one I have to make sure I don’t forget before going back to refining my overloaded itinerary (and packing)… Wear comfortable shoes!

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I just returned from the NIH where I was invited to lecture on translating science into therapies. I had presented my science there before and I was not quite sure how interesting they might find my broader perspective, which I had entitled: “The long course from ‘the Aha!’ to cures: can we do better – together?“

The standing room only audience provided a first clue that emphasis is evolving at the NIH… During the Q&A and in talking individually to several people, I could sense their intense interest and excitement regarding the many challenges – and opportunities – created by the translation of basic science into positive health outcomes. Several independently pointed out that Francis Collins, M.D., Ph.D., took no break from being confirmed to making his first appearance as the new NIH chief where he announced what he hoped to accomplish during his term. The overall underlying message was clear: no time to spare!

For those relying mainly on the funding that comes from the NIH to carry on science, it is very important to understand what the change at the NIH helm might mean for its future directions and priorities to increase chances of successful funding. In the bigger picture, all of us will be affected as the NIH-sponsored research is a major – if not the major – source for the new ideas that become one day life saving treatments. I dare to say that the success of these ideas is in no small measure due to the fact that the NIH, throughout various administrations (maybe in spite of?), has been one of the original and perennial implementers of innovation models, yet not even themselves might think of it that way. For instance, the NIH has a signature initiative called an “RFA” (requests for applications), where they invite independent researchers to submit proposals related to specific scientific and health questions, and they fund the winners. Isn’t this a classic case of “crowd-sourcing”, implemented way before the term was coined? The NIH also has an “RFP” (request for proposals) mechanism by which they contract projects with the various independent winners and create the network needed to sustain the project – isn’t that what is called elsewhere “out-sourcing” and “open innovation”?

I could not find a script of Collins’ speech, but I watched it for you! Here is a short run down of what he announced as his top 5 priorities for the NIH during his term:

  1. Apply new high throughput (“comprehensive”) technologies (e.g., nanotechnologies, genome wide-scans, proteomics) to understand fundamental biology questions as well as causes for different diseases.
  2. Emphasize translation of basic sciences into treatments, making “discoveries amenable for public benefit”
  3. Put science to work for the benefit of the heath care reform: “inform the conversation based on scientific evidence not on prejudice” by performing comparative effectiveness studies (e.g., study effect of life style changes vs. therapies for treatment of diabetes)
  4. Put greater focus on global health, including AIDS, malaria, tuberculosis and other major diseases in developing countries, by working with them in research and helping them develop their own capabilities
  5. Reinvigorate the biomedical research enterprise by making sure that funds are available to support younger investigators, increase work force diversity, encourage risk taking and innovation.  

I for one, cannot but applaud and embrace all these goals. Even as an academic researcher, I have always sought to “begin with the end in mind”, or how I like to refer to it “going back to the future”. In my case, this means starting with examining the real life case (the patient) to formulate the questions to take back to the lab for study in detail, increasing the chance that the answers from our research would be used to alter for the better the patient’s health in future

Some of the more hard core basic researchers might not entirely feel comfortable with the emphasis on translation. I agree that there is a fundamental need for fundamental research: the pursuit of questions that are so “out there” that no one can really tell where they might lead us or what they might connect with. Yet, after putting a lot of bright dots on… the blue sky, some need to concentrate on seeing patterns and be able to connect them, yet others will need to start figuring out how we might touch upon the new dots and patterns. I see the issue of translating science not as an imposition on fundamental research, but as an invitation to an open intellectual dialogue between basic, applied and clinical scientists, as well as product developers, regulators, and the public, where all can contribute with their own proficiency: the “constructive interference” effect. It is still not easy most of the times, as many places still operate based on narrow definitions of expertise and make make others feel as strangers in a stranger land. Thus, making scientific innovation happen for the benefit of humankind will require skilled, open-minded, and maybe fearless translators who can make sense of various intellectual languages and lands

Here is a list of related links:

Francis Collins, M.D., Ph.D., inaugural address to the NIH

About Translational research

The NIH Overview

In Wikipedia

Nature Medicine: In the land of the monolingual

NIH Funding opportunities for translational research

NIH-RAID (Rapid Access to Interventional Development 

NIH Translational research meetings

The NIH Roadmap

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You guessed it! Location, location, location

A new research study from my Alma Mater, McGill University in Montreal, demonstrates major DNA differences between genes in blood cells and tissue cells of the same individual. Specifically, the researchers found a DNA mutation (of the BAK gene involved in cell death) in the tissue cells harvested from patients, but not in their blood cells. This study and other recent ones challenge the major current assumption under which we have operated for years, i.e. that our DNA is the same in all the cells throughout the body, a specific master template faithfully reproduced in each of us. We are not talking cancer where local mutations are known to occur in tumors. What does this mean for you?

–       As a researcher, therapy and/or diagnostic developer, etc., it means that you will likely have to look in the right place in the body, analyzing “the right” (relevant) cells. This is exciting, as it opens up a lot of potential great discoveries, cures and diagnostics. It is also good news for those who had set up or already work with tissue banks (is anybody reading: much more work needed? are we going to run into the needle in the haystack issue?)

–       As a regulator, decision maker, media, etc. you will have to realize that there is much more to come, so you might want to give it a chance… Many have begun not only to openy question the wisdom of genetic testing to derive disease associations, but to actively block any initiative along these lines.

–        As a patient and consumer of health innovation, you might have to be willing to allow removal of tissues (other than blood) from your body for accurate genetic testing. Only you can decide if that is good for you…

Yet another dimension is being added to “personalized medicine”. The biology of our bodies includes features that are manifested and influence locally and systemically (globally). The genetic information is less global than previously thought. Thus the testing, treatment and care will need to be not only tailored to the individual, but also to the specific tissue/body component affected and targeted for prevention or cure of the disease.

So, coming back to the old tried and true wisdom, when it comes to our most precious piece of real estate, our own body, we will need to chose wisely the location (of genetic testing, treatment, etc.)…

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Recently I was fortunate to hear Professor Leon Lederman, Physics Nobel Prize Laureate 1988, speak and to continue with him the conversation regarding understanding science. He is not only brilliant but also very funny. His main message was that nature is likely very simple once we finally understand it. He also emphasized the need to be able to explain science to a large audience in order to engage others.

His opinion completely resonated with my own central belief that a few fundamental principles could explain – and rule – nature in her many representations. Maybe this is because I started my own scientific education journey with Physics then went on into biology and medicine, or maybe it is why I pursued my education in that order (mentioned in an earlier post on our educational journey). In fact, Professor Lederman is on a crusade to re-haul high-school science education. He believes the sequence in which this is currently taught in the USA is wrong and that students should be first introduced to Physics, then go on to study Chemistry, and finally Biology (the exact sequence I pursued myself!) He argues that we should be building up the knowledge of our world from understanding the few elemental particles to studying the list of chemical elements, and then go on to studying the much more complex collection of biological systems. As a simple yet brilliant demonstration that something simple could the basis of something much more profound, Professor Lederman offered the following thought: “consider for instance a simple problem such as: Johnny drives at 60 mph from point A to point B which is 360 miles away. How long will it take him to get there? When solving this problem, you are basically… predicting the future!” (If only Wall Street would be better at that…)

Agh, I finally felt understood! To me, physics is all about fundamentally simple building blocks, about learning a few fundamental principles (like E=mc2) and using them to deduct anything else needed and build up from there. As I might have mentioned somewhere else, the perceived simplicity and lack of expectations to memorize things were the very reasons due to which I had decided to begin my scientific training to become a biomedical researcher with Physics. Later, during my years among biologists and physicians (yes, I did not mean physicists), in the process of analyzing puzzles presented by biological systems I often raised eyebrows when expressing my fundamental belief: “It just cannot be so complicated. If it were… we would be broken most of the time. It must be simple, we just don’t get it!” If starting with this premise, one makes a conscientious effort to ask the “simplest” fundamental question that might explain the observation (allowing the quickest way to confirm of infirm the hypothesis) and then design the simplest experiment to test it.

And, I think Physics is all about unifying theories and the “big picture!” On the other hand, biology’s building blocks are already rather complicated and display great apparent variability, and it only gets harder from there! Biology delves into the details and variability of things, while physics constantly seeks the unifying themes. A quick analogy of the difference between physics and biology can be gleaned from the quintessential tools used by these two scientific disciplines: telescopes and microscopes. The first can help one see galaxies millions of times bigger than us and the world we came to know, all captured in one little circle, and they all look basically very similar, some sort of “speckle”… The other type of tool, reveals the extraordinary intricacy and variability of worlds millions of times smaller than us and the microscope calls for … two (!) oculars to do it.

The same quest for simplicity should guide our efforts to solve any outstanding problems: great solutions, as well as great innovations, are really simple. These rely on ideas that are easy to understand, therefore easy to design and build, test, implement, and easy to “sell!” If you still have doubts about this, think of the proverbial “30 seconds elevator speech” or consider the continuously rising popularity of Tweeter (if can you say it in 140 characters, we’ll read it and might be persuaed to became your followers!). One should be able to explain the most brilliant ideas in a few simple sentences. This is the surest way to win support, whether it is in terms of human following, gaining resources, or the funding needed to develop it. When the benefits of the innovation are obvious, the product literally sells itself.

While travelling I was pondering the concept of the beauty of simple innovations, so I was more tuned into observing them around me. I don’t know about you, but I used to cringe every time I got into the shower of a hotel room knowing that in spite of my best efforts the curtain will be sticking to my wet body. I knew they did not change the shower curtain too frequently, and I dreaded the almost certain occurrence. However, lately, this daily stress has completely disappeared. Thank you, inventor of the… curved shower curtain rod, whoever you are, you deserve all the royalties for this simple innovation that finally allows me to start my days completely refreshed.

Simple is beautiful!

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