A handful of visionary US universities and the US National Institutes of Health (NIH) have also seen a more perfect health future, and it is nanomedicine. They are spending sizeable sums on risky but imaginative nanomedicine projects intended “to stimulate really big leaps forward in research.” This, and the recent announcement of the first 12 of 60 planned NIH “Clinical and Translational Science” awards, attests that through its “Roadmap for Medical Research” strategy the NIH knows that the acceleration of innovation in medicine requires proactive management if it is to be safe and efficient, and requires re-engineering of the traditional medical research model.

Others too are looking beyond the traditional way of doing things. In the private sector, for example, the X Prize Foundation, which in 2004 awarded a million dollars to a team that flew the first private craft to the edge of space, is now offering a similar prize to the first team to sequence the complete genomes of 100 individuals in 10 days. And in the (non-medical) military sector, the teams that built robotic cars able to drive themselves around a complex course in the Mojave Desert are gearing up for the next Grand Challenge: To build cars that will drive themselves through a 60 mile urban course. This will be the final step toward a paradigm shift in transportation, where vehicles can be called and dispatched at will. Your car can drive you to the office, then return home to take the kids to school, then park itself somewhere convenient and cheap or free until called to pick you up.

* * *

If Google was an important development in the life of the Web, a “Google” of the genetic influence of specific drug compounds and specific diseases in human cells is an important development in pharmacogenomics and systems biology. Though published in the respected scientific literature, the opening on the Web of this free “drug-discovery Google” has not received nearly as much attention in other media as it deserves. Five years from now, anyone working on a potential drug will, as the first thing they do, quickly “Google” it to see what diseases it might work on.

Source article

Healthcare pundit and physician Richard L. Reece predicts that by the year 2020, the US will have “a market-based, consumer-driven [healthcare] system with enlightened private-public partnerships.” Medical practice will be evidence-based, and consumers will “know what they want, what to expect, what to demand, and how to control completely access to their sensitive personal health data.” Health spending will have been capped at 20 percent of GNP, and Americans will “brim with good health and delay disease until late in life,” which will mean, on average, 90 years old. Key enablers of this Utopia will be “free genomic profiles at birth” and cardiopulmonary stress testing of all citizens at age 35. Allied to artificial intelligence-based predictive computer modeling, these tests will point to gene therapies that will stop the advance of many previously irreversible fatal diseases, including heart disease and stroke. Improved worker health will beget improved productivity will beget healthier corporate bottom lines.

The US will have “outlawed junk foods, banned smoking, prohibited drinking, enforced healthy eating, mandated pedometers, restored school recesses, required suburban sidewalks, rationed driving mileage, and even policed children’s hours before TV and computer screens.” It will have “universalized, standardized, and controlled healthcare coverage and access, fee schedules, price transparency, pay-for-performance, diagnostic support measures, episodes of care costs, interoperable computer systems, quality indicator compliance, consumer health information, evidence-based medicine, practice variations, best practice protocols, personal health records, doctors’ charts, and medical histories.” What it will not have are hospital systems, “only large multispecialty clinics with joint physician-administrator leaders and hospital subdivisions. These clinics cover and dominate geographic swathes of territory. In megaclinics, subspecialists and specialists use the same joint prostheses, coronary stents, and cardiac, neurologic, pain implant devices and share the resulting savings.”

Primary care will have been “saved” because of technology-driven efficiences and because consumers will pay up at the point of care, where “sellers and buyers” (doctors and patients) can also “right wrongs of care and can rate on everyone within the system, guaranteeing no one cheats, strays, or profits unduly.” Misinformation, maltreatment, and malpractice will be things of the past. There is a perfect balance between legality and rationality, regulation and innovation, instantaneity and spontaneity, collectivism and individualism. “All is well. All is swell.” Reece concludes with a caveat: That the patient-physician relationship, and freedom and decision-making latitude of doctors, have been overlooked. It is not clear whether he means overlooked in his argument, or overlooked in 2020, and it is not clear to us that they matter.

Nanomedicine at Georgia Tech

Source article

On top of funding for a US$11.5 million nanocardiology lab and a $19 million nanocancer center, Georgia Tech has now received a $10 million grant from the US National Institutes of Health to build a nanomedicine center. All this is just part of an overall plan for a $90 million nanotechnology center. Georgia Tech and its collaborator Emory University will jointly have the only program in the nation with three nanomedicine centers. MIT and Harvard University have two, as does University of Washington. Columbia University, Purdue University and UCLA were among eight recipients of the latest NIH awards to build nanomedicine centers as part of the NIH Nanomedicine Roadmap Initiative, designed to further our understanding of the machinery inside human cells and finding ways to mend broken parts. Tech got the NIH award in part because its proposal took risks and showed “more imagination than usual,” which the NIH wanted in order “to stimulate really big leaps forward in research.”

Acceleration from Bench to Bedside

Source article

In October, 12 academic health centers received the first of some 60 Clinical and Translational Science Awards from the US National Institutes of Health. By 2012, this consortium of 60 institutions will be linked together “to energize the discipline of clinical and translational science,” as an NIH press release put it. The release quotes NIH director Zerhouni as saying: “The development of this consortium represents the first systematic change in our approach to clinical research in 50 years. Working together, these sites will serve as discovery engines that will improve medical care by applying new scientific advances to real world practice. We expect to see new approaches reach underserved populations, local community organizations, and health care providers to ensure that medical advances are reaching the people who need them.”

The CTSA institutions are expected to:

• Develop better designs for clinical trials to ensure that patients with rare as well as common diseases benefit from new medical therapies 

   

• Produce enriched environments to educate and develop the next generation of researchers trained in the complexities of translating research discoveries into clinical trials and ultimately into practice 

   

• Design new and improved clinical research informatics tools 

   

• Expand outreach efforts to minority and medically underserved communities 

   

• Assemble interdisciplinary teams that cover the complete spectrum of research — biology, clinical medicine, dentistry, nursing, biomedical engineering, genomics, and population sciences 

   

• Forge new partnerships with private and public health care organizations 

The CTSA initiative grew out of the NIH commitment to re-engineer the clinical research enterprise, one of the key objectives of the NIH Roadmap for Medical Research, a series of far-reaching initiatives designed to transform the Nation’s medical research capabilities and speed the movement of scientific discoveries from the bench to the bedside. The CTSA consortium will be led by the National Center for Research Resources (NCRR), a part of the NIH.

Genome X Prize

Source article

The X Prize Foundation, which in 2004 awarded US$10 million to a private company that developed and successfully sent a reusable spaceship to space and back, is now offering $10 million to any team that can completely decode the genes of 100 people in 10 days. The winning team will then be paid $1 million more to decode the genes of a further 100 people — mostly wealthy donors and celebrities. The X Prize Foundation wants to drive public interest in DNA research and hasten the age of personalized medicine, in much the same way that its earlier contest hastened the age of space tourism.

“Faster, cheaper ways to decode more individuals’ DNA could have a huge impact on health care,” writes Antonio Regalado in the Wall Street Journal. “If patients knew their genetic makeup, doctors could help them decide what medicines to take or to determine what diseases they are at risk for. And databases teeming with genetic code could speed the search for new treatments.”

For a sense of the size of the challenge: It took more than 10 years and $300 million for the Human Genome Project to generate — a mere five years ago — the first genome of the “average” human. While prices for DNA sequencing have fallen rapidly, sequencing an individual’s entire genome is still far too expensive to undertake routinely, notes Regalado, and will require the invention of entirely new techniques — hence the X Prize contest, to encourage those inventions.

The US National Institutes of has also provided encouragement through awards totaling more than $71 million since 2003 for next-generation sequencing instruments, and said its goal is to ultimately lower the cost of decoding a person’s DNA to around $1,000.

The X Prize Foundation ‘s Peter Diamandis says a cash purse still has a place. It will “attract teams from outside the stovepipe” who may make unexpected breakthroughs, he told Regalado. The $10 million purse is being put up by Stewart Blusson, a Canadian geologist involved in discovering a trove of diamonds south of the Arctic Circle in 1991.

Driverless Cars

Source article

On November 3, 2007, at an undisclosed location in the western United States, robotic vehicles will attempt to drive themselves over a 60-mile course through traffic in less than six hours. They must obey traffic laws while merging into moving traffic, navigating traffic circles, negotiating busy intersections, and avoiding obstacles.

The US military’s Defense Advanced Research Projects Agency (DARPA)’s “Urban Challenge” contest for a US$1 million prize is the follow-up to the “Grand Challenge” race, won in 2004 by a VW Tuareg car that drove itself around a complex course in the Mojave Desert. Urban Challenge will test the ability of robots to operate safely and effectively in populated areas.

Drug Discovery Google

Source article

Source article

A free “Google of drug discovery” called the “Connection Map” or “C-Map” [here’s the website] helps researchers quickly find potential new compounds to treat particular diseases. In initial testing, reports Gareth Cook in the Boston Globe, the search engine identified a potential leukemia drug — already approved for another use — for which a clinical trial is likely to begin in a few months — “a testament to the speed of the new approach,” writes Cook, and a major boon given that “developing a new drug is frustratingly slow and expensive.”

C-Map was created at the Broad Institute of Harvard and MIT. It matches drugs and diseases that have opposite effects on genes. A disease known to turn a gene off could be countered by a drug known to turn the same gene on. C-Map’s creators have already begun work to expand the database to include more than 10 times as many compounds, and hope that other laboratories will contribute to create a massive, cooperative venture similar to the Human Genome Project.

Broad Institute director Eric S. Lander told Cook he imagines “a world, five years from now, where everyone who is working on a potential drug will, as the first thing they do, quickly look it up” to see what diseases it might work on. “What gives the software its value,” said Cook, “is its Google-like ability to sift through the vast array of information for a few relevant facts.” The database had 164 compounds when launched in September, but for the next round of development the team wants to gather genetic signatures for virtually all drugs approved by the US Food and Drug Administration, some 2,000 compounds, as well as trying more variations in the doses and types of cells used to generate the signatures.